A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?

Correct Answer: A

Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.

Correct Answer: D

Rationale: After a pneumonectomy, positioning the client in a semi-Fowler's position is crucial for optimal ventilation. This position helps improve lung expansion on the remaining side, facilitating better oxygenation and preventing complications like atelectasis. Placing the client prone, on the nonoperative side, or in Sims' position would not provide the same respiratory benefits post-pneumonectomy.

Correct Answer: B

Rationale: In the case of a client with peptic ulcer disease prescribed sucralfate, the nurse should instruct the client to take sucralfate 1 hour before meals. This timing is crucial because sucralfate forms a protective barrier over the ulcer, which is most effective when the stomach is empty. Taking sucralfate with meals (Option A) may hinder its ability to coat the ulcer properly. Taking sucralfate with antacids (Option C) is not recommended as antacids can interfere with the effectiveness of sucralfate. Taking sucralfate 2 hours after meals (Option D) may not provide optimal coverage over the ulcer during the digestive process. Educationally, understanding the timing of medication administration in relation to meals is essential in pharmacology. This question highlights the importance of knowing the rationale behind specific medication instructions to ensure its therapeutic effectiveness. It also emphasizes the significance of patient education in promoting medication adherence and optimal treatment outcomes in clients with peptic ulcer disease.

Correct Answer: C

Rationale: In the context of pharmacology, it is important for healthcare professionals to understand the potential adverse effects of medications to ensure safe administration and patient monitoring. In the case of vancomycin, the correct answer is C) Red Man Syndrome. Red Man Syndrome is a common adverse reaction associated with vancomycin administration. It is characterized by flushing, erythema, and pruritus on the face, neck, and upper torso. This reaction is not an allergic response but rather an infusion-related histamine release. Monitoring for this adverse effect is crucial to prevent severe reactions and ensure patient safety. A) Nephrotoxicity and B) Hepatotoxicity are potential adverse effects of other medications but are not commonly associated with vancomycin. Monitoring for kidney function and liver enzymes may be necessary with different drugs, but they are not the primary concerns with vancomycin. D) Diarrhea is a potential adverse effect of vancomycin due to its impact on the normal flora of the gut, leading to overgrowth of pathogenic bacteria like Clostridium difficile. However, Red Man Syndrome is a more immediate and specific adverse effect associated with vancomycin use. By understanding the specific adverse effects of vancomycin, healthcare professionals can provide safe and effective care to patients. Monitoring for Red Man Syndrome during vancomycin administration is critical to prevent complications and ensure optimal patient outcomes in clinical practice.

Correct Answer: B

Rationale: The correct instruction for a client starting a new prescription for prednisone is not to stop taking the medication abruptly. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, emphasizing the importance of gradual tapering under healthcare provider guidance. Increasing potassium-rich foods may be necessary based on individual needs, but it is not the priority instruction in this context. Grapefruit juice interaction is more commonly associated with certain medications but not specifically with prednisone. Taking prednisone at bedtime to prevent drowsiness is not a key instruction related to its administration.