A patient had an orthopedic surgery and is prescribed enoxaparin. What would the nurse teach the patient and/or family members about this low–molecular-weight heparin before discharge?

Correct Answer: D

Rationale: The correct answer is D: Watch for bleeding or excessive bruising. Enoxaparin is an anticoagulant medication that helps prevent blood clots. The nurse should teach the patient and family members to monitor for signs of bleeding or excessive bruising, as these could indicate a potential complication of the medication. This is crucial for early detection and intervention to prevent serious consequences. Explanation for incorrect choices: A: Visual demonstration of intramuscular heparin administration is not applicable to enoxaparin as it is typically administered subcutaneously. B: Prothrombin time and international normalized ratio monitoring are not usually required for enoxaparin as it works through a different mechanism compared to warfarin. C: Avoidance of green leafy vegetables is not necessary for enoxaparin, unlike warfarin which interacts with vitamin K found in green leafy vegetables.

Correct Answer: B

Rationale: The correct answer is B: Allow the design of custom drugs. Pharmacogenetics involves studying how genes influence a person's response to drugs. By understanding how genetic variations affect drug metabolism and efficacy, researchers can design personalized medications tailored to an individual's genetic profile. This approach can lead to more effective and safer treatments. Choice A is incorrect because removing genes that cause illness is not the focus of pharmacogenetics; it is more about optimizing drug therapies based on genetic information. Choice C is incorrect as pharmacogenetics primarily deals with drug responses, not food development. Choice D is incorrect as splicing genes for health improvement is more related to genetic engineering and gene therapy, not specifically pharmacogenetics.

Correct Answer: D

Rationale: The sudden elevation in body temperature post-surgery under general anesthesia is indicative of malignant hyperthermia (MH), a rare but life-threatening condition triggered by certain anesthetics. Here's why D is the correct answer: 1. MH is characterized by a rapid increase in body temperature due to uncontrolled muscle metabolism. 2. Common signs include tachycardia, muscle rigidity, and high fever. 3. Prompt recognition and treatment are crucial to prevent serious complications. On the other hand: A: Tachyphylaxis is a rapid decrease in response to a drug with repeated dosing. B: Postoperative infection would typically present with localized signs like redness, swelling, and purulent discharge. C: Malignant hypertension is marked by severely elevated blood pressure, not body temperature.

Correct Answer: A

Rationale: The correct answer is A: 10 minutes. Sodium nitroprusside is a potent vasodilator used in hypertensive emergencies. It has a rapid onset of action and short half-life. Infusing the maximum dose for a longer duration could lead to excessive hypotension. Therefore, it should be titrated carefully, usually starting with a lower dose and increasing gradually. In this case, the nurse should monitor the patient's response closely and adjust the dose as needed every 5-10 minutes. Choices B, C, and D are incorrect because they suggest longer infusion durations, which could pose a risk of severe hypotension and adverse effects.

Correct Answer: C

Rationale: The correct answer is C: acetaminophen (Tylenol). Acetaminophen is the preferred pain reliever for patients on warfarin therapy because it does not interfere with the blood-thinning effects of warfarin. Aspirin, ibuprofen, and opioids can increase the risk of bleeding when taken with warfarin due to their antiplatelet or anti-inflammatory effects. Acetaminophen provides effective pain relief without affecting the anticoagulant properties of warfarin, making it the safest choice for this patient.