A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse™s response is based on which rationale?

Correct Answer: D

Rationale: The correct answer is D. Heparin is a fast-acting anticoagulant used to immediately start anticocoagulation, while warfarin takes time to reach therapeutic levels. By starting heparin first, it allows time for warfarin to build up in the blood gradually. This ensures continuous anticoagulation without an initial lag period, reducing the risk of clot formation. A: This is incorrect as the oral and injection forms do not work synergistically. They have different mechanisms of action and are used for different purposes. B: This is incorrect because combining heparin and an oral anticoagulant does not necessarily result in fewer adverse effects. Adverse effects depend on various factors. C: This is incorrect as heparin alone can achieve adequate anticoagulation levels. Warfarin is typically added for long-term management.

Correct Answer: D

Rationale: The correct answer is D: Dysrhythmias. Antidysrhythmic drugs can paradoxically cause new or worsened dysrhythmias due to their mechanism of action on the heart's electrical conduction system. This can lead to potentially life-threatening arrhythmias. Deficiency of fat-soluble vitamins (choice A) is not a common adverse effect of antidysrhythmic drugs. Hyperkalemia (choice B) and heart failure (choice C) can be potential complications of some medications but are not the primary adverse effect of antidysrhythmics. Dysrhythmias (choice D) are the main concern when initiating antidysrhythmic therapy due to the drug's effects on cardiac conduction.

Correct Answer: D

Rationale: The correct answer is D: Withhold administration of the medication and notify the physician. An apical pulse of 58 bmp indicates bradycardia, which is a contraindication for Propranolol, a beta-blocker that can further reduce heart rate. By withholding the medication and informing the physician, the nurse ensures patient safety and avoids potential harm. Cutting the tablet in half (choice B) or giving the XR form (choice C) would still expose the patient to the medication, risking adverse effects. Administering the medication as normal (choice A) would be unsafe due to the already low heart rate.

Correct Answer: C

Rationale: The correct answer is C: Assess weight. Before administering levothyroxine, the nurse should assess the patient's weight because levothyroxine dosage is often based on weight. This ensures accurate dosing and prevents under or overdosing. Assessing degree of numbness (A) and monitoring for intensified pain (B) are not directly related to levothyroxine administration. Assessing apical pulse (D) is important for monitoring thyroid function, but it is not a prerequisite before administering levothyroxine.

Correct Answer: C

Rationale: The correct answer is C: Vitamin K. Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors. Therefore, the antidote for Warfarin is vitamin K, as it helps restore the clotting factors to their normal activity levels. Vitamin D (choice A), Vitamin C (choice B), and Vitamin B (choice D) do not have a direct role in counteracting the effects of Warfarin and are thus incorrect choices.