A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin therapy. Which instruction is essential for the nurse to include in patient education about warfarin therapy?

Correct Answer: D

Rationale: It is essential for the nurse to instruct the patient to "Report any unusual bleeding or bruising to your healthcare provider." Warfarin is a medication that works by decreasing the clotting ability of the blood. This can increase the risk of bleeding, so it is important for the patient to be vigilant for any signs of abnormal bleeding. Prompt reporting of any unusual bleeding or bruising allows healthcare providers to adjust the dosage of warfarin to maintain a balance between preventing blood clots and minimizing the risk of bleeding complications. This instruction emphasizes the importance of close monitoring and communication with healthcare providers while on warfarin therapy.

Correct Answer: B

Rationale: The nurse should monitor the International Normalized Ratio (INR) closely during anticoagulant therapy for the prevention of VTE. The INR measures the clotting ability of the blood and is used to monitor the effectiveness of anticoagulant therapy, such as warfarin. Maintaining the INR within the target therapeutic range is crucial to prevent both excessive bleeding due to over-anticoagulation and clotting events due to under-anticoagulation. Close monitoring of the INR helps healthcare providers adjust the anticoagulant dosage as needed to ensure optimal therapeutic outcomes and minimize risks. Platelet count, serum sodium levels, and blood urea nitrogen (BUN) are important laboratory parameters to monitor for other medical conditions but are not specific to anticoagulant therapy.

Correct Answer: D

Rationale: Patients prescribed proton pump inhibitors (PPIs) for the treatment of GERD should be closely monitored for the development of osteoporosis. PPIs have been associated with an increased risk of developing osteoporotic fractures, particularly in long-term users. This risk is thought to be due to decreased calcium absorption as stomach acidity is reduced by PPIs, leading to potential alterations in bone metabolism and density. Therefore, it is important for healthcare providers to assess bone health, educate patients on calcium and vitamin D supplementation, and consider other risk factors for osteoporosis in individuals taking PPIs long-term. While hypoglycemia, hyperkalemia, and Clostridium difficile infection may be seen as adverse effects with other medications or conditions, osteoporosis is the adverse effect most closely monitored in patients taking PPIs for GERD.

Correct Answer: A

Rationale: If visible residue is noticed on the surgical instruments, it is crucial to re-sterilize them before using them for any procedure. Visible residue may indicate that the instruments are not sterile and could potentially introduce contaminants into the patient during the procedure, leading to infection or other complications. It is essential to maintain the highest standards of cleanliness and sterility in healthcare settings to ensure patient safety. Therefore, the nurse should take immediate action to re-sterilize the instruments before proceeding with any surgical procedure.

Correct Answer: C

Rationale: It is crucial to ensure that the autoclave is functioning properly to achieve proper sterilization of surgical instruments. If the autoclave is not reaching the required temperature, it signifies a technical issue that needs to be addressed promptly. The nurse should notify the sterile processing department immediately and request maintenance to investigate and resolve the problem. Continuing with sterilization without addressing the temperature issue can compromise the effectiveness of sterilization and pose a risk of infection to patients. Adjusting the settings on the autoclave or using an alternative method of sterilization are not appropriate actions in this situation.