Nurse Carla is caring for a male client on warfarin (Coumadin) and heparin I.V. The partial thromboplastin time (PTT) is 68 seconds. What should Nurse Carla do?

Correct Answer: B

Rationale: The correct answer is B: Continue treatment as ordered. In this scenario, the PTT value of 68 seconds falls within the therapeutic range for heparin therapy. Stopping the heparin infusion (Choice A) could lead to a risk of thrombosis. Warfarin does not directly affect the PTT (Choice C), and increasing the dosage (Choice D) without a valid reason could result in adverse effects. Therefore, the most appropriate action is to continue the heparin treatment as ordered.

Correct Answer: B

Rationale: The correct answer is B: Current health promotion activities. This information is crucial for planning care as it provides insight into the client's current habits and practices that can impact their health. By knowing their current health promotion activities, healthcare providers can tailor care plans to support and enhance these activities. A: General health for the last 10 years may provide historical context but may not reflect the current status or needs of the client. C: Family history of diseases is important but may not directly impact the care planning for the individual client. D: Marital status is relevant for certain aspects of care planning, but it may not be as directly linked to the client's current health status and needs as their health promotion activities.

Correct Answer: C

Rationale: The correct answer is C: Cocaine. Sinus tachycardia is a condition characterized by a fast heart rate originating from the sinus node. Cocaine is a stimulant drug that can significantly increase heart rate, exacerbating sinus tachycardia. The nurse should question the client about cocaine use to address the potential cause of the elevated heart rate. Other choices are incorrect: A: Barbiturates are central nervous system depressants and can slow heart rate, not cause sinus tachycardia. B: Opioids are also central nervous system depressants and do not typically cause sinus tachycardia. D: Benzodiazepines are sedatives and do not commonly lead to sinus tachycardia.

Correct Answer: A

Rationale: The correct answer is A because rubbing with long smooth strokes from distal to proximal parts of the extremities follows the direction of venous blood flow towards the heart, aiding venous return. This action helps prevent blood pooling in the extremities. Circular massage strokes (B) may not be as effective in promoting venous return. Rubbing with short strokes from proximal to distal parts (C) goes against the natural flow of venous blood. Smooth long strokes alternating with chopping motions (D) may not consistently promote venous blood flow in the correct direction.

Correct Answer: B

Rationale: Correct Answer: B - Avoid green leafy vegetables. Rationale: 1. Coumadin is a blood thinner that works by affecting vitamin K levels. 2. Green leafy vegetables are high in vitamin K, which can interfere with Coumadin's effectiveness. 3. Instructing the client to avoid green leafy vegetables helps maintain a consistent level of vitamin K in the diet, thus ensuring the proper effect of Coumadin. Summary of other choices: A: Having a PTT done monthly is not necessary for a client discharged with Coumadin. C: Drinking more liquids is not directly related to Coumadin therapy. D: Avoiding crowds is unrelated to Coumadin therapy and does not impact its effectiveness.