The nurse is caring for a patient receiving IV heparin therapy for treatment of a pulmonary embolus. The patient is being converted to warfarin (Coumadin) therapy. The following questions relate nursing considerations when caring for this patient. Nursing considerations for conversion of IV heparin to oral warfarin (Coumadin) therapy will include

Correct Answer: B

Rationale: When converting a patient from IV heparin to oral warfarin (Coumadin) therapy, overlapping therapy of both medications for at least 5 days is typically recommended. This overlap ensures that the patient's blood remains appropriately anticoagulated during the transition period. The effectiveness of warfarin is delayed and it takes time for the INR to reach the therapeutic range; therefore, it is important to continue the IV heparin until the INR is within the desired range. Monitoring the INR is essential to adjust the dosages of warfarin accordingly and to ensure that the patient is receiving adequate anticoagulation therapy.

Correct Answer: B

Rationale: Spironolactone is a potassium-sparing diuretic that works by blocking the effects of aldosterone in the distal tubules of the kidney, leading to increased excretion of sodium and water while retaining potassium. This class of diuretics helps to conserve potassium, making them suitable for patients at risk of hypokalemia. In contrast, furosemide, hydrochlorothiazide, and bumetanide are loop diuretics, thiazide diuretics, and another loop diuretic, respectively, which all promote the loss of potassium along with sodium and water.

Correct Answer: A

Rationale: Nausea is one of the early manifestations of lithium toxicity. It is important to monitor for this symptom in patients taking lithium to detect toxicity early and prevent more serious complications. Hypotension and renal failure are more severe manifestations of lithium toxicity that occur at later stages. Muscle weakness is not typically associated with early lithium toxicity.

Correct Answer: B

Rationale: Protamine is the antidote for Heparin. Heparin is an anticoagulant medication that prevents the formation of blood clots. In case of an overdose of Heparin or if there is a need to reverse its effects quickly (such as during surgery), Protamine is administered as the specific antidote. Protamine works by binding to Heparin and neutralizing its anticoagulant effects. Therefore, Protamine is the appropriate antidote to counteract the effects of Heparin.

Correct Answer: C

Rationale: An agonist is a substance that binds to a receptor and triggers a biological response. By activating the receptor, an agonist mimics the action of the body's natural ligand that typically binds to the receptor. This activation may lead to a cascade of events within the cell, resulting in a specific physiological response. In contrast, antagonists block the receptor from being activated, while agonists work by binding to the receptor and initiating the desired response.