A Patient-Centered Nursing Process
Approach
The nurse is caring for a postoperative patient. The nurse will anticipate administering
which medication to this patient to help prevent thrombus formation caused by slow
venous blood flow? a. Alteplase (Activase) b. Aspirin c. Clopidogrel (Plavix) d. Low-
molecular-weight heparin - correct answerANS: D Low-molecular-weight heparin is an
anticoagulant, which is used to inhibit clot formation and is used prophylactically to
prevent postoperative deep vein thrombosis. Alteplase is a thrombolytic, which is used
to break down clots after they form; alteplase is contraindicated in any patient with
recent surgery. Aspirin and clopidogrel are antiplatelet drugs and are used to prevent
arterial thrombosis. A nursing student asks why the anticoagulant heparin is given to
patients who have disseminated intravascular coagulation (DIC) and are at risk for
excessive bleeding. The nurse will explain that heparin is used in this case for which
reason? a. To decrease the risk of venous thrombosis b. To dissolve blood clots as they
form c. To enhance the formation of fibrous clots d. To preserve platelet function -
correct answerANS: A The primary use of heparin for patients with DIC is to prevent
venous thrombosis, which can lead to pulmonary embolism or stroke. Heparin does not
break down blood clots, enhance the formation of fibrous clots, or preserve platelet
function. A patient has been receiving intravenous heparin. When laboratory tests are
drawn, the nurse has difficulty stopping bleeding at the puncture site. The patient has
bloody stools and is reporting abdominal pain. The nurse notes elevated partial
thromboplastin time (PTT) and activated PPT (aPTT). Which action will the nurse
perform? a. Ask for an order for oral warfarin (Coumadin). b. Obtain an order for
protamine sulfate. c. Request an order for vitamin K. d. Suggest that the patient receive
subcutaneous heparin. - correct answerANS: B Protamine sulfate is given as an
antidote to heparin when patient's clotting times are elevated. Oral warfarin will not stop
the anticoagulant effects of heparin. Vitamin K is used as an antidote for warfarin.
Administering heparin by another route is not indicated when there is a need to reverse
the effects of heparin. A patient who has received heparin after previous surgeries will
be given enoxaparin sodium (Lovenox) after knee-replacement surgery. The patient
asks how this drug is different from heparin. The nurse will explain that enoxaparin a.
decreases the need for laboratory tests. b. has a shorter half-life than heparin. c.
increases the risk of hemorrhage. d. may be taken orally instead of subcutaneously. -
correct answerANS: A Enoxaparin is a low-molecular-weight heparin, which produces
more stable responses at lower doses, thus reducing the need for frequent lab
monitoring. It has a longer half-life than heparin. It decreases the risk of hemorrhage
because it is more stable at lower doses. It is given subcutaneously. The nurse is caring
Approach
The nurse is caring for a postoperative patient. The nurse will anticipate administering
which medication to this patient to help prevent thrombus formation caused by slow
venous blood flow? a. Alteplase (Activase) b. Aspirin c. Clopidogrel (Plavix) d. Low-
molecular-weight heparin - correct answerANS: D Low-molecular-weight heparin is an
anticoagulant, which is used to inhibit clot formation and is used prophylactically to
prevent postoperative deep vein thrombosis. Alteplase is a thrombolytic, which is used
to break down clots after they form; alteplase is contraindicated in any patient with
recent surgery. Aspirin and clopidogrel are antiplatelet drugs and are used to prevent
arterial thrombosis. A nursing student asks why the anticoagulant heparin is given to
patients who have disseminated intravascular coagulation (DIC) and are at risk for
excessive bleeding. The nurse will explain that heparin is used in this case for which
reason? a. To decrease the risk of venous thrombosis b. To dissolve blood clots as they
form c. To enhance the formation of fibrous clots d. To preserve platelet function -
correct answerANS: A The primary use of heparin for patients with DIC is to prevent
venous thrombosis, which can lead to pulmonary embolism or stroke. Heparin does not
break down blood clots, enhance the formation of fibrous clots, or preserve platelet
function. A patient has been receiving intravenous heparin. When laboratory tests are
drawn, the nurse has difficulty stopping bleeding at the puncture site. The patient has
bloody stools and is reporting abdominal pain. The nurse notes elevated partial
thromboplastin time (PTT) and activated PPT (aPTT). Which action will the nurse
perform? a. Ask for an order for oral warfarin (Coumadin). b. Obtain an order for
protamine sulfate. c. Request an order for vitamin K. d. Suggest that the patient receive
subcutaneous heparin. - correct answerANS: B Protamine sulfate is given as an
antidote to heparin when patient's clotting times are elevated. Oral warfarin will not stop
the anticoagulant effects of heparin. Vitamin K is used as an antidote for warfarin.
Administering heparin by another route is not indicated when there is a need to reverse
the effects of heparin. A patient who has received heparin after previous surgeries will
be given enoxaparin sodium (Lovenox) after knee-replacement surgery. The patient
asks how this drug is different from heparin. The nurse will explain that enoxaparin a.
decreases the need for laboratory tests. b. has a shorter half-life than heparin. c.
increases the risk of hemorrhage. d. may be taken orally instead of subcutaneously. -
correct answerANS: A Enoxaparin is a low-molecular-weight heparin, which produces
more stable responses at lower doses, thus reducing the need for frequent lab
monitoring. It has a longer half-life than heparin. It decreases the risk of hemorrhage
because it is more stable at lower doses. It is given subcutaneously. The nurse is caring
