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283 - Transition To Registered Nurse Practice With Complete And Complete Answers

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Interventions for PE - CORRECT ANSWERS- oxygen therapy - mechanical ventilation may be indicated for patients w/ severe hypoxia close monitoring of ABGs & oxygen saturation continuous monitoring for complications: - vital signs, lung sounds, cardiac & respiratory status - watch for dysrhythmias, distended neck veins, & dyspnea anticoagulation medication - to prevent clot from enlarging and to prevent new clots unfractionated heparin is usually started unless there is hemodynamic instability - fibrinolytic drugs are used if patient experiences shock, hemodynamic collapse, or instability You learned about Tricyclic Antidepressants (e.g. Amitriptyline) in Pharm & Mental Health. These medications block reuptake of norepinephrine and serotonin in the synaptic space, thereby intensifying the effects of these neurotransmitters. What are the complications associated w/ these medications? - CORRECT ANSWERS- Orthostatic Hypotension Anticholinergic Effects: - dry mouth - blurred vision - photophobia - urinary hesitancy or retention - constipation - tachycardia Sedation Toxicity Interventions: * Connect to cardiac monitor * Obtain baseline ECG * Monitor v/s frequently * Monitor s/s of toxicity * Notify PHCP if s/s of toxicity occur

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283 - TRANSITION TO REGISTERED
NURSE PRACTICE WITH COMPLETE
AND COMPLETE ANSWERS

, Details on inserting NG tube for gastric decompression -
pg. 1013 Saunders - - CORRECT ANSWERS-✦ patient
should be in high-fowlers position
✦ measure & tape tube to indicate length to be inserted
✦ lubricate tip before inserting in nasopharynx &
advancing
✦ as tube enters back of throat - have pt swallow sip of
water (unless contraindicated) - flex head toward chest
while passing tube down throat into the stomach
✦ secure tube
✦ confirm placement w/ x-ray
✦ connect to suction

Patients experiencing a PE - heparin therapy is
prescribed for at least 5 days - warfarin is also started
on most patients on day 1 or 2 of heparin therapy - the
patient will receive both heparin & warfarin until the INR
reaches 2-3. Heparin is infused for 24 hours after the
INR is greater than 2, then the Heparin is discontinued.
The overlap period of at least 5 days for Warfarin &
Heparin is necessary because the drug action of each is
different. Warfarin works in the liver to inhibit the
synthesis of Vit K-dependent clotting factors and takes
3-4 days before a therapeutic effect is realized. -
CORRECT ANSWERS-

As an entry level nurse, it is important that you
understand monitoring of lab values for patient
prescribed anticoagulants such as Heparin and
Warfarin. What are normal values for PT/INR, PTT and

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