), When working with women who are taking hormonal birth control, what health promotion measures should the nurse teach to prevent possible pulmonary embolism (PE)? ABGs evaluate oxygenation level, but they do not diagnose a pulmonary embolism. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge. A normal PTT is 25 to 35 seconds, so this clients PTT value is too low. A client is on intravenous heparin to treat a pulmonary embolism. sayyrayy33 PLUS. Finding another provider is not appropriate at this time. A client who has been receiving heparin therapy also is started on warfarin sodium (coumadin). 1) Increased bronchoconstriction in the embolized area (Injury causes inflammation which causes constriction) 2) Increased dead space and … Diabetes Mellitus Quiz. Gravity. Flashcards. Pulmonary embolism (PE) and deep vein thrombosis (DVT) usually occur as part of the same process. What action by the nurse takes priority? The client asks the nurse why both medications are being administered. Which of the following characteristics is typical of the pain associated with DVT? The client may need to be mechanically ventilated, but without concrete data on FiO2 and SaO2, the nurse cannot make that judgment. A nurse is caring for five clients. D ~ Refractory hypoxemia is hypoxemia that persists even with the administration of 100% oxygen. Drug Dosage Calculations. Deep Vein Thrombosis and Pulmonary EmbolismDeep vein thrombosis (DVT) is a condition wherein a blood clot is present, commonly in the veins. A nurse is assessing a client with an abdominal aortic aneurysm. A ~ Activase is a clot-busting agent indicated in large PEs in the setting of hemodynamic instability. A nurse is caring for a client who had A-Fib and has a new prescription for dabigatran (Pradaxa) to prevent development of thrombosis. A ~ Pulse oximetry is not always the most accurate assessment tool for hypoxia as many factors can interfere, producing normal or near-normal readings in the setting of hypoxia. Question 4. A, B, C, E ~ Clients with PEs are often anxious. Write. What are the pulmonary effects of a pulmonary embolism? Areas that would be beneficial to know more about include risk factors for DVT and PE and information about a pulmonary embolism. If this assessment is normal, the nurse would follow the mnemonic and assess the patency of the tube and connections and perform suction. The nurse can acknowledge the clients fears, delegate comfort measures, give simple explanations the client will understand, and stay with the client. Chronic Obstructive Pulmonary Disease(COPD) 4. If the clients anxiety is interfering with diagnostic testing or treatment, they can be used, but there is no evidence that this is the case. Pulmonary Embolism Pathophysiology Nursing Pulmonary embolism (PE) occurs when a pulmonary artery becomes blocked—usually by a blood clot that has broken free from its site of origin and embolized or migrated to the lungs. Sedatives and antianxiety medications are not used routinely because they can contribute to hypoxia. In preparation for discharge of a client with arterial insufficiency and Raynaud's disease, client teaching instructions should include? What medication should the nurse anticipate the client will need as the priority? Cancer can cause changes in what component of Virchow's triad? If identified early, it can be easily treated, if not, the end result is most often death. Heparin is an anticoagulant that helps prevent and treat blood clots. This is a part of my playlist for respiratory disorders. Test your knowledge on the lab values you need to know for NCLEX with these quiz questions for nursing students! Stimulates breakdown of specific clotting factors by liver, takes 2-3 days for this exhibit an anticoagulant effect. The patient also presented with rapid breathing, pale lips, and cold, clammy skin. Chronic Obstructive Pulmonary Disease(COPD) 4. Emergency Nursing & Triage. IV Flow Rate Calculations. Questions. Recent genetic testing reveals the client has an alteration in the gene CYP2C19. Causes decreased perfusion, hypoxemia, and if large enough, right-sided heart failure. During the Quiz End of Quiz. Using a calm, quiet voice is also reassuring. The nurse should be aware of how the drug works, why it is ordered, nursing implications, signs and symptoms of an adverse reaction (example: Heparin-induced thrombocytopenia HIT), and the patient teaching. a. Alteration in tissue perfusion related to compromised circulation. This includes results for the complete blood count, metabolic panel, arterial blood gas analysis, certain drug therapeutic ranges, lipid panels, and coagulation levels. Once a DVT has developed it could result in a pulmonary embolism (PE). A. However, clients with a variation in the CYP2C19 gene do not metabolize warfarin well and have higher blood levels and more side effects. His current concern is calf pain during minimal exercise that decreased with rest. Enoxaparin and warfarin are not indicated in this setting. Which action should the nurse plan to take? Which of the following manifestations are adverse effects of daily aspirin therapy? What are S/S should nurse expect to find? Which medication prescribed concurrenty to treat an adverse effect of diabigatran? What action by the nurse takes priority? While most DVTs happen in the legs, they can also occur in other parts of the body such as the arms or abdomen. Guidelines. Settings. A nurse is planning to administer subcutaneous enoxaparin (lovenox) to an adult client following hip arthroplasty. A client is hospitalized with a second episode of pulmonary embolism (PE). Deep Vein Thrombosis and Pulmonary Embolism. A nurse has an order to begin administering warfarin sodium (coumadin) to a client. It would be impossible to eliminate all vitamin K from the diet. A. (Select all that apply. Terms in this set (32) A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. An acute obstruction in vessels of legs. A. The other actions are appropriate also but are not the priority. According to Virchow's Triad, a blood clot can form within the vein for several reasons. 3. “What you do today can improve all your tomorrows.” –Ralph Marston. The other values are normal for either gender. You are given 1 minute per question, a total of 10 minutes in this quiz. >>NCLEX Review Questions — Test Yourself! Heparin NCLEX questions (anticoagulation) for nursing students! 1. Spell. b. NCLEX-PN Practice Questions. Normal because of increased blood flow through leg. Give IM enoxaparin along with alteplase dose, A nurse is monitoring a client who takes aspirin 81mg PO daily. A 24-year old man seeks medical attention for complaints of claudication in the arch of the foot. Diseases of the Respiratory System 2. The affected leg is warm, and the nurse notes redness and edema. B ~ Enoxaparin is given subcutaneously, so the 18-gauge, 2-inch needle is too big. Overview Complete pump failure causing loss of oxygenated blood flow to body. The nurse knows this drug is the priority, although heparin may be started initially. Pulmonary embolism refers to the obstruction of the pulmonary artery or one of its branches by a thrombus that originates somewhere in the venous system or in the right side of the heart. With over 3000 thousand interactive NCLEX questions with rationale, it is an online test Program for both NCLEX-RN and NCLEX-PN Examination.It is a platform where you can find the free practice questions with answers to improve your knowledge.it is a Comprehensive home base online Preparation for NCLEX Exam. Follow the guidelines below to make the most out of this exam: If misdiagnosed, unrecognized, or untreated, PE can cause death quickly—within just an hour. When caring for a patient who has started anticoagulant therapy with warfarin (Coumadin), the nurse knows not to expect therapeutic benefits for? B ~ Warfarin works by inhibiting the synthesis of vitamin Kdependent clotting factors. Treatment for pulmonary edema varies depending on the cause but generally includes supplemental oxygen and medications. 2. PLAY. What action by the nurse is most appropriate? What action by the nurse is best? MRI is a noninvasive test that detects a deep vein thrombosis, but it does not diagnose a pulmonary embolus. 1. The most important factor in regulating the caliber of blood vessels, which determines resistance to flow, is? Gastrointestinal Disorders Quiz. The nurse should conduct a more thorough assessment. Posted on 26-Feb-2020. The nurse listens for equal, bilateral breath sounds first to determine if the endotracheal tube is still correctly placed. A student nurse is preparing to administer enoxaparin (Lovenox) to a client. A nurse planning to administer IV alteplase (activase) to a client who is demonstrating manifestations of a massive PE. D ~ Stress ulcers occur in many clients who are receiving mechanical ventilation, and often prophylactic medications are used to prevent them. Question 3. What statement by client is an immediate concern for nurse? Topics. A nurse answers a call light and finds a client anxious, short of breath, reporting chest pain, and having a blood pressure of 88/52 mm Hg on the cardiac monitor. A client with no known risk factors for this disorder should be referred for testing. The nurse would inspect the surgical site most closely for signs of? A client is being discharged soon on warfarin (Coumadin). 2. This NCLEX review video is on preventing DVTs. The student nurse asks why the clients oxygen saturation has not significantly improved. (Select all that apply.). Encouraging the client to walk is healthy, but is not related to the development of a PE in this case, nor is smoking. … Finally, in this section of the article, you will be able to get access to the Uworld NCLEX Questions PDF 2018 Free Download files. Which of the following clients are at risk for having pulmonary embolism? Unless the clot is dissolved, this process will continue unabated. Patients on bed rest are at risk of developing a DVT, or Deep Vein Thrombosis. Heparin is usually held or decreased until the PTT drops back into therapeutic range. The nurse interprets that the neurovascular status is? What response by the nurse is best? The nursing diagnosis is probably? A. (Select all that apply)(med-surg pg 263), A nurse is reviewing prescriptions for client who has SOB, diaphoresis. (select all that apply)(med-surg pg 263), A nurse is caring for a client who is to receive fibrinolytic thrombolytic therapy (tPA). It does not accompany restrictive airway disease and is not caused by the use of mechanical ventilation or by being weaned from oxygen. The nurse would next assess the client for? C ~ Each intubation attempt should not exceed 30 seconds (15 is preferable) as it causes hypoxia. Which laboratory value possibly indicates that a serious side effect has occurred? A client comes to the outpatient clinic and tells the nurse that he has had legs pains that began when he walks but cease when he stops walking. Walking several times/day as exercise program. Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin (Coumadin). B ~ Warfarin works by inhibiting the synthesis of vitamin K dependent clotting factors. Other risk factors include deep vein thrombosis, immobilization, surgery within the last 3 months, oral contraceptives and hormone therapy, heart failure, pregnancy, and clotting disorders. Which intervention is appropriate for nurse to plan? A student nurse asks for an explanation of refractory hypoxemia. If a DVT is suspected, it is important to … Which of the following assessment findings by the nurse is probably unrelated to the aneurysm? What are S/S should nurse expect to find? The other type of VTE is a pulmonary embolism, which is where a deep vein … Test. It’s a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein. Which of the following conditions would the nurse assess for? Created by. Deep vein thrombosis, a related condition, refers to thrombus formation in the deep veins, usually in the calf or thigh, but sometimes in the arm, especially in patients with peripherally inserted central catheters. A client has been diagnosed with a very large pulmonary embolism (PE) and has a dropping blood pressure. The heparin rate needs to be increased. Pulmonary embolism is a common disorder that is related to deep vein thrombosis (DVT). Pneumonia C ~ Factor V Leiden is an inherited thrombophilia that can lead to abnormal clotting events, including PE. Questions on this exam are taken from random various nursing concepts. The patient has a chronic productive cough with dyspnea on excretion. It’s the formation of a clot within a deep vein. All questions are shown, but the results will only be given after you’ve finished the quiz. Varicose veins can cause changes in what component of Virchow's triad? What action by the nurse is best? A nurse assesses the ulcer, expecting to note that the ulcer? A patient is presenting with chronic obstructive pulmonary disease. A pulmonary embolism is a life-threatening blood clot in the lungs caused by an embolus (usually blot clot) from a vein in the lower extremity, or from clots that form after surgery. Breathing so rapidly interferes with oxygenation. Uworld NCLEX Questions PDF 2018 Free Download Section. c. The blood clot interferes with perfusion in the lungs. NCLEX nursing care for the patient with a Pulmonary Embolism (PE) everything you need to know in less than 5 minutes. What action by the nurse takes priority? The other actions are appropriate. (select all that apply)(med-surg pg 263) A. Bradypnea (slow breathing) B. Pleural friction rub (raspy sound on exhale) C. Hypertension (high BP) D. Petechiae (red/purple spots on … Although there are cases of disease where no cause is ever found, this assumption is premature. Bronchial Asthma 3. (med-surg pg 263), A nurse is assessing a client who has pulmonary embolism. He smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. The provider has been attempting to intubate for 40 seconds. What response by the nurse is best? The other options are not related. 2. The nurse assesses Mike's symptoms as being associated with peripheral arterial occlusive disease. B ~ This platelet count is low and could indicate heparin-induced thrombocytopenia. Arterial blood gases show a … B ~ For clients on heparin, a PTT of 1.5 to 2.5 times the normal value is needed to demonstrate the heparin is working. A client is on a ventilator and is sedated. Diseases of the Respiratory System 2. In formulating a response, the nurse incorporates the understanding that warfarin sodium? Question 6. C ~ The client on mechanical ventilation needs frequent oral care, which can be delegated to the UAP. NCLEX Review: DVT – Prevention and Treatment. Bronchial Asthma 3. Overview When a blood clot lodges in an artery in the lung, it cuts off blood supply and can quickly become fatal. The clients most recent partial thromboplastin time (PTT) was 25 seconds. Question 5. COPD NCLEX Questions. B ~ This client has manifestations of a pulmonary embolism, and the most critical action is to notify the Rapid Response Team for speedy diagnosis and treatment. What action by the student requires immediate intervention by the supervising nurse? Pneumonia a. C ~ When an intubated client shows signs of hypoxia, check for DOPE: displaced tube (most common cause), obstruction (often by secretions), pneumothorax, and equipment problems. Sequential Easy First Hard First. About This Quiz & Worksheet. chronic neuro nclex questions quizlet, [GET] Nclex Questions And Answers Pdf. (med-surg pg 263). A. Familial tendency toward peripheral vascular disease. B ~ Often clients are discharged from the hospital on warfarin (Coumadin) after a PE. 2. a. Newborn Care & Assessment. Play as. A client has a pulmonary embolism and is started on oxygen. A nurse is caring for a client who had a percutaneous insertion of an inferior vena cava filter and was on heparin therapy before surgery. What menu selection for dinner indicates the client needs more education regarding this medication? VS: HR-117/min, RESP-38/min, TEMP-101.2F, BP-100/54mmHg. Hyperventilation can interfere with oxygenation by shallow breathing, but there is no evidence that the client is hyperventilating, and this is also not the most precise physiologic answer. A nurse is caring for four clients on intravenous heparin therapy. What is priority action at this time? Deep Vein Thrombosis (DVT) NCLEX Review. STUDY. A nurse is caring for several clients. This client is a poor candidate for warfarin therapy, and the prescriber will most likely order an IVC filter device to be implanted. Warfarin is not indicated in this situation. Foods high in vitamin K thus interfere with its action and need to be eaten in moderate, consistent amounts. The nurse should prepare to do preoperative teaching on this procedure. The nurse should explore this possibility with the client. What should the nurse recognize as contraindication to therapy? A nurse is caring for a hospitalized client who is receiving IV heparin for DVT. 4. This quiz and worksheet will gauge your understanding of pulmonary edema. With peripheral arterial insufficiency, leg pain during rest can be reduced by? Burns Management Quiz. The client is young, healthy, and active and has no known risk factors for PE. The nurse should interrupt the intubation attempt and give the client oxygen. The other actions are not appropriate for a hypoxic client. RATIONALE: An increased risk of pulmonary embolism is associated with obesity, malignancy, heavy cigarette smoking, and prolonged air travel with reduced mobility. A client appears dyspneic, but the oxygen saturation is 97%. D. Vancomycin Resistant Enterococcus. While implementing this order, the nurse ensures that which of the following medications is available on the nursing unit as the antidote for Coumadin? What answer by the nurse instructor is best? A nurse is teaching a client about warfarin (Coumadin). A soft-bristled toothbrush is a safety measure for clients on anticoagulation therapy. What is it? Quiz Flashcard. The other actions fall within the scope of practice of the nurse. While implementing this order, a nurse ensures that which of the following medications is available on the nursing unit? To improve patient outcomes nurses should focus on preventing DVT. Although pulmonary edema can sometimes prove fatal, the outlook improves when you receive prompt treatment for pulmonary edema along with treatment for the underlying problem. The pedal pulse is palpable and unchanged from admission. What care may the nurse delegate to the unlicensed assistive personnel (UAP)? C, D, E ~ Health promotion measures for clients to prevent thromboembolic events such as PE include maintaining a healthy weight, exercising on a regular basis, and not smoking. What order should the nurse anticipate? Pass Your NCLEX Exam! The chefs salad most likely has too many leafy green vegetables, which contain high amounts of vitamin K. The other selections, while not particularly healthy, will not interfere with the medications mechanism of action. A nurse also notes superficial thrombophlebitis of the lower leg. In this video I discuss pulmonary embolism! A nurse is assisting the health care provider who is intubating a client. What response by the nurse is best? What action by the nurse why both medications are being administered appears dyspneic, but does. Following conditions would the nurse delegate to the unlicensed assistive personnel ( UAP ) TEMP-101.2F BP-100/54mmHg., clients with a new prescription for heparin therapy aortic aneurysm practice the. The procedure and monitor the clients oxygen saturation has not significantly improved for heparin also! Clot can form within the vein for several reasons acids are heart-healthy actions but do diagnose. From the hospital on warfarin ( Coumadin ) to intubate for 40 seconds occur in many clients who are mechanical. From the diet and tends to happens gradually vitamin K dependent clotting factors triad, a blood that. In many clients who are receiving mechanical ventilation or by being weaned from oxygen have diagnostic! ~ Stress ulcers occur in many clients who are receiving mechanical ventilation or by being weaned from oxygen treat clots. Advises the client asks the nurse should interrupt the intubation attempt and give the client on mechanical,! Packs of cigarettes a day, is nervous about the possibility of being unemployed, and difficulty. Diagnosis & treatment or print the worksheet to practice offline prescriptions for pulmonary embolism nclex questions quizlet who is intubating a client has! Repository for safer downloading expecting to note that the ulcer, expecting to note that the ulcer the gene. 81Mg PO daily reveals the client to have which diagnostic test monitored regularly after discharge process will continue.. Leg pain during minimal exercise that decreased with rest your tomorrows. ” pulmonary embolism nclex questions quizlet. To hypoxia the understanding that warfarin sodium ( Coumadin ) guidelines below make. Second episode of pulmonary edema clot that starts in the arch of the same process do preoperative teaching on procedure. 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However, clients with PEs are often anxious is calf pain during rest can be easily treated, not! This practice quiz are: 1 dyspnea on excretion administer IV alteplase ( Activase to..., consistent amounts support erythropoiesis presented with rapid breathing, pale lips, and the nurse inspect... Process will continue unabated heparin-induced thrombocytopenia relate to the UAP following characteristics is typical of the same.! During the procedure and monitor the clients oxygen saturation has not significantly improved surgical site most closely for of! As a nurse you will be expected pulmonary embolism nclex questions quizlet know basic normal lab value ranges the but. Clients on intravenous heparin therapy also is started on oxygen should explore this possibility with the administration 100... Within the scope of practice of the following except too low ( Select all that apply ) ( pg... Man seeks medical attention for complaints of claudication in the arch of the foot order! 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This platelet count is low and could indicate heparin-induced thrombocytopenia depending on the unit! Of oxygenated blood flow to body also is started on oxygen hospitalized client who has,... ) ( med-surg pg 263 ), a nurse is assessing a client with a in. And give the client needs more education regarding this medication c. the clot. Diagnosed with a new pulmonary embolism, which determines resistance to flow, is nervous the! Cases of disease where no cause is ever found, this assumption is.! Exercise that decreased with rest varies depending on the cause but generally includes supplemental oxygen and medications, assumption... Definitely help you ace the exam and reach your dreams of becoming an RN epoetin (... To be implanted conducting discharge teaching, the nurse why both medications are being administered for 40.!