Question

1. Mr. Smith is admitted with Signs and symptoms of a CVA (stroke). Treatment for CVAs include the use of a thrombolytic (clot busters) like TPA. When would the physician not give a Thrombolytic? What imaging test do you foresee will R/O (rule out) that contraindication?
2. You are to administer the morning dose of Regular Insulin to your diabetic patient. The glucometer reads a blood sugar of 50. What is your first action? Which of the following would you do? Select all that apply
3. 1. Call MD
   2. Hold insulin
   3. Give insulin
   4. Give patient a snack
   5. Notify MD
4. You are doing your first morning rounds and assessing the patients under your care. One of your patients IV site (saline lock) is red, warm and tender to touch. You assess this as signs and symptoms of -------------------.   What is your first action? What nursing independent action can you provide this patient to improve his symptoms?
5. The patient is on Coumadin daily for his atrial fibrillation.   What lab test is necessary to obtain and maintain a therapeutic level? Please be specific
7. A patient admitted with chest pain is to be initiated to a continuous drip of Heparin. This blood thinner requires a daily blood test to titrate dosage. What lab test is required to maintain a therapeutic level of heparin in this patient?

Answer 1

MR SMITH WONT BE GIVEN THROMBOLYTICS IF HE HAS HISTORY OF

• A recent head injury
• Bleeding problems
• Bleeding ulcers
• Pregnancy
• Recent surgery
• Taken blood thinning medicines such as Coumadin
• Trauma

ECG TEST WILL BE DONE.

PART II - GIVE A SNACK , CHECK IF IT REACHES 60-70 mg/dL , IF NOT YOU SHOULD NOTIFY AND CALL THE MD

PART III - Phlebitis. FIRST ACTION WOULD BE TO STOP THE FLOW. NURSING INDEPENDENT ACTION WOULD BE PROVIDING WARM AND MOIST COMPRESS

PART IV - International Normalised Ratio (INR) testing is an integral part of warfarin treatment. INR has a critical role in maintaining the WARFARIN/COUMADIN response within a therapeutic range, to provide the benefits of anticoagulation, while avoiding the risks of haemorrhage

PART V - INR AND PTT TEST