Question

7- 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?

8- 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

9- 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?

10- DVT(Deep Vein Thrombosis) prophylaxis is often initiated for immobilized patients to prevent clot formation. What medication is most commonly used? Where is the recommended type of injection required for this medication? Where can you administer this medication? What would you watch for in patients who are treated with Thrombus prophylaxis?

Answer 1

7.Inflammation of the vein is known as phlebitis, and it is characterised by pain,redness,warmth,hardness of IV site.

Hence the answer is phlebitis.

First action when we suspect phlebitis is ,

• Immediately stops the infusion if it ongoing.
• Elevate the affected limb to releive swelling.

Nursing management includes.

• Elevate the affected extremity.
• Provide warm compress.
• Provide compression stockings.
• Anti-inflammatory medications.
• Blood thinning ointments.

8.Caumadin is warfarin.

• warfarin therapy is advised for patient with atrial fibrillation.It is a blood thinning medication.
• A Prothtombin time is done to diagnose bleeding and clotting disorders .
• International normalized ratio is done to determine how the blood thinning medication is working well.

9.PTT is a blood test done to identify patient response to Heparin infusion.

Heparin is an anticoagulant and it will cause prolonged PTT.It should be maintain in between 1.5 to 2.5 times longer than a pretreatment level.

10.

• Antocoagulant medications are used in prophylaxis treatment of deep vein thrombosis.
• Low molecular Heparin is used in the prophylaxis treatment.
• It is administered subcutaneous route .
• When taking these medications, observe the patient for any side effects such as bleeding, heamaturia,g bleeding ,redness over the body.