RN101
Home of the Registered Nurses (RN) and
Licensed Practical Nurses (LPN)

QUESTIONS

 

CASE I

Mrs. A suffered an acute Myocardial Infarction. The physician prescribed I.V.  Heparin 25,000 units in 250 mL of normal saline solution to infuse at 600 units/hour. After 6 hours of heparin therapy, the patient’s partial thromboplastin time was 157 seconds. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Question 1:

After consulting the nomogram, identify four (4) interventions you must carry out?

1.____________________________________________________________________________________________________________________________________________________.

2.____________________________________________________________________________________________________________________________________________________.

3.____________________________________________________________________________________________________________________________________________________.

4.____________________________________________________________________________________________________________________________________________________.

 

The next morning, you brought a 5mg warfarin sodium (Coumadin) tablet, as per new medical order. You explain to her that it is also an anticoagulant. She asks you: “Why do I have to take Coumadin when I already have a heparin infusion?”

 

Question 2:

What would be your reply to the patient’s question? Give the main reason:

1.____________________________________________________________________________________________________________________________________________________.

 

CASE II

Mr. B 80 years old with advance heart failure cannot care for himself and hasn't been able to eat for the past week because of dyspnea. The patient does not want a feeding tube to be inserted and expresses that he accepts whatever happens to him. The patient family is pleading with him to have a feeding tube inserted.

 

Question 1:

What is the most appropriate action for you to take?

1._____________________________________________________________________________________________________________________________________________________.

 

CASE III

A postoperative patient is receiving heparin after developing thrombophlebitis. The nurse monitors the patient carefully for bleeding and other adverse effects of heparin. 

 

Question 1:

If the patient exhibit signs of excessive bleeding, the nurse should expect to administer an antidote specific to heparin. What agent should the nurse administer?

1.______________________________________________________________________________________________________________________________________________________.

 

CASE IV

Patient C with severe angina pectoris and ST-segment elevation on an electrocardiogram is being seen in the emergency department today.

 

Question 1:

In terms of diagnostic laboratory testing, what is the most important serum indicator of MI?

1.______________________________________________________________________________________________________________________________________________________.

 

CASE V

You are the nurse caring for a patient with Congestive Heart Failure (CHF) who has been prescribed with digoxin (Lanoxin). 

 

Question 1:

Identify three (3) guidelines that you should include when teaching the patient about digoxin?

1.______________________________________________________________________________________________________________________________________________________.

2.______________________________________________________________________________________________________________________________________________________.

3.______________________________________________________________________________________________________________________________________________________.