1. Assignment: Cardiac and leadership 1
Assignment: Cardiac and leadership 1Assignment: Cardiac and leadership 1Nursing
Teaching for PAD includes:-? Educate the client tomaintain aseptic technique.? Instruct the
client on howto administer IV antibiotics.? Have the client recordtemp daily for six weeks.?
Encourage oral hygeine forsix weeks with a soft bristletoothbrush 2x daily.? Have the client
clean anyskin lacerations and applyantibiotic ointment.? Client should inform allHCP’s of hx
ofendocarditis.? Client should useprophylactic antibiotics fororal procedures.? Tech the
client the signsand symptoms of emboliand HF.Medical treatment for PAD includes:-?
Arterial bypass withautogenous vein orsynthetic graft.? Endarterectomy.? Patch graft
angioplasty.? Amputation.Text, letter Description automatically generatedText, letter
Description automatically generatedA patient is being discharged following insertion of a
permanent pacemaker. The nurse determines that the patient requires further instruction
on safety precaution after the following statement: OverviewA new pacemaker requires
limitation of physical activity, including no lifting, pulling, or pushing more than 5 pounds,
so the patient will need to be educated further if they speak of lifting something greater
than 5 pounds.Learning OutcomesA new pacemaker requires limitation of physical activity,
including no lifting, pulling, or pushing more than 5 pounds. Other limitations include
limiting tasks like sweeping in repetitive motions, keeping the area free from pressure
(such as tight clothing or suspenders), and not raising the arm on the affected side above
the level of the heart for the first few weeks. The pacemaker insertion site may be bruised,
swollen, tender, and instructions may include gentle washing of incision site, and not
applying lotion or powder.Text Description automatically generatedText Description
automatically generatedORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE PAPERSText,
letter Description automatically generatedHeparin64. A client with atrial fibrillation who is
receiving maintenance therapy ofwarfarin sodium has a prothrombin time (PT) of 35
seconds. On the basis ofthese laboratory values, the nurse anticipates which prescription?1.
Adding a dose of heparin sodium2. Holding the next dose of warfarin3. Increasing the next
dose of warfarin4. Administering the next dose of warfarin64. Answer: 2Rationale: The
normal PT is 11 to 12.5 seconds (conventional therapy and SIunits). A therapeutic PT level
is 1.5 to 2 times higher than the normal level. Becausethe value of 35 seconds is high, the
nurse should anticipate that the client would notreceive further doses at this time.
Therefore, the prescriptions noted in the remainingoptions are incorrect Assignment:
Cardiac and leadership 168. A client is receiving a continuous intravenous infusion of
heparin sodium totreat deep vein thrombosis. The client’s activated partial thromboplastin
2. time(aPTT) is 65 seconds. The nurse anticipates that which action is needed?1.
Discontinuing the heparin infusion2. Increasing the rate of the heparin infusion3.
Decreasing the rate of the heparin infusion4. Leaving the rate of the heparin infusion as
is68. Answer: 4Rationale: The normal aPTT varies between 30 and 40 seconds (30 and
40seconds), depending on the type of activator used in testing. The therapeutic dose
ofheparin for treatment of deep vein thrombosis is to keep the aPTT between 1.5 (45 to60)
and 2.5 (75 to 100) times normal. This means that the client’s value should not beless than
45 seconds or greater than 100 seconds. Thus, the client’s aPTT is within thetherapeutic
range and the dose should remain unchanged.Test-Taking Strategy: Focus on the subject,
the expected aPTT for a clientreceiving a heparin sodium infusion. Remember that the
normal range is 30 to 40seconds and that the aPTT should be between 1.5 and 2.5 times
normal when theclient is receiving heparin therapy. Simple multiplication of 1.5 and 2.5 by
30 and 40will yield a range of 45 to 100 seconds. This client’s value is 65 seconds.Activated
partial thromboplastin time (aPTT)1. The aPTT evaluates how well the
coagulationsequence (intrinsic clotting system) is functioning bymeasuring the amount of
time it takes in seconds forrecalcified citrated plasma to clot after partialthromboplastin is
added to it.2. The test screens for deficiencies and inhibitors of allfactors, except factors VII
and XIII.3. Usually, the aPTT is used to monitor theeffectiveness of heparin therapy and
screen for4. Normal reference interval: 30 to 40 seconds(conventional and SI units
[International System ofUnits]), depending on the type of activator used.5. If the client is
receiving intermittent heparin therapy,draw the blood sample 1 hour before the
nextscheduled dose.6. Do not draw samples from an arm into which heparinis infusing.7.
Transport specimen to the laboratory immediately.8. Provide direct pressure to the
venipuncture site for 3to 5 minutes.9. The aPTT should be between 1.5 and 2.5 times
normalwhen the client is receiving heparin therapy.10. Elevated values occur in the
following: Deficiency ofone or more of the following: factor I, II, V, or VIII;factors IX and X;
factor XI; and factor XII; hemophilia;heparin therapy; liver diseaseIf the aPTT value is
prolonged (longer than 100 seconds or peragency policy) in a client receiving IV heparin
therapy or in any client atrisk for thrombocytopenia, initiate bleeding precautions.E.
Prothrombin time (PT) and international normalized ratio (INR)1. Prothrombin is a vitamin
K–dependent glycoproteinproduced by the liver that is necessary for fibrin clotformation.
Assignment: Cardiac and leadership 12. Each laboratory establishes a normal or control
valuebased on the method used to perform the PT test.3. The PT measures the amount of
time it takes inseconds for clot formation and is used to monitorresponse to warfarin
sodium therapy or to screen fordysfunction of the extrinsic clotting system resultingfrom
liver disease, vitamin K deficiency, ordisseminated intravascular coagulation.4. A PT value
within 2 seconds (plus or minus) of thecontrol is considered normal.5. The INR is a
frequently used test to measure theeffects of some anticoagulants.6. The INR standardizes
the PT ratio and is calculated inthe laboratory setting by raising the observed PT ratioto the
power of the international sensitivity indexspecific to the thromboplastin reagent used.7. If
a PT is prescribed, baseline specimen should bedrawn before anticoagulation therapy is
started; notethe time of collection on the laboratory form.8. Provide direct pressure to the
venipuncture site for 3to 5 minutes.9. Concurrent warfarin therapy with heparin therapy
3. canlengthen the PT for up to 5 hours after dosing.10. Diets high in green leafy vegetables
canincrease the absorption of vitamin K, which shortensthe PT.11. Orally administered
anticoagulation therapyusually maintains the PT at 1.5 to 2 times thelaboratory control
value.12. Normal reference intervalsa. PT: 11 to 12.5 seconds (conventionaland SI units)b.
INR: 0.81 to 1.20 (conventional and SIunits)13. For both the PT and INR, elevated values
occur in thefollowing: deficiency of one or more of the following:factor I, II, V, VII, or X; liver
disease; vitamin Kdeficiency; warfarin therapyIf the PT value is longer than 25 seconds and
the INR isgreater than 3.0 in a client receiving standard warfarin therapy (or peragency
policy), initiate bleeding precautions.Graphical user interface, text Description
automatically generatedText, letter Description automatically generatedText, letter
Description automatically generatedText, letter Description automatically generatedText
Description automatically generatedThiazide diuretics (Box 53-7)1. Descriptiona. Thiazide
diuretics increase sodium andwater excretion by inhibiting sodiumreabsorption in the
distal tubule of thekidney.b. Used for hypertension and peripheraledemac. Not effective for
immediate diuresisd. Used in clients with normal renalfunction (contraindicated in
clientswith renal failure)e. Thiazide diuretics should be used withcaution in the client
taking lithium,because lithium toxicity can occur, andin the client taking
digoxin,corticosteroids, or hypoglycemicmedications. Assignment: Cardiac and leadership
12. Side and adverse effectsa. Hypercalcemia, hyperglycemia,hyperuricemiab. Hypokalemia,
hyponatremiac. Hypovolemiad. Hypotensione. Rashesf. Photosensitivityg. Dehydration3.
Interventionsa. Monitor vital signs.b. Monitor weight.c. Monitor urine output.d. Monitor
electrolytes, glucose, calcium,blood urea nitrogen (BUN), creatinine,and uric acid levels.e.
Check peripheral extremities for edema.f. Monitor for signs of digoxin or lithiumtoxicity if
the client is taking thesemedications.
![time(aPTT) is 65 seconds. The nurse anticipates that which action is needed?1.
Discontinuing the heparin infusion2. Increasing the rate of the heparin infusion3.
Decreasing the rate of the heparin infusion4. Leaving the rate of the heparin infusion as
is68. Answer: 4Rationale: The normal aPTT varies between 30 and 40 seconds (30 and
40seconds), depending on the type of activator used in testing. The therapeutic dose
ofheparin for treatment of deep vein thrombosis is to keep the aPTT between 1.5 (45 to60)
and 2.5 (75 to 100) times normal. This means that the client’s value should not beless than
45 seconds or greater than 100 seconds. Thus, the client’s aPTT is within thetherapeutic
range and the dose should remain unchanged.Test-Taking Strategy: Focus on the subject,
the expected aPTT for a clientreceiving a heparin sodium infusion. Remember that the
normal range is 30 to 40seconds and that the aPTT should be between 1.5 and 2.5 times
normal when theclient is receiving heparin therapy. Simple multiplication of 1.5 and 2.5 by
30 and 40will yield a range of 45 to 100 seconds. This client’s value is 65 seconds.Activated
partial thromboplastin time (aPTT)1. The aPTT evaluates how well the
coagulationsequence (intrinsic clotting system) is functioning bymeasuring the amount of
time it takes in seconds forrecalcified citrated plasma to clot after partialthromboplastin is
added to it.2. The test screens for deficiencies and inhibitors of allfactors, except factors VII
and XIII.3. Usually, the aPTT is used to monitor theeffectiveness of heparin therapy and
screen for4. Normal reference interval: 30 to 40 seconds(conventional and SI units
[International System ofUnits]), depending on the type of activator used.5. If the client is
receiving intermittent heparin therapy,draw the blood sample 1 hour before the
nextscheduled dose.6. Do not draw samples from an arm into which heparinis infusing.7.
Transport specimen to the laboratory immediately.8. Provide direct pressure to the
venipuncture site for 3to 5 minutes.9. The aPTT should be between 1.5 and 2.5 times
normalwhen the client is receiving heparin therapy.10. Elevated values occur in the
following: Deficiency ofone or more of the following: factor I, II, V, or VIII;factors IX and X;
factor XI; and factor XII; hemophilia;heparin therapy; liver diseaseIf the aPTT value is
prolonged (longer than 100 seconds or peragency policy) in a client receiving IV heparin
therapy or in any client atrisk for thrombocytopenia, initiate bleeding precautions.E.
Prothrombin time (PT) and international normalized ratio (INR)1. Prothrombin is a vitamin
K–dependent glycoproteinproduced by the liver that is necessary for fibrin clotformation.
Assignment: Cardiac and leadership 12. Each laboratory establishes a normal or control
valuebased on the method used to perform the PT test.3. The PT measures the amount of
time it takes inseconds for clot formation and is used to monitorresponse to warfarin
sodium therapy or to screen fordysfunction of the extrinsic clotting system resultingfrom
liver disease, vitamin K deficiency, ordisseminated intravascular coagulation.4. A PT value
within 2 seconds (plus or minus) of thecontrol is considered normal.5. The INR is a
frequently used test to measure theeffects of some anticoagulants.6. The INR standardizes
the PT ratio and is calculated inthe laboratory setting by raising the observed PT ratioto the
power of the international sensitivity indexspecific to the thromboplastin reagent used.7. If
a PT is prescribed, baseline specimen should bedrawn before anticoagulation therapy is
started; notethe time of collection on the laboratory form.8. Provide direct pressure to the
venipuncture site for 3to 5 minutes.9. Concurrent warfarin therapy with heparin therapy](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)