NUR 283 COMPREHENSIVE EXAM 1 STUDY

NUR 283 COMPREHENSIVE EXAM 1 STUDY

GUIDE Latest Update 2024-2025 Actual Exam Questions and 100% Verified Correct Answers Guaranteed A+ Approved by the Professor

As an entry level nurse, it is important that you understand monitoring of lab values for patient prescribed anticoagulants such as Heparin and Warfarin. What are normal

values for PT/INR, PTT and aPTT for these patients? - CORRECT ANSWER: ✦ PT -

prothrombin time -

• normal is 11-12.5 seconds
• 1.5 to 2.5 times the normal control (*16-31) for patients receiving Warfarin

✦ INR - international normalized ratio -

• normal is 0.9-1.2 seconds
• desirable therapeutic level is 2-3 times the normal for patients receiving Warfarin
• for patients w/ mechanical heart valve replacement an INR of 3-4 may be the goal

✦ PTT - partial thromboplastin time -

• 1.5-2.5 times the normal control (*30-75) for patients receiving Heparin

✦ aPTT - activated partial thromboplastin time -

• normal is 30-40 seconds
• 5-2.5 times the normal control (*40-100) on Heparin

Details on inserting NG tube for gastric decompression - pg. 1013 Saunders - -

CORRECT ANSWER: ✦ patient should be in high-fowlers position

✦ measure & tape tube to indicate length to be inserted ✦ lubricate tip before inserting in nasopharynx & advancing ✦ as tube enters back of throat - have pt swallow sip of water (unless contraindicated) - flex head toward chest while passing tube down throat into the stomach ✦ secure tube 1 / 2

✦ confirm placement w/ x-ray ✦ connect to suction

For a patient Dx w/ a Pulmonary Embolism - who may be included in the

Interdisciplinary Team? - CORRECT ANSWER: ✦ Pulmonologist - to manage lung

function ✦ Respiratory Therapist - for oxygen therapy ✦ Physical Therapist - to maintain muscle conditioning ✦ Occupational Therapist - for information and home suggesting for energy conservation if endurance is affected ✦ Dietician - for caloric and protein needs ✦ Pastoral care/clergy - for those experiencing spiritual distress ✦ Social workers/homecare nurses - to arrange care needs at home ✦ Mental health professional - for coping support

Interventions for PE - CORRECT ANSWER: ✦ oxygen therapy - mechanical ventilation may be indicated for patients w/ severe hypoxia ✦ close monitoring of ABGs & oxygen saturation

✦ continuous monitoring for complications:

• vital signs, lung sounds, cardiac & respiratory status
• watch for dysrhythmias, distended neck veins, & dyspnea

✦ anticoagulation medication - to prevent clot from enlarging and to prevent new clots ✦ unfractionated heparin is usually started unless there is hemodynamic instability

• fibrinolytic drugs are used if patient experiences shock, hemodynamic collapse, or

instability

Maintain tube patency (e.g. nasogastric tube for decompression, chest tubes) - per

IGGY for patients w/ NG tube, assess the following every 4 hours: - CORRECT

ANSWER: - Assess Q4H -

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