You are administering heparin and following the protocol below for a client weighing 189 lbs. The order is to administer an initial heparin bolus IV followed by a titrated IV infusion. Round to the tenths place. HEPARIN PROTOCOL Initial bolus- 50 units/kg Initial rate – 18 units/kg/hr Obtain a PTT every 6 hours, and adjust dosage and rate as follows: If  PTT is less than 35 secs:      Repeat bolus with 80 units/kg and increase the rate by 4 units/kg/hr. If  PTT is 36 to 44 seconds:       Repeat bolus with 40 units/kg and increase the rate by 2 units/kg/hr. If  PTT is 45 to 75 seconds:       Continue current rate. If  PTT is 76 to 90 seconds:       If  PTT is 76 to 90 seconds:          Decrease rate by 2 units/kg/hr. If  PTT is greater than 90 secs: Hold the heparin for 1 hour and decrease rate by 3 units/kg/hr. Available (for bolus)  – heparin 1,000 units/mLAvailable (for infusion) –  heparin 25,000 units in 250 mL D5W    How many mL will the client receive for the repeat heparin IV bolus in response to the PTT of 40 secs?

Identify which laboratory test should be ordered for each client complaint. Each laboratory test can only be used 1 time.

A client is admitted to the hospital post MVA with history of hemophilia A and bleeding from a head laceration.  Which of these HCP orders is the priority to be administered? 

A nurse was assigned to an outpatient infusion center to provide treatment for a 55-year-old client who was recently diagnosed with Hodgkin Lymphoma. What do you anticipate is the best treatment goal for this client?

A client is on neutropenic precautions following treatment for acute lymphocytic leukemia and now presents with hypotension, tachycardia and an elevated temperature.  The nurse notifies the HCP. Which order from the HCP would be the nurse’s priority intervention?

During a follow-up visit, a client who has been on estrogen therapy reports daily use of cigarettes. The nurse explains to the client use of nicotine while on estrogen will increase the likelihood of which adverse event?

A nurse is preparing a presentation for a local community group about preventing allergic rhinitis. Which of the following should the nurse include as a preventive  strategy?

A homecare nurse is following up with a woman who is 7 days post-op right total mastectomy surgery for breast cancer. The nurse’s priority assessment is focused on which of the following complication?

The nurse is completing an admission assessment on a client and notes an asymmetrical shaped lesion with blurred borders and inconsistent coloring.  The nurse suspects that the client may have developed which of the following?

You are planning care for a client receiving the first treatment of external beam radiation treatment for prostate cancer. The nurse develops a teaching plan based on the nursing diagnosis of knowledge deficit. The nurse includes which of the following in the teaching plan to maintain skin integrity?