Health Promotion and Maintenance
60. A nurse assesses a client who is 40 years old, gravida 11, para 9 at 14 weeks' gestation, and has a history of thromboembolitic disease. The client is placed on daily heparin therapy. Which laboratory test will be the most important for this client?
Test-Taking Tip
The question is asking which test should be used for monitoring this client's heparin therapy. Choose the test that reflects monitoring heparin effectiveness.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Assessment; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Laboratory Values
Health Promotion and Maintenance
.
Answer 1 is incorrect because prothrombin time is assessed to maintain correct dosages of warfarin (Coumadin). Coumadin crosses the placental barrier and is contraindicated in pregnancy. Answer 2 is correct because partial thromboplastin time is evaluated to determine the effectiveness of heparin therapy. Answer 3 is incorrect because a bleeding time is not routinely performed on women who are pregnant, and it is unnecessary for a pregnant woman on heparin therapy. Answer 4 is incorrect because D-dimer tests are ordered, along with other laboratory tests and imaging scans, to help rule out and diagnose conditions that cause hypercoagulability. Since this client already has a history of thromboembolitic disease, the D-dimer is unnecessary.
