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Case study progress The physician decides not to administer an antidote and orders the heparin to be held, with a second aPTT drawn in 2 hours. M.M. is monitored closely. After 2 hours, the aPTT is 95 seconds. 12. What is your evaluation of this aPTT level? 13. The physician resumes the heparin at a lower rate, and there are no further issues with the lab results. The next day, the physician’s orders read, “Warfarin (Coumadin) 2.5 mg PO, PT/INR in a.m.;D/C heparin.” Do you have any concerns about these orders? Explain your answer.|| 14. List 3 priority problems related to the care of M.M. in his current situation. 15. Several days later you hear M.M. asking his son to bring in a “decent razor” because he is tired of having beard stubble. How would you address this issue? 16. Before M.M. goes home, the physician switches the oral anticoagulant to rivaroxaban Xarelto), after the heparin drip is discontinued. You inform him that he will be on this medication for several months to prevent another occurrence of VTE. Which statements will you include in the teaching? Select all that apply. a. “Take the Xarelto at the same time every day.” b. “There are no dietary restrictions while on this drug.” c. “Watch for bleeding from your gums, nose, and bowels.”
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