A nurse is caring for a client prescribed Levothyroxine. Which nursing action is most appropriate regarding administering on an empty stomach in the morning and monitoring for signs of hyperthyroidism?
1不暫停使用apixaban,而是將劑量調降為2.5 mg每日兩次,以平衡中風預防與出血風險;同時給予促進止血的藥物,如tranexamic acid 1 g靜脈注射,每8小時一次,以促進血塊穩定;提供支持性照護,包括嚴格控制血壓(收縮壓<140 mm Hg)及神經外科會診以評估是否需要進行血塊清除;每小時監測神經學狀態,並在4小時內重複頭部電腦斷層掃描,以評估血腫是否擴大。
2暫停使用apixaban;以緩慢靜脈輸注給予vitamin K 10 mg,每12小時一次,為期3天,以逆轉抗凝血作用;若24小時後INR仍偏高,可考慮給予新鮮冷凍血漿(FFP) 15 mL/kg;提供支持性照護,包括血壓控制、神經外科會診及癲癇預防措施;每日監測INR,觀察血栓或體液過多之徵象,若神經學狀態惡化則在6小時內重複頭部電腦斷層掃描。
When administering Levothyroxine, key nursing considerations include monitoring patient status, checking critical laboratory values, and providing appropriate safety education. Unsafe practices such as stopping medications abruptly or doubling missed doses are incorrect.
Andexanet劑量protocol — Low-dose(400 mg bolus over ~15分+4 mg/min for ≤120分)·High-dose(800 mg bolus over ~30分+8 mg/min for ≤120分)。Apixaban ≤5 mg或rivaroxaban ≤10 mg或≥8h since last dose→low。其餘→high。機構protocol不同。