Chapter 12: Disorders of Hemostasis Prep U

The nurse is preparing a client for a total hip replacement by reviewing preoperative and postoperative instructions. The postoperative antcoagulation protocol is reviewed with the client because the client will be immobile for an extended amount of time. The nurse stresses the need for compliance with this protocol to avoid the development of deep vein thrombosis. What would be the most effective initial treatment as a thrombosis prophylactic? Pneumatic compression boots Nonsteroidal anti-inflammatory drug (NSAID) therapy Heparin therapy Antiembolism stockings

Heparin therapy

A 75-year-old client with a history of heart valve replacement arrives at the outpatient clinic with multiple red pinpoint lesions. The nurse identifies the lesions as: Erythema Ecchymoses Petechiae Purpura

Petechiae

A nurse is caring for a client with sepsis who was recently transferred to the intensive care unit following the development of disseminated intravascular coagulation (DIC). The nurse understands that DIC is most likely secondary to the infection causing the release of cytokines, which can cause: Amenorrhea and black, tarry stools Petechiae, purpura, and renal failure Severe soft-tissue hemorrhages Oozing from puncture sites and hypertension

Petechiae, purpura, and renal failure

A client with Von Willebrand disease type 3 comes to the clinic for an examination. Which problem reported by this client is most important for the nurse to communicate to the physician? Bleeding gums Tarry stools Cough and congestion Bruising on the arms

Tarry stools

A client asks the health care provider why his lower legs look purple. The health care provider will base the response on which pathophysiologic principle? The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher. Morbid obesity causes veins to enlarge and bleed into tissues due to stress the abdomen is placing on the vascular system. Too much trauma breaks capillaries and they bleed into the tissue. There is a problem with the plasminogen levels.

The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher.

Select the first stage of hemostasis. Formation of the platelet plug Clot dissolution Vessel spasm Clot retraction

Vessel spasm

The father of a 2-year-old boy recently diagnosed with hemophilia A asks the nurse how to prevent complications for his son. The best response would be: "Avoid administering aspirin and nonsteroidal anti-inflammatory drugs." "Do not allow the child to play outside or with other children." "Small bleeding in the joints is to be expected and can be treated at home." "Hemophilia A will no longer be a concern once treated with a blood transfusion."

"Avoid administering aspirin and nonsteroidal anti-inflammatory drugs."

A client is newly diagnosed with impaired platelet function, thrombocytopathia. Which question is most appropriate for the nurse to ask in order to determine the possible cause of this problem? "Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?" "Have you recently been exposed to any organic pesticides?" "Do you have a family history of hemophilia?" "Have you recently vacationed out of the country?"

"Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?"

The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The best response by the nurse would be: "Infants have a higher body fat content, which prohibits the absorption of vitamin K." "Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting." "The infant was exposed to high levels of heparin upon birth." "It is hospital policy to administer the injection to newborns."

"Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting."

The parent of a 5-year-old who was admitted with a sudden onset of purpura following the flu and who was diagnosed with acute idiopathic thrombocytopenic purpura (ITP) is very concerned that the child will have ITP for the rest of his life. The best response for the nurse to make is: "This presentation suggests a primary ITP." "It is usually self-limiting." "There are many effective treatments for ITP." "The disorder is an autoimmune disorder."

"It is usually self-limiting."

A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client's husband is confused as to why a disease of coagulation can result in bleeding. Which statement by the nurse best characterizes DIC? "These same hormones and bacteria that cause clotting also cause bleeding." "Excessive activation of clotting causes an overload of vital organs, resulting in bleeding." "Massive clotting causes irritation, friction, and bleeding in the small blood vessels." "So much clotting takes place that there are no available clotting components left, and bleeding ensues."

"So much clotting takes place that there are no available clotting components left, and bleeding ensues."

A client refuses to take the 81 mg of aspirin ordered by the physician, stating, "I do not have any pain." The best response by the nurse would be: "The 81 mg of aspirin daily will help protect you from a stroke or a heart attack." "This dose of aspirin will break apart the blood clot that you have in your leg." "The doctor wants you to take the medication to prevent you from experiencing pain." "Low-dose aspirin will help prevent you from having increased bleeding after surgery."

"The 81 mg of aspirin daily will help protect you from a stroke or a heart attack."

A client with thrombotic thrombocytopenic purpura (TTP) is signing consent for plasmapheresis. The client asks, "What is this procedure and why do I need it?" Which response by the health care provider is most accurate? "Instead of giving you packed red blood cells, the health care provider will infuse white blood cells into your veins." "It is very similar to donating a unit of blood at the Red Cross." "The health care provider will perfom a bone marrow aspiration to withdraw plasma to analyze." "The laboratory will remove plasma from the withdrawn blood and replace it with fresh-frozen plasma."

"The laboratory will remove plasma from the withdrawn blood and replace it with fresh-frozen plasma."

After assessment, the nurse asks how long the client has had red, pinpoint hemorrhages on the lower legs. The client responds, "This is the first time I have noticed this. What is wrong with me that is causing these small hemorrhages?" Which response by the nurse is most accurate? "More than likely, you bumped something and these are a result of trauma to the vessel." "These hemorrhages are called petechiae and occur when platelets are deficit." "Your platelets are developing a deformity as they are being produced by the bone marrow." "You might have a pooling of all your platelets in the spleen. I will assess for that next."

"These hemorrhages are called petechiae and occur when platelets are deficit."

A client tells the nurse that he has recently begun to take over-the-counter (OTC) calcium supplements to ensure that his blood will clot. The best response by the nurse would be: "It is a good idea; you will prevent bleeding." "Take the supplement twice a day with milk to increase absorption." "This is not necessary, unless it has been prescribed by your health care provider." "It will not cause problems, and it will keep your bones strong."

"This is not necessary, unless it has been prescribed by your health care provider."

A child with leukemia hears the health care provider tell the parents that the child has "pancytopenia." This child asks the nurse, "What does 'pancy' mean? Am I going to die?" Which response by the nurse is most appropriate for this 10-year-old child? "This is just a way of saying that you are sick and need to rest more.Your medicine is fighting your cancer cells so that you will not die." "This means the chemotherapy is attacking your bone marrow and your body has to find a way to fight back. No, you are not going to die." "This means the chemotherapy has lowered your blood counts including red blood cells, white blood cells and platelets. You are very sick, but we are working hard to make you healthy again." "This is very serious and could possibly lead to death if you start bleeding badly."

"This means the chemotherapy has lowered your blood counts including red blood cells, white blood cells and platelets. You are very sick, but we are working hard to make you healthy again."

A 36-year old woman with a diagnosis of antiphospholipid syndrome is receiving a scheduled checkup from her nurse practitioner. Which teaching point would the nurse most likely prioritize? "Good nutrition and blood sugar control are important in your case." "We need to ensure your birth control pills don't contain estrogen." "You'll need to avoid taking nonsteroidal anti-inflammatory drugs when you have menstrual cramps." "It's important for you to do regular physical activity and maintain a healthy body weight."

"We need to ensure your birth control pills don't contain estrogen."

A medical student is familiarizing herself with recent overnight admissions to an acute medical unit of a university hospital. Which client would the student recognize as least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history? A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks A 30-year-old female with a diagnosis of left leg deep vein thrombosis and a pulmonary embolism

A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use

In which client would diagnostic investigations be least likely to reveal increased thrombopoietin production? A 55-year-old man with dehydration secondary to Crohn disease A 66-year-old woman with a diagnosis of lung cancer with bone metastases An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

In which client would diagnostic investigations be least likely to reveal increased thrombopoietin production? A 66-year-old woman with a diagnosis of lung cancer with bone metastases An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive A 55-year-old man with dehydration secondary to Crohn disease A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

A student asks a nurse educator why a platelet will stick in the injured site but not in the normal uninjured blood vessel. What would be the best response? Adhesion occurs when the platelet receptor binds to von Willebrand factor (vWF) at the injury site. The release of platelet-derived growth factor (PDGF) from endothelial cells produces a platelet plug. Platelets are naturally attracted to a damaged vessel wall and will stick. Platelet degranulation results in an aggregation and the formation of the plug.

Adhesion occurs when the platelet receptor binds to von Willebrand factor (vWF) at the injury site.

A client with a diagnosis of hemophilia A has been admitted with bilateral knee pain. The nurse should anticipate performing what intervention during the client's treatment? Administration of factor VIII and implementation of fall prevention measures Administration of corticosteroids and desmopressin acetate (DDAVP) Passive range of motion exercises and transfusion of platelets Protective isolation and daily administration of subcutaneous vitamin K to prevent bleeding

Administration of factor VIII and implementation of fall prevention measures

A client with a diagnosis of hemophilia A has been admitted with bilateral knee pain. The nurse should anticipate performing what intervention during the client's treatment? Administration of factor VIII and implementation of fall prevention measures Passive range of motion exercises and transfusion of platelets Protective isolation and daily administration of subcutaneous vitamin K to prevent bleeding Administration of corticosteroids and desmopressin acetate (DDAVP)

Administration of factor VIII and implementation of fall prevention measures

Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body? Increases prothrombin Increases vitamin K-dependent factors in the liver Increases procoagulation factors Alters vitamin K, reducing its ability to participate in the coagulation of the blood

Alters vitamin K, reducing its ability to participate in the coagulation of the blood

How does low-dose aspirin therapy impact clot formation? Aspirin has a negative effect on the platelet's adhesion abilities. Aspirin acts as a clot buster by damaging fibrin strands. Aspirin increases capillary permeability. Aspirin is a platelet aggregation inhibitor.

Aspirin is a platelet aggregation inhibitor.

The nurse reviews the lab results of a client who has a thrombocyte count of 60 ×103/µL (60 ×109/L). The client is at risk for: Disseminated intravascular coagulation Deep vein thrombosis Hypercoagulation Bleeding

Bleeding

A client with von Willebrand disease is admitted to the hospital for an elective surgical procedure. The nurse caring for this client will review which lab result to monitor the client's coagulation? Thrombin time Prothrombin time Bleeding time Platelet count

Bleeding time

A client with a history of antiphospholipid syndrome is admitted to the emergency deparatment with acute onset of both renal and liver failure, along with signs of a cerebrovascular accident. The admitting nurse is concerned that the client has developed: Active antiphospholipid syndrome Malignant antiphospholipid syndrome Catastrophic antiphospholipid syndrome Terminal antiphospholipid syndrome

Catastrophic antiphospholipid syndrome

Fibrinolysis is part of the hemostasis process and requires a series of steps. Which statement is true of the process? Circulating plasmin is rapidly inactivated, which limits the fibrinolytic process to the local clot. Plasminogen digests the fibrin strands of the clot. Plasmin is converted into its active form, plasminogen. The dissolution of a blood clot begins long after its formation.

Circulating plasmin is rapidly inactivated, which limits the fibrinolytic process to the local clot.

In a client with DIC, microemboli form, causing obstruction of blood vessels and tissue hypoxia. Common clinical signs may be due to what? Select all that apply. Respiratory failure Renal failure Right ventricular failure Immunologic failure Circulatory failure

Circulatory failure Renal failure Respiratory failure

A client is admitted to the hospital to rule out secondary thrombocytosis after suffering recurrent episodes of deep-vein thrombosis and pulmonary embolisms. The admitting nurse is obtaining a medical history. Which condition would make anticoagulation contraindicated? Smoking history Crohn disease Prostate cancer Coronary artery disease

Crohn disease

A 57-year-old man is diagnosed with thrombocytopenia. The nurse knows that thrombocytopenia refers to a decrease in the number of circulating platelets. The nurse also knows that thrombocytopenia can result from what? Decreased sequestration of platelets Decreased platelet production Increased platelet survival Increased platelet production

Decreased platelet production

A nurse working in an ambulatory care unit is working with a client who has recently been diagnosed with a V Leiden mutation. The nurse tells the client the importance of smoking cessation to avoid: Deep vein thrombosis (DVT) Essential hypertension Coronary artery disease Pulmonary hypertension

Deep vein thrombosis (DVT)

A newborn has a clotting disorder that results in the body being unable to produce fibrin. Which of the following could be the cause? Deficiency of fibrinogen Increase in the number of megakaryocytes Iron deficiency Decreased spleen function

Deficiency of fibrinogen

A nurse is caring for a client recently admitted to the emergency department with drug-induced thrombocytopenia and a platelet count of 50,000/μL. The client's medications include quinidine, sulfamethoxazole/trimethoprim, esomeprazole, and oral contraceptives. The nurse anticipates which initial course of treatment? Platelet monitoring Platelet transfusion Initiation of heparin Discontinuation of all medications

Discontinuation of all medications

A nurse is caring for a client receiving heparin therapy who has developed heparin-induced thrombocytopenia. Which nursing intervention does the nurse anticipate? Administration of platelets Discontinuation of heparin therapy Switching the client to warfarin therapy Monitoring the client's blood pressure every 2 hours

Discontinuation of heparin therapy

A week after starting atorvastatin for high cholestrol, the client returns reporting bleeding from the mouth (mucous membranes) and nose. What priority intervention should the health care provider perform? Discontinue the atorvastatin immediately. Request prescription for a good blood thinner to interrupt the coagulation. Send the client to see an ears, nose, throat (ENT) specialist. Apply an ice bag to the mouth and nose.

Discontinue the atorvastatin immediately.

Disseminated intravascular coagulation (DIC) is a grave coagulopathy resulting from the overstimulation of clotting and anticlotting processes in response to: Disease or injury Septicemia and acute hypertension Neoplasms and nonpoisonous snakebites Severe trauma and acute hypertension

Disease or injury

A postpartum client develops uncontrolled postpartum bleeding, oozing from IV sites, a blood pressure of 82/40, and respiratory distress. Which complication does the nurse suspect is occurring? Immune thrombocytopenic purpura Disseminated intravascular coagulation (DIC) Septic shock Thrombocytopathia

Disseminated intravascular coagulation (DIC)

A postpartum client develops uncontrolled postpartum bleeding, oozing from IV sites, a blood pressure of 82/40, and respiratory distress. Which complication does the nurse suspect is occurring? Septic shock Disseminated intravascular coagulation (DIC) Immune thrombocytopenic purpura Thrombocytopathia

Disseminated intravascular coagulation (DIC)

A client has been placed on sulfamethoxazole/trimethoprim as treatment for community-acquired methicillin-resistant Staphylococcus aureus (MRSA) for 10 days. After taking the medication for 8 days, the client comes to the health care provider's office complaining of multiple nosebleeds over the past day. Laboratory work shows a platelet count of 80,000/μL. The nurse practitioner suspects which condition? Antiphospholipid syndrome Drug-induced thrombocytopenia Drug-induced thrombocytosis Hypersplenic thrombocytopenia

Drug-induced thrombocytopenia

A client has been placed on sulfamethoxazole/trimethoprim as treatment for community-acquired methicillin-resistant Staphylococcus aureus (MRSA) for 10 days. After taking the medication for 8 days, the client comes to the health care provider's office complaining of multiple nosebleeds over the past day. Laboratory work shows a platelet count of 80,000/μL. The nurse practitioner suspects which condition? Antiphospholipid syndrome Drug-induced thrombocytosis Drug-induced thrombocytopenia Hypersplenic thrombocytopenia

Drug-induced thrombocytopenia

A client is admitted to the hospital with a diagnosis of deep vein thrombosis and started on intravenous heparin therapy. Seven days later, the client's lab values identify a rapid decrease in platelets. The health care provider recognizes this as: Immune thrombocytopenic purpura (ITP) Drug-induced thrombocytopenia Hemolytic-uremic syndrome (HUS) Thrombotic thrombocytopenic purpura (TTP)

Drug-induced thrombocytopenia

A pregnant woman contacts her physician because she has developed sudden, severe pain and swelling in her left lower leg. The physician explains to her that her past medical includes an inherited defect in factor V Leiden, which predisposes her to the development of: Thrombocytopenia Abnormal bleeding Platelet disorders Excessive clotting

Excessive clotting

A pregnant woman contacts her physician because she has developed sudden, severe pain and swelling in her left lower leg. The physician explains to her that her past medical includes an inherited defect in factor V Leiden, which predisposes her to the development of: Platelet disorders Thrombocytopenia Excessive clotting Abnormal bleeding

Excessive clotting.

There are two pathways that can be activated by the coagulation process. One pathway begins when factor XII is activated. The other pathway begins when there is trauma to a blood vessel. What are these pathways? Clotting and bleeding pathways Extrinsic and intrinsic pathways Inner and outer pathways Factor and trauma pathways

Extrinsic and intrinsic pathways

At her first prenatal visit, a pregnant woman who is 5' 1" and weighs 180 lb asks the nurse why her physician has ordered a protein C resistance blood test. The nurse's best response is to rule out: Factor III deficiency von Willebrand disease Factor V Leiden mutation Hemophilia A

Factor V Leiden mutation

A client has been diagnosed with inherited hypercoagulability. Select the most likely cause. Hyperestrogenic state Factor V gene mutation Myocardial infarction Prolonged immobility

Factor V gene mutation

A client with hemophilia type A comes to the emergency department with severe pain and swelling in the right knee. To reduce musculoskeletal damage, the nurse anticipates the administration of: Heat to the knee Nonsteroidal anti-inflammatory drug Factor VIII replacement therapy Corticosteroids

Factor VIII replacement therapy

The nurse is caring for a postsurgical client who is recovering from knee replacement surgery secondary to rheumatoid arthritis. When planning the client's care, the nurse should include what action? Passive range of motion exercises to the nonsurgical joints to prevent hemorrhage. Administration of vitamin K injections as ordered. Frequent assessment for signs of thrombosis or hemorrhage. Administration of a platelet transfusion, if deemed necessary.

Frequent assessment for signs of thrombosis or hemorrhage.

The nurse is studying hemostasis. She knows that which statements are true? Select all that apply. Blood clot formation is a malfunction of hemostasis Vessel constriction or spasm is a factor in effective hemostasis. Hemostasis occurs in established stages. Hemostasis refers to the body's ability to control bleeding. Hemostasis results in the formation of a platelet plug.

Hemostasis refers to the body's ability to control bleeding. Vessel constriction or spasm is a factor in effective hemostasis. Hemostasis results in the formation of a platelet plug. Hemostasis occurs in established stages.

Which medication is known to interfere with the body's ability to control bleeding? Select all that apply. Nonsteroidal anti-inflammatory drugs (NSAIDs) Hormone replacement therapies Potassium chloride Heparin Warfarin

Heparin Warfarin Nonsteroidal anti-inflammatory drugs (NSAIDs)

An intensive care nurse is caring for a client who has been admitted for a deep-vein thrombus and who has a history of immune-mediated heparin-induced thrombocytopenia (HIT). The nurse would expect the client to be discharged with a prescription for which medication? Nonsteroidal anti-inflammatory drugs High-molecular-weight heparin Low-molecular-weight heparin Tissue plasminogen activator

Low-molecular-weight heparin

A nurse orienting to the surgical suite is studying medications that affect platelet function and notes that the most common medications are: Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin Aspirin and proton pump inhibitors Antibiotics and antihistmines NSAIDs and acetaminophen

Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin

The nurse is reviewing hospital discharge instructions with a client who has been diagnosed with secondary thrombocytosis and who also suffers from chronic ulcerative colitis, making anticoagulation inadvisable. The nurse stresses that the client should avoid: Select all that apply. Folate supplements Immobilization Oral contraceptives Low-fat diet Smoking

Oral contraceptives Smoking Immobilization

The nurse is reviewing hospital discharge instructions with a client who has been diagnosed with secondary thrombocytosis and who also suffers from chronic ulcerative colitis, making anticoagulation inadvisable. The nurse stresses that the client should avoid: Select all that apply. Folate supplements Oral contraceptives Immobilization Low-fat diet Smoking

Oral contraceptives Smoking Immobilization

Which intervention will likely be prescribed for thrombotic thrombocytopenic purpura (TTP)? Plasmapheresis Intravenous administration of vitamin C Heparin infusion Transfusion with factor VIII

Plasmapheresis

When discussing the sequence of clot dissolution, the science instructor will talk about which item that begins the process? Dabigatran Platelets Plasminogen α2-plasmin inhibitor

Plasminogen

A 71-year-old male client with a history of myocardial infarction (MI) and peripheral vascular disease (PVD) has been advised by his family physician to begin taking 81 mg aspirin once daily. Which statement best captures an aspect of the underlying rationale for the physician's suggestion? Aspirin helps to inhibit ADP action and minimizes platelet plug formation. Aspirin can reduce unwanted platelet adhesion by inhibiting TXA2 synthesis. Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation. Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.

Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.

A nurse is caring for a client who was recently diagnosed with primary thrombocytosis. The client does not understand why hydroxyurea is given. The best explanation would be that this medication decreases: Red blood cells Platelet counts Platelet aggregation Platelet adhesion

Platelet counts

A nurse is assessing a child brought to the clinic with multiple petechiae and excessive bruising covering his body. Laboratory tests reveal a low platelet count. The nurse is aware that these clinical manifestations are caused due to which pathological process? An increase in the clotting process causes large blood clots to form under the skin, which appear as areas of bruising. Platelets contain fibrinogen, which converts to fibrin and forms a blood clot. Without enough platelets, a blood clot cannot form and bleeding will occur. Platelets function to form the platelet plug to help control bleeding after injury. Without enough platelets, the blood cannot clot properly and bleeding occurs. During injury, platelets cause the blood vessel wall to constrict, decreasing the flow of blood until clotting occurs. Without enough platelets, the blood vessels will not constrict and bleeding occurs.

Platelets function to form the platelet plug to help control bleeding after injury. Without enough platelets, the blood cannot clot properly and bleeding occurs.

A young man has been diagnosed with hemophilia, and the nurse is planning his discharge teaching. The nurse knows to include what in the discharge teaching? The client will be on IV factor VIII therapy at home. It is an X-linked recessive disorder. Prevent trauma to the body. Only use nonsteroidal anti-inflammatory drugs (NSAIDs) for mild pain.

Prevent trauma to the body.

Heparin is an anticoagulant given by injection to prevent the formation of blood clots. How does heparin work? Promotes the inactivation of factor VIII Promotes the inactivation of clotting factors Binds to factor Xa Binds to factor X

Promotes the inactivation of clotting factors

A 30-year-old woman who is 2 months pregnant is discussing concerns with her physician regarding potential complications that may arise because she has lupus and has already had two miscarriages. The physician is concerned that the lupus has caused the development of: Primary thrombocytopenia Secondary antiphospholipid syndrome Primary antiphospholipid syndrome Secondary Factor V Leiden mutation

Secondary antiphospholipid syndrome

A client with a diagnosis of myelogenous leukemia is being admitted to the hospital with an exacerbation of Crohn disease. Laboratory results include a white blood cell count of 200,000/μL and a platelet count of 600,000/μL. The nursing assessment reveals swelling and pain in the right leg. The nurse suspects the presence of which condition? Secondary thrombocytosis Secondary thrombocytopenia Primary leukopenia Primary thrombocytopenia

Secondary thrombocytosis

Which factors have been identified as having a negative effect on platelet function? Select all that apply. Diabetes mellitus Exposure to toxic chemicals High fat diet Inactive lifestyle Smoking

Smoking Diabetes mellitus

A hospital client is receiving intravenous infusion of heparin for treatment of a pulmonary embolus. Which phenomenon is most likely occurring, resulting in the drug's therapeutic effect? Inhibition of ADP-induced platelet aggregation Deactivation of the intrinsic clotting pathway Suppression of fibrin formation Inhibition of vitamin K synthesis in the liver

Suppression of fibrin formation

A client has an impaired platelet function that may have developed from inheritance, drugs, disease, or extracorporeal circulation. The health care provider would document this as: Fibrinolysis Disseminated intravascular coagulation Plasmapheresis Thrombocytopathia

Thrombocytopathia

A nurse is assessing a client and finds these results: Areas of bruising (purpura) on the client's arms and legs Pinpoint hemorrhages (petechiae) on the legs Pinpoint hemorrhages (petechiae) in the mouth Platelets level of 90,000/μL (90 ×109/L) What condition should the nurse suspect the client is exhibiting? Neutropenia Thrombocytopenia Leukopenia Thrombocytosis

Thrombocytopenia

A nurse is treating a client with aplastic anemia. Due to the replacement of normal bone marrow with malignant cells, the nurse teaches the client to prevent scratches, scrapes, and cuts. What root cause likely underlies the client's increased risk for hemorrhage? Disseminated intravascular coagulation (DIC) Thrombocytopenia Polycythemia Neutrophilia

Thrombocytopenia

A client with renal disease comes to the emergency department with reports of excessive gingival bleeding over the past week. The nurse documents a platelet level of 100,000/μL and anticipates a follow-up blood test for: Endothelin 1 Prothrombin Thrombopoietin Fibrinogen

Thrombopoietin

A client with renal disease comes to the emergency department with reports of excessive gingival bleeding over the past week. The nurse documents a platelet level of 100,000/μL and anticipates a follow-up blood test for: Thrombopoietin Prothrombin Fibrinogen Endothelin 1

Thrombopoietin

The nurse is caring for a client in the intensive care unit who has lung cancer and bacterial sepsis from a centrally inserted intravenous line. The nurse realizes that the client is at high risk of developing: Thrombosis Hemorrhages Immune complexes Purpura

Thrombosis

A client diagnosed with autosomal dominant von Willebrand factor disease (vWF) is experiencing mild to moderate bleeding. The health care provider would classify the diagnosis as: Type 2 Type 1 Type 3 Type 4

Type 2

A group of nursing students are studying the process of hemostasis and determine that there is a specific order of events. Organize the following phases in the correct order of hemostasis. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1Blood coagulation 2Platelet plug formation 3Clot retraction 4Thrombolysis 5Vessel vasoconstriction

Vessel vasoconstriction Platelet plug formation Blood coagulation Clot retraction Thrombolysis

A 44-year-old female client presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which diagnosis would the medical team be most justified in suspecting as a cause of the client's bleeding? Hemophilia B Idiopathic immune thrombocytopenic purpura (ITP) Vitamin K deficiency Excess calcium

Vitamin K deficiency

A client presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which diagnosis should the medical team first suspect? Calcium deficiency Idiopathic immune thrombocytopenic purpura (ITP) Hemophilia B Vitamin K deficiency

Vitamin K deficiency

A client with an apparent clotting disorder is admitted to hospital. His health record reveals that he has been treated for complications of chronic alcoholism for the past 10 years. The nurse should suspect what cause of his clotting disorder? Hemophilia Vitamin K deficiency Von Willebrand disease Immune thrombocytopenic purpura (ITP)

Vitamin K deficiency

A nurse is caring for a client who has sustained severe trauma and has developed disseminated intravascular coagulation (DIC). The nurse will explain this complication to the family based on which physiologic principle? Widespread coagulation and bleeding in the vascular compartment Thrombocytosis as a result of widespread infection Impaired platelet function due to vitamin K deficiency Bleeding due to structurally weak vessels resulting from vitamin C deficiency

Widespread coagulation and bleeding in the vascular compartment

A teenage girl, seen in the clinic, is diagnosed with nonthrombocytopenic purpura. The girl states, "You have taken a lot of blood from me. Which of my tests came back abnormal?" How should the nurse respond? Your CBC with differential showed a normal platelet count. Your complete blood count (CBC) with differential showed a shift to the left. Your CBC with differential showed a normal hematocrit. Your CBC with differential showed you do not have enough iron.

Your CBC with differential showed a normal platelet count.

The process of clot retraction squeezes serum from the clot, thereby joining the edges of the broken vessel. Through the action of actin and myosin, filaments in platelets contribute to clot retraction. Failure of clot retraction is indicative of: a high platelet count. an overabundance of factor Xa. absence of factor Xa. a low platelet count.

a low platelet count.

The process of clot retraction squeezes serum from the clot, thereby joining the edges of the broken vessel. Through the action of actin and myosin, filaments in platelets contribute to clot retraction. Failure of clot retraction is indicative of: an overabundance of factor Xa. a high platelet count. a low platelet count. absence of factor Xa.

a low platelet count.

A 10-month-old infant has begun to take his first steps and his mother has brought him for assessment because of swelling in his ankles and knees. The mother also states that he was eager to walk but has now regressed and cries when she tries to encourage it. The clinician should: prescribe a trial of desmopressin acetate (DDAVP) to rule out von Willebrand disease. order testing to rule out disseminated intravascular coagulation (DIC). administer vitamin K STAT. assess the child for signs and symptoms of hemophilia A.

assess the child for signs and symptoms of hemophilia A.

A young woman diagnosed with prostacyclin deficiency is admitted to the hospital with recurrent deep vein thrombosis and an ovarian infarction asks the nurse why she keeps having these problems. Understanding the role of prostacyclin in hemostasis, the nurse explains that prostacyclin enables: blood vessel vasodilation and enhancement of platelet adhesion. blood vessel vasoconstriction and platelet adhesion. platelet aggregation and adhesion. blood vessel vasodilation and inhibition of platelet aggregation.

blood vessel vasodilation and inhibition of platelet aggregation.

A critical care nurse is preparing a case study on the treatment of acute coronary syndrome (ACS), which describes glycoprotein factor (GPIIb/IIIa) inhibitors and their role in decreasing thrombosis by: activating prostaglandin and von Willebrand factor release. interfering with the conversion of fibrinogen to fibrin. interfering with the ability of platelets to bind to one another. supporting the antiplatelet function of prostacyclin.

interfering with the ability of platelets to bind to one another.

The school nurse has several children with hemophilia A. After recess, one hemophilia student comes to the school nurse complaining of pain in the knee from falling on the playground. The nurse notes there is swelling in the knee and pain on palpation. The nurse should: apply some warm compresses to the knee. wrap the knee in an ace bandage for compression. administer some NSAIDs to relieve the pain. notify parents to pick up the child and possibly administer Factor VIII.

notify parents to pick up the child and possibly administer Factor VIII.

A client undergoing chemotherapy has a critically low platelet count. To stimulate platelet cell production, the nurse expects to administer: interferons, which support the proliferation of stem cells. filgrastim, which is a granulocyte colony-stimulating factor. Epoetin alfa, which is an erythropoietin oprelvekin, which is a thrombopoietin

oprelvekin, which is a thrombopoietin

A 42-year-old male client recently diagnosed with liver cancer is noted as at high risk for bleeding abnormalities. The nurse recognizes this risk as a result of: a vitamin C deficiency in the diet. the reduction of clotting factors synthesized in the liver. increased amounts of vitamin K being produced in the liver. weakening of the organ walls as a result of inflammation.

the reduction of clotting factors synthesized in the liver.

Many different proteins, enzymes, and hormones are involved in maintaining hemostasis. Which protein is required for platelet adhesion? Growth factors von Willebrand factor Ionized calcium Platelet factor 4

von Willebrand factor