Med-Surg Ch. 40

The nurse is educating a patient who is taking an anticoagulant drug. Which patient statement indicates a need for further teaching?

'I should take aspirin whenever I have severe pain.

The nurse is providing teaching for a female patient diagnosed with hemophilia A. What statement by the patient indicates a need for further teaching?

'I will be able to use steroids to help my body create the clotting factors.'

A diagnosis of autoimmune thrombocytopenic purpura is made after detection of what finding in the blood?

Antiplatelet antibodies

While caring for a patient diagnosed with hemophilia, the nurse notices swelling around the ankle and knee. What action should the nurse take first?

Contact the health care provider

What laboratory reports should be assessed for complications secondary to thrombotic thrombocytopenic purpura? Select all that apply.

Creatinine Blood urea nitrogen (BUN)

The nurse is caring for a patient diagnosed with septic shock. The patient develops bleeding from puncture sites after a blood draw. What complications does the nurse suspect?

Disseminated intravascular coagulation

The nurse is providing teaching to a patient scheduled for a splenectomy secondary to idiopathic thrombocytopenic purpura (ITP). What teaching is priority?

Risk for infection

What disorder is classified by less than 150,000 platelets per microliter?

Thrombocytopenia

A 35-year-old female complains of bruises on her legs, arms, and thighs and has heavy menstrual bleeding. While taking the medical history of patient, the nurse finds that the patient had a history of frequent nose and gum bleeding. A complete blood count revealed the platelet count to be 10,000 mm 3. What should be the immediate intervention given to the patient?

Transfusing platelets

What percentage of patients diagnosed with hemophilia account for the form of hemophilia called 'Christmas disease'?

20%

The nurse assesses the patient with which hematologic problem first?

81-year-old with thrombocytopenia and an increase in abdominal girth

Which laboratory parameter helps to differentiate between classic hemophilia and Christmas disease?

Coagulation factor

What medications may be given for treatment of heparin- induced thrombocytopenia (HIT)? Select all that apply.

Lepirudin Bivalirudin Argatroban

The nurse is caring for a patient diagnosed with idiopathic thrombocytopenic purpura (ITP). The patient's platelet count is 38,000/mm 3. What treatment does the nurse anticipate for this patient?

Corticosteroids

What findings indicate significant blood loss in a patient diagnosed with idiopathic thrombocytopenic purpura? Select all that apply.

Hematocrit 25% Hemoglobin 9 g/dL

What medication is used to prevent the destruction of antibody- coated platelets in a patient with idiopathic thrombocytopenic purpura?

Intravenous (IV) immunoglobulin

The nurse is caring for a patient diagnosed with idiopathic thrombocytopenic purpura (ITP). What manifestations of this diagnosis should the patient be assessed for? Select all that apply.

Petechiae Ecchymosis Mucosal bleeding

What is the focus of management of thrombotic thrombocytopenic purpura (TTP)? Select all that apply.

Prevention of platelet clumping Stopping the autoimmune process

The nurse is caring for a patient with multiple sclerosis who presents with a petechial rash on the upper chest and neck. Laboratory results show low platelets, hemoglobin, and hematocrit, as well as high megakaryocytes in the bone marrow. What drugs are most likely to be prescribed for this patient? Select all that apply.

Rituximab (Rituxan) Azathioprine (Imuran)

Which laboratory value indicates hemophilia?

Increased partial thromboplastin time

Which drug has a recombinant antihemophilic factor?

Helixate FS

Which clotting disorder may be caused by X-linked inheritance?

Hemophilia A

Which intervention most effectively protects a patient with thrombocytopenia?

Encouraging the use of an electric shaver

What treatment does the nurse expect a patient diagnosed with hemophilia to receive?

Synthetic factor VIII

What clotting factor deficiencies cause hemophilia? Select all that apply.

VIII IX

Which patient is at increased risk for development of hemophilia?

The son of the woman who is a carrier

What symptom is priority for the nurse to assess for in a patient diagnosed with hemophilia A?

Joint swelling

What statement by a patient diagnosed with hemophilia indicates a need for further teaching?

'I have been flossing my teeth once a day.'

A patient diagnosed with idiopathic thrombocytopenic purpura has received teaching about the diagnosis. What statement by the patient indicates a need for further teaching?

'I should not have major issues with clotting.'

Which antihemophilic drug is obtained from animal serum?

Hyate: C

A patient with thrombocytopenia is being discharged. What information does the nurse incorporate into teaching plan for this patient?

'Use a soft-bristled toothbrush.

A patient with thrombocytopenia is being discharged. What information does the nurse incorporate into the teaching plan for this patient?

'Use a soft-bristled toothbrush.

The nurse is caring for four patients. Which patient should the nurse assess first?

A patient diagnosed with hemophilia who is complaining of knee pain

The nurse is caring for a female patient who has been receiving prophylactic heparin following surgery 10 days ago. The patient has swelling and tenderness in the right leg, and laboratory results show low platelets. What drugs are most likely to be prescribed for this patient? Select all that apply.

Argatroban (Acova) Lepirudin (Refludan)

A patient is being treated for thrombotic thrombocytopenic purpura. What does the nurse anticipate administering to reduce the clumping of the platelets? Select all that apply.

Aspirin Alprostadil

Which nursing intervention is priority when caring for a patient diagnosed with thrombotic thrombocytopenic purpura?

Assessing for headache and confusion

Which disorder causes antiplatelet antibody formation even when platelet production is normal?

Autoimmune thrombocytopenic purpura

A patient diagnosed with septic shock should be assessed for which complication?

Disseminated intravascular coagulation

The nurse is caring for a patient diagnosed with idiopathic thrombocytopenic purpura (ITP). The patient's platelet count is 38,000/mm . What treatment does the nurse anticipate for this patient?

Corticosteroids

Which blood product may be administered to a patient diagnosed with thrombotic thrombocytopenic purpura?

Fresh frozen plasma

What laboratory reports should be used to assess a patient diagnosed with idiopathic thrombocytopenic purpura who is symptomatic? Select all that apply.

Hematocrit Hemoglobin

A patient diagnosed with acute liver failure should be assessed for what coagulation disorder?

Hemophilia

A patient presents to the emergency department with a new onset of bruising and a petechial rash around the upper chest and arms. The patient's lab demonstrates a platelet count of 51,000 platelets per milliliter. What action by the nurse is most appropriate?

Implement bleeding precautions

What findings are consistent with a diagnosis of hemophilia? Select all that apply.

Long-term joint problems Tendency to bruise easily Excessive bleeding from minor cuts

What findings are consistent with a diagnosis of idiopathic thrombocytopenic purpura (ITP)? Select all that apply.

Low platelet count Antiplatelet antibodies High megakaryocyte count

What should be assessed when ruling out intracranial bleeding in a patient diagnosed with idiopathic thrombocytopenic purpura (ITP)? Select all that apply.

Mental status Neurologic function

A patient diagnosed with idiopathic thrombocytopenic purpura is scheduled for a splenectomy. What interventions are priority?

Vaccinations two weeks prior to surgery

The nurse is assessing a newly admitted patient with thrombocytopenia. Which factor needs immediate intervention?

Nosebleed

Which platelet disorder involves the failure of blood to clot after a trauma, in spite of having the ability to form blood clots?

OThrombotic thrombocytopenic purpura

Which clotting factor is deficient in patients with hemophilia B?

Plasma thromboplastin

Where are the level defects that cause coagulation disorders? Select all that apply.

Platelet Vascular Clotting factor

What treatment does the nurse anticipate for a patient with a platelet count of 8,000 mm 3?

Platelet transfusion

The nurse is caring for a patient diagnosed with autoimmune idiopathic thrombocytopenic purpura (ITP). The patient's platelet count is 6,000/mm . What treatment should be administered first?

Platelets

What vaccinations are recommended for a patient who is scheduled for a splenectomy? Select all that apply.

Pneumococcal Meningococcal Haemophilus influenza

What lab result would the nurse expect to find in a patient diagnosed with hemophilia A?

Prolonged activated partial thromboplastin time (APTT)

A patient diagnosed with thrombotic thrombocytopenic purpura should be assessed for which complications? Select all that apply.

Renal failure Myocardial infarction Cerebrovascular accident

What trigger is suspected in the production of autoimmune antibodies in autoimmune thrombocytopenic purpura?

Virus

A patient who is pregnant with a girl has a family history of hemophilia. The patient knows she is a carrier and is worried that her daughter will be a carrier and/or be hemophilic. What can the nurse tell her?

There's a 50% chance she will be a carrier but is unlikely to be hemophilic.

Which patient is at highest risk for development of idiopathic thrombocytopenic purpura?

A 30-year-old female with Hashimoto's thyroiditis

What interventions does the nurse include when planning care for a patient diagnosed with thrombocytopenia? Select all that apply.

Avoid venipuncture Apply ice to areas of trauma Use the smallest gauge needle possible

Which statement indicates a failure of blood clotting as a result of hemophilia?

Formation of the fibrin mesh is inadequate to stop the bleeding.