A 55-year-old patient with thrombocytopenia is scheduled for a venipuncture procedure. Which of the following actions should the nurse take to minimize the risk of bleeding?
Instruct the patient to elevate the arm above the heart immediately after the procedure.
Apply firm pressure to the site for at least 10 minutes after the procedure.
Avoid using a tourniquet during the procedure.
Use a larger gauge needle to ensure quicker blood flow.
The Correct Answer is B
Choice A: Instruct the patient to elevate the arm above the heart immediately after the procedure
Elevating the arm above the heart can help reduce blood flow to the area, potentially minimizing bleeding. However, this method alone is not sufficient to ensure proper hemostasis, especially in patients with thrombocytopenia. Applying direct pressure to the puncture site is more effective in stopping bleeding and preventing hematoma formation.
Choice B: Apply firm pressure to the site for at least 10 minutes after the procedure
Applying firm pressure to the venipuncture site is crucial in patients with thrombocytopenia to ensure proper clotting and prevent bleeding. This method helps in forming a stable clot at the puncture site, reducing the risk of prolonged bleeding and hematoma formation. Given the patient’s low platelet count, maintaining pressure for an extended period is essential to achieve hemostasis.
Choice C: Avoid using a tourniquet during the procedure
While avoiding a tourniquet might seem beneficial to reduce pressure on the veins, it is not a standard practice to minimize bleeding risk in thrombocytopenic patients. Tourniquets are typically used to make veins more prominent for easier access during venipuncture. The key to minimizing bleeding is proper post-procedure care, such as applying firm pressure to the site.
Choice D: Use a larger gauge needle to ensure quicker blood flow
Using a larger gauge needle is not advisable for patients with thrombocytopenia. Larger needles can cause more trauma to the vein, increasing the risk of bleeding and hematoma formation. Instead, using the smallest gauge needle that can effectively draw blood is recommended to minimize vein damage.
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Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Increased appetite is not typically associated with anemia. Anemia generally leads to symptoms related to decreased oxygen-carrying capacity of the blood, such as fatigue, weakness, and shortness of breath. Increased appetite is more commonly linked to other conditions, such as hyperthyroidism or certain metabolic disorders.
Choice B Reason:
Fatigue is a common and significant symptom of anemia. When hemoglobin levels are low, the body’s tissues do not receive adequate oxygen, leading to feelings of tiredness and exhaustion. This is because hemoglobin is responsible for transporting oxygen from the lungs to the rest of the body. In anemia, the reduced oxygen delivery results in decreased energy levels and persistent fatigue.
Choice C Reason:
Weight gain is not typically associated with anemia. In fact, some forms of anemia, such as those caused by chronic diseases or malnutrition, may lead to weight loss rather than gain. Weight gain can be associated with other health issues, such as hypothyroidism or fluid retention, but not directly with anemia.
Choice D Reason:
Hypertension is not a common manifestation of anemia. Anemia usually leads to symptoms like pallor, shortness of breath, and fatigue due to the reduced oxygen-carrying capacity of the blood. Hypertension, or high blood pressure, is more commonly associated with cardiovascular diseases, kidney disorders, or endocrine conditions.
Correct Answer is A
Explanation
Choice A Reason:
An adenoma of the parathyroid gland is the most common cause of primary hyperparathyroidism. This benign tumor leads to the overproduction of parathyroid hormone (PTH), which in turn causes elevated calcium levels in the blood. The excessive PTH secretion disrupts the normal calcium balance, leading to symptoms such as fatigue, muscle weakness, and depression. Parathyroid adenomas account for approximately 80% of primary hyperparathyroidism cases.
Choice B Reason:
Thyroid carcinoma is a type of cancer that originates in the thyroid gland, not the parathyroid glands. While thyroid carcinoma can cause various symptoms, it does not typically lead to elevated PTH levels or hyperparathyroidism. Therefore, it is not the most likely cause of the patient’s condition.
Choice C Reason:
Vitamin D deficiency can lead to secondary hyperparathyroidism, where low levels of vitamin D cause decreased calcium absorption, prompting the parathyroid glands to produce more PTH to maintain calcium levels. However, this condition is usually associated with low or normal calcium levels, not elevated calcium levels as seen in this patient. Therefore, it is not the most likely cause of her hyperparathyroidism.
Choice D Reason:
Chronic kidney disease (CKD) can also cause secondary hyperparathyroidism due to impaired kidney function, which affects calcium and phosphate balance and vitamin D metabolism. However, similar to vitamin D deficiency, CKD-related hyperparathyroidism typically presents with low or normal calcium levels rather than elevated levels. Thus, it is not the most likely cause in this scenario.
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