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 D
Explanation
Choice A Reason:
Primary hyperparathyroidism is characterized by elevated PTH levels, which lead to increased serum calcium levels and decreased serum phosphate levels. The patient’s lab results show low PTH and low serum calcium, which are not consistent with primary hyperparathyroidism.
Choice B Reason:
Chronic kidney disease (CKD) can cause disturbances in calcium and phosphate metabolism, but it typically presents with elevated PTH levels due to secondary hyperparathyroidism. The patient’s low PTH levels make CKD an unlikely diagnosis in this context.
Choice C Reason:
Vitamin D deficiency can lead to low serum calcium levels, but it usually results in elevated PTH levels as the body attempts to compensate for the low calcium. The patient’s low PTH levels do not align with a diagnosis of vitamin D deficiency.
Choice D Reason:
Hypoparathyroidism is characterized by low serum calcium, low PTH levels, and elevated serum phosphate levels. This condition occurs when the parathyroid glands do not produce enough PTH, leading to the observed lab results and symptoms such as tingling, muscle cramps, and fatigue. The patient’s lab results are consistent with hypoparathyroidism.
Correct Answer is A
Explanation
Choice A Reason:
Cloudiness in the lens of the eyes is the hallmark symptom of cataracts. Cataracts cause the lens to become opaque, leading to blurred vision and difficulty seeing clearly. This cloudiness can make it challenging to perform everyday tasks and is the most indicative sign of cataracts.
Choice B Reason:
Double vision in one eye can occur with cataracts, but it is not the most indicative symptom. While cataracts can cause visual disturbances, the primary symptom is the cloudiness of the lens, which directly impacts vision clarity.
Choice C Reason:
Eye pain and redness are not typical symptoms of cataracts. These symptoms are more commonly associated with other eye conditions such as infections or glaucoma. Cataracts primarily cause visual disturbances without significant pain or redness.
Choice D Reason:
Sudden loss of vision is not characteristic of cataracts. Cataracts develop gradually over time, leading to a slow progression of vision impairment. Sudden vision loss is more likely to be associated with acute conditions such as retinal detachment or vascular occlusions.
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