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:
Shortness of breath is not typically associated with Meniere’s disease. This condition primarily affects the inner ear, leading to symptoms related to balance and hearing. Shortness of breath is more commonly linked to respiratory or cardiovascular issues.
Choice B Reason:
Chest pain is not a characteristic symptom of Meniere’s disease. Chest pain is usually related to cardiac or musculoskeletal problems. Meniere’s disease affects the inner ear and does not typically cause chest pain.
Choice C Reason:
Fever is not a common symptom of Meniere’s disease. Fever is generally associated with infections or inflammatory conditions. Meniere’s disease involves the buildup of fluid in the inner ear, leading to vertigo, tinnitus, and hearing loss, but not fever.
Choice D Reason:
Vertigo is the most characteristic symptom of Meniere’s disease. Vertigo involves a spinning sensation that can be severe and debilitating. It is caused by the abnormal fluid buildup in the inner ear, which disrupts the balance and hearing functions. This symptom is a hallmark of Meniere’s disease and is often accompanied by tinnitus and hearing loss.
Correct Answer is C
Explanation
Choice A: Optic Neuritis
Optic neuritis is an inflammation of the optic nerve that can cause pain and vision loss. The pain typically worsens with eye movement, and vision loss usually occurs in one eye. Symptoms include temporary vision loss, visual field loss, loss of color vision, and flashing lights. However, optic neuritis does not typically cause nausea or seeing halos around lights, and the pupil reaction to light is usually preserved.
Choice B: Macular Degeneration
Macular degeneration primarily affects central vision and is more common in older adults. It can cause blurred or reduced central vision, difficulty recognizing faces, and visual distortions such as straight lines appearing bent. However, it does not cause sudden onset eye pain, nausea, or seeing halos around lights. The pupil reaction to light remains normal in macular degeneration.
Choice C: Narrow Angle Glaucoma
Narrow angle glaucoma, also known as acute angle-closure glaucoma, is a medical emergency characterized by a sudden increase in intraocular pressure. Symptoms include severe eye pain, nausea, vomiting, seeing halos around lights, and a mid-dilated, non-reactive pupil. This condition occurs when the drainage angle between the iris and cornea becomes blocked, leading to a rapid rise in eye pressure. Immediate treatment is necessary to prevent permanent vision loss.
Choice D: Cataract
Cataracts cause clouding of the lens, leading to symptoms such as blurred vision, difficulty seeing at night, sensitivity to light, and seeing halos around lights. However, cataracts develop gradually and do not cause sudden onset eye pain or nausea. The pupil reaction to light is also typically normal in cataract patients.
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