A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelets are low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?
Transfusion of platelets
Replacement of ADAMTS-13
Administration of protamine sulfate
Laparoscopic splenectomy
The Correct Answer is D
A. While a platelet transfusion can temporarily increase platelet counts, it does not reduce the destruction of platelets in ITP and is generally not effective as a long-term solution.
B. Replacement of ADAMTS-13 is relevant in thrombotic thrombocytopenic purpura (TTP), not ITP. It is not used for reducing platelet destruction in ITP.
C. Protamine sulfate is an antidote for heparin overdose and does not address the platelet destruction in ITP.
D. A laparoscopic splenectomy is often considered for clients with ITP who do not respond to medication therapy. The spleen is a primary site for platelet destruction, and its removal can reduce the destruction of platelets, leading to increased platelet counts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Lisinopril is not used to reduce LDL cholesterol and triglycerides; statins are used for that purpose.
B. Lisinopril does not prevent platelet aggregation; antiplatelet agents like aspirin are used for that purpose.
C. Lisinopril is not used to relieve acute angina; nitrates like nitroglycerin are used for that purpose.
D. Lisinopril is an ACE inhibitor that helps decrease blood pressure and reduce the workload on the heart, which is beneficial in managing chronic stable angina.
Correct Answer is A
Explanation
A. Transporting the patient to the cardiac catheterization lab for percutaneous coronary intervention (PCI) is the priority intervention for a patient with an ST-elevation myocardial infarction (STEMI). PCI is the preferred treatment to restore blood flow to the affected coronary artery.
B. Aggressive diuresis and digoxin are not appropriate for the acute management of a STEMI. Diuresis may be used in cases of heart failure but is not the immediate priority.
C. Synchronized cardioversion and radiofrequency catheter ablation are treatments for certain arrhythmias but are not indicated for the acute management of STEMI.
D. Administering gemfibrozil, a lipid-lowering agent, and preparing for a stress test are not appropriate interventions in the acute setting of a STEMI. Immediate reperfusion therapy is necessary.
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