A nurse is reviewing laboratory data from a client who has pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?
Platelets 74,000/mm3
White blood cell count 8,000/mm3
Partial thromboplastin time (PTT) 55 seconds
Hematocrit 45%
The Correct Answer is A
A. Platelets 74,000/mm: A platelet count of 74,000/mm³ is significantly lower than the normal range (typically 150,000 to 450,000/mm³). This could indicate heparin-induced thrombocytopenia (HIT), a serious adverse effect of heparin therapy where the immune system forms antibodies against heparin bound to platelet factor 4, leading to a decrease in platelets and increased risk of thrombosis. This is a critical finding and should be reported immediately to the provider for further evaluation and potential adjustment of the treatment plan.
B. White blood cell count 8,000/mm³: This is within the normal range (typically 4,000 to 11,000/mm³) and does not indicate an immediate problem related to heparin therapy or pulmonary embolism management.
C. Partial thromboplastin time (PTT) 55 seconds: While slightly elevated, this PTT is within the therapeutic range for a patient receiving IV heparin (typically 1.5 to 2.5 times the normal control value, or about 45 to 70 seconds). This indicates that the heparin is having the desired anticoagulant effect.
D. Hematocrit 45%: This is within the normal range for adults (typically 38-50% for men and 35-45% for women) and does not indicate an immediate concern related to heparin therapy or pulmonary embolism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Have suction equipment at the bedside. Clopidogrel is an antiplatelet medication that inhibits blood clot formation. While it does not typically increase the risk of bleeding to the extent that requires constant suctioning, it's prudent to have suction equipment readily available for any patient who may be at risk of bleeding due to their underlying condition or concurrent medications. However, the administration of clopidogrel alone does not necessitate the need for constant suctioning.
B. Monitor the client for black, tarry stools. This is the correct answer. Clopidogrel, like other antiplatelet medications, increases the risk of bleeding, including gastrointestinal bleeding. Black, tarry stools can indicate gastrointestinal bleeding, which can be a serious complication of clopidogrel therapy. Therefore, monitoring for this symptom is essential for early detection of potential bleeding complications.
C. Administer the medication with each meal. Clopidogrel can be administered with or without food, as it is not significantly affected by food intake. However, there is no specific recommendation to administer it with meals. The timing of administration may vary based on the prescriber's instructions or patient preferences, but it does not need to be consistently administered with meals.
D. Initiate contact precautions. Clopidogrel therapy does not require contact precautions. Contact precautions are typically implemented for patients with contagious infections that spread via direct or indirect contact. Clopidogrel does not pose a risk of transmission to others and does not warrant contact precautions.
Correct Answer is B
Explanation
A. Check with a reputable pharmacist: This option is a good practice, especially when starting any new medication or supplement regimen. Pharmacists are trained to understand drug interactions and potential adverse effects. They can provide valuable information about herbal products, their interactions with prescription medications, and potential allergic reactions. However, it might not be the best way to identify allergic reactions firsthand.
B. Take less than the recommended dose initially: This approach, known as dose titration, can be beneficial for identifying potential adverse reactions, including allergies. By starting with a smaller dose, the client can gauge their body's response to the herbal product. If there's any adverse reaction, it's likely to be less severe than if they took a full dose. This option allows for a controlled introduction to the herbal product. This option allows for a controlled introduction to the herbal product, minimizing the risk of severe adverse reactions while still providing valuable information about the client's tolerance and potential allergies.
C. Use only one herbal preparation at a time: This is a prudent approach because it simplifies the process of identifying the cause of any adverse reactions. If the client is using multiple herbal products simultaneously and experiences a reaction, it can be challenging to determine which product is responsible. Using only one product at a time helps isolate the source of any adverse effects, making it easier to identify allergies or other reactions.
D. Never take with prescription medications: This option is not entirely accurate. While it's essential to be cautious about potential interactions between herbal products and prescription medications, there are instances where they can be safely taken together. However, it's crucial to consult with a healthcare provider or pharmacist to ensure there are no contraindications or adverse effects when combining herbal products with prescription medications.
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