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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
- White Blood Cell Count (WBC): WBCs are part of the immune system and play a role in fighting infections. However, they are not directly involved in hemostasis or clot formation. WBCs do not adhere to the vessel wall during hemostasis.
- Activated Partial Thromboplastin Time (aPTT): aPTT measures the time it takes for blood to clot. It is primarily used to monitor heparin therapy, not warfarin. aPTT is not specific for warfarin monitoring.
- Prothrombin Time (PT): PT measures how quickly blood clots. It is used to monitor warfarin therapy and assess clotting factors. PT is essential for monitoring warfarin effectiveness.
- Platelet Count: Platelets are crucial for clot formation. Platelet count helps assess platelet function. Platelets play a direct role in hemostasis.
Correct Answer is D
Explanation
A. May improve cardiac function: This statement avoids claiming to diagnose, treat, cure, or prevent disease. It uses general language about supporting heart health, which is permissible.
B. May reduce pain and inflammation: Similar to option A, this statement avoids disease claims and uses general terms about pain and inflammation, which is allowed.
C. Helps promote a healthy immune system: This follows the same principle. It avoids disease claims and uses general language regarding the immune system.
D. Reduces blood pressure and the risk for stroke: This statement specifically mentions a disease (stroke) and claims to reduce its risk. Dietary supplement labels are not allowed to make disease claims. They can only make general claims about supporting bodily functions.
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