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 D
Explanation
A. Food, Drug and Cosmetic Act (FD&C Act): This act sets the groundwork for food and drug regulations, but it's not the specific legislation governing dietary supplements. While FD&C Act applies to some aspects of supplements, DSHEA has more specific regulations.
B. Joint Commission on the Accreditation of Healthcare Organizations (JCAHO): This organization focuses on accrediting healthcare facilities, not regulating supplements.
C. Health and Human Services (HHS): HHS is a broad department encompassing various healthcare agencies, but DSHEA is the specific act within HHS that governs supplements.
D. Dietary Supplement Health and Education Act (DSHEA): This 1994 act specifically addresses dietary supplements, outlining regulations for labeling, manufacturing, and marketing. It places the responsibility for ensuring the safety and effectiveness of supplements on the manufacturers, unlike prescription drugs approved by the FDA.
Correct Answer is D
Explanation
A. Most CAM therapies are not totally ineffective: While some CAM therapies may lack strong scientific evidence, it's not accurate to say they are all ineffective. Some CAM therapies may have benefits, but it's important to be aware of them to avoid interactions.
B. Not all CAM therapies are dangerous: Many CAM therapies are generally safe. However, some can interact with medications or have unforeseen side effects, so assessing use is crucial.
C. Additional treatment may still be needed: Even if a patient uses CAM, they might still require conventional medical treatment. Assessing CAM use helps ensure a complete picture of the patient's healthcare regimen.
D. CAM therapies could interact with prescription and OTC medications. Correct. The primary reason to assess CAM use is to identify potential interactions with medications, potentially improving patient safety and treatment effectiveness.
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