A nurse is reviewing the laboratory results of a client who had a postpartum hemorrhage due to placenta accreta.
The nurse notes that the client’s platelet count is 80,000/mm3, fibrinogen level is 150 mg/dL, and prothrombin time is 18 seconds.
What is the most appropriate interpretation of these findings?
The client has normal coagulation parameters
The client has mild coagulation impairment
The client has moderate coagulation impairment
The client has severe coagulation impairment
The Correct Answer is D
The client has severe coagulation impairment.
This is because the client’s platelet count, fibrinogen level, and prothrombin time are all significantly abnormal compared to the normal ranges.
• The normal platelet count is 150,000 to 450,000/mm3.
A platelet count of 80,000/mm3 indicates thrombocytopenia, which is a low number of platelets that can impair clotting and cause bleeding.
• The normal fibrinogen level is 200 to 400 mg/dL.
A fibrinogen level of 150 mg/dL indicates hypofibrinogenemia, which is a low level of fibrinogen that can impair clotting and cause bleeding.
• The normal prothrombin time is 11 to 13.5 seconds.
A prothrombin time of 18 seconds indicates a prolonged clotting time that can impair clotting and cause bleeding.
Choice A is wrong because the client does not have normal coagulation parameters.
All three tests are abnormal and indicate a severe coagulation impairment.
Choice B is wrong because the client does not have mild coagulation impairment.
The degree of abnormality in the test results is too high to be considered mild.
Choice C is wrong because the client does not have moderate coagulation impairment.
The degree of abnormality in the test results is too high to be considered moderate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Oxytocin is a hormone that causes the uterine muscles to contract and compress the blood vessels that connect the uterus to the placenta.This helps prevent excessive bleeding after delivery, especially in cases of uterine atony, which is the failure of the uterus to contract sufficiently.
Choice B is wrong because oxytocin does not have any direct effect on infection or wound healing.
Choice C is wrong because oxytocin does not enhance milk production, although it does facilitate milk ejection during breastfeeding.Choice D is wrong because oxytocin does not relieve pain or discomfort from uterine cramping, but rather causes it by stimulating contractions.
Correct Answer is C
Explanation
Oxytocin is the most effective medication for preventing and treating postpartum hemorrhage caused by uterine atony, which is the failure of the uterus to contract after delivery.Oxytocin stimulates uterine contractions and reduces bleeding.
Choice A is wrong because methylergonovine maleate (Methergine) is a second-line uterotonic drug that can cause hypertension and should not be used in women with high blood pressure.
Choice B is wrong because magnesium sulfate (MgSO4) is used to prevent seizures in women with preeclampsia or eclampsia, not to treat postpartum hemorrhage.
Choice D is wrong because carboprost tromethamine (Hemabate) is another second-line uterotonic drug that can cause severe diarrhea and bronchospasm and should not be used in women with asthma.
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