A nurse is reviewing the PT/INR and aPTT laboratory values for a client who is experiencing an acute episode of disseminated intravascular coagulation (DIC). Which of the following laboratory results should the nurse expect?
The laboratory values are increased
The laboratory values are decreased
The laboratory values are within the expected reference range
The laboratory values are the same as the previous test values
The Correct Answer is A
A. The laboratory values are increased: In disseminated intravascular coagulation (DIC), both the prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) are typically increased because excessive clotting leads to the consumption of clotting factors, which results in prolonged clotting times.
B. The laboratory values are decreased: A decrease in PT/INR and aPTT would indicate that blood clotting is occurring faster than normal, which is not consistent with DIC. In DIC, the clotting factors are consumed, which results in prolonged clotting times, not shorter.
C. The laboratory values are within the expected reference range: If PT/INR and aPTT are within the normal range, it would not be expected in a case of DIC. DIC causes abnormal results, including increased clotting times, not normal results.
D. The laboratory values are the same as the previous test values: In DIC, the lab values would not be expected to remain unchanged. As the condition progresses, there should be notable changes in PT/INR and aPTT due to the ongoing consumption of clotting factors.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "PEEP will prevent lung damage while the patient is on the ventilator.": While PEEP helps keep the lungs inflated, it is not specifically aimed at preventing lung damage. Its primary function is to prevent alveolar collapse and improve oxygenation.
B. "PEEP will push more air into the lungs during inhalation.": PEEP does not affect the volume of air delivered during inhalation. It helps keep the alveoli open during exhalation, but does not increase the amount of air pushed into the lungs during inhalation.
C. "PEEP prevents the alveoli from collapsing during exhalation.": PEEP applies pressure to the lungs at the end of exhalation, preventing the alveoli from collapsing, which improves oxygenation by maintaining functional residual capacity and enhancing gas exchange.
D. "PEEP allows the breathing machine to deliver 100% O2 to the lungs.": PEEP does not affect the percentage of oxygen delivered. It works to improve oxygenation by keeping the alveoli open, but the fraction of inspired oxygen (FiO2) is what determines the oxygen concentration delivered by the ventilator.
Correct Answer is C
Explanation
To calculate the total intravenous fluids infused in 24 hours for a burn client, use the Parkland formula.
- Calculate Fluid Resuscitation Volume (Parkland Formula)
Convert client's weight from pounds (lb) to kilograms (kg).
Client weight = 147.4 lb / 2.2 lb/kg
= 67 kg.
- Calculate the total fluid volume needed for the first 24 hours using the Parkland formula.
Parkland Formula = 4 mL × client weight (kg) × % TBSA burned
Total fluid volume (24 hrs) = 4 mL × 67 kg × 31.5%
= 8442 mL.
- Calculate Insulin Infusion Volume in 24 hours
Concentration of the insulin solution = 100 units / 100 mL
= 1 unit/mL.
- Calculate the volume of insulin solution infused per hour.
Infusion rate = 5 units/hr
Volume infused per hour (mL/hr) = Desired units/hr / Concentration (units/mL)
= 5 units/hr / 1 unit/mL
= 5 mL/hr.
- Calculate the total volume of insulin solution infused in 24 hours.
Total insulin volume (24 hrs) = Volume infused per hour (mL/hr) × 24 hours
= 5 mL/hr × 24 hours
= 120 mL.
- Calculate Total Intravenous Fluids Infused in 24 hours
Total IV fluids = Total fluid resuscitation volume + Total insulin volume
= 8442 mL + 120 mL Total IV fluids
= 8562 mL.
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