The nurse is caring for a client who has thrombocytopenia.
Which of the following will the nurse administer for this disorder?

Corticosteroid.

Diphenhydramine.

Desmopressin (DDAVP).

Hydrochlorothiazide (HCTZ).

Answer and Explanation

The Correct Answer is A

Choice A rationale

Corticosteroids are used in thrombocytopenia because they suppress the immune response, particularly in immune thrombocytopenic purpura (ITP). They reduce platelet destruction by inhibiting autoantibody formation and increasing platelet lifespan. Normal platelet count ranges from 150,000 to 400,000/µL. Thrombocytopenia occurs when platelets drop below 150,000/µL, increasing bleeding risk. Corticosteroids can also decrease capillary permeability, minimizing petechiae and ecchymoses.

Choice B rationale

Diphenhydramine, an antihistamine, is used for allergic reactions but has no role in treating thrombocytopenia. It does not address the underlying immune or hematologic causes of low platelet counts. Its primary actions include H1 receptor antagonism, reducing histamine-mediated symptoms like itching and swelling. However, it lacks immunosuppressive or hematologic-stimulating effects essential for managing thrombocytopenia.

Choice C rationale

Desmopressin (DDAVP) is a synthetic antidiuretic hormone analog used for certain bleeding disorders like von Willebrand disease or mild hemophilia A. It increases factor VIII and von Willebrand factor levels, improving clotting. However, it is not indicated for thrombocytopenia as it does not address platelet count deficiencies or immune-mediated platelet destruction.

Choice D rationale

Hydrochlorothiazide (HCTZ) is a thiazide diuretic used for hypertension and edema. Its mechanism of action involves inhibiting sodium reabsorption in the distal tubule, promoting diuresis. HCTZ has no effect on platelet counts or immune mechanisms and is not used in thrombocytopenia. Its side effects, like electrolyte imbalances, may complicate patient management.

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Correct Answer is A

Explanation

Choice A rationale

Venison stew and ice cream are high in animal protein and calcium. Excess dietary calcium and animal protein can increase the urinary excretion of oxalate, contributing to kidney stone formation. Hyperoxaluria leads to the precipitation of calcium oxalate crystals in the renal tubules, exacerbating stone development.

Choice B rationale

Poached salmon and green beans are suitable because salmon is low in oxalate content, and green beans are unlikely to contribute significantly to oxalate excretion. Low-oxalate foods help reduce the recurrence risk of kidney stone formation and support overall renal health.

Choice C rationale

Spinach salad and rhubarb pie are rich in oxalate. Spinach contains 970 mg per 100 g, and rhubarb contributes significantly to dietary oxalate, promoting hyperoxaluria and increasing kidney stone risks. These foods should be avoided by individuals prone to oxalate stones.

Choice D rationale

Sautéed mushrooms and fried rice are acceptable choices, as mushrooms have negligible oxalate content and fried rice does not contribute significantly to oxalate excretion. Both options support balanced nutrition while minimizing renal stone risks.

A. The client is obese and has been exercising for 20 minutes per day twice each week. B. The client has reduced sodium intake from 5 grams per day to 3.5 grams per day. C. The client drinks 1 to 2 glasses of wine with dinner a few nights per week. D. The client has reduced smoking cigarettes from 2 packs per day to 1.5 packs per day.

Correct Answer is A

Explanation

Choice A rationale

Obesity and minimal exercise contribute significantly to hypertension due to increased vascular resistance and poor cardiac health. Recommendations for hypertension management include regular physical activity at least 30 minutes daily, five times per week. Current exercise efforts are insufficient, indicating a need for intervention to optimize blood pressure reduction.

Choice B rationale

Sodium intake reduction to 3.5 grams daily is an improvement but still exceeds the recommended limit of 2.3 grams. Excess sodium contributes to hypertension by increasing fluid retention and vascular resistance, though this change alone does not prioritize follow-up over sedentary behavior, which has a larger impact.

Choice C rationale

Alcohol consumption can elevate blood pressure by affecting vascular tone and increasing sympathetic nervous system activity. While 1-2 glasses per day may be within moderation, prioritizing increased physical activity would have a greater benefit on hypertension management than reducing alcohol intake alone.

Choice D rationale

Reducing cigarette smoking from 2 packs to 1.5 packs per day lowers nicotine exposure but still significantly contributes to hypertension through vasoconstriction and arterial damage. Exercise intervention is more impactful for cardiovascular health and blood pressure management in this context.

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The nurse is caring for a client who has thrombocytopenia.Which of the following will the nurse administer for this disorder?

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The nurse is caring for a client who has thrombocytopenia.
Which of the following will the nurse administer for this disorder?