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).
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is A
Explanation
Choice A rationale
Stones lodged in the ureter cause severe, colicky pain due to intense peristaltic waves attempting to dislodge the obstruction. The pain often radiates down the thigh and groin as the ureter's path follows these areas. Additionally, urinary retention or frequent urges with minimal voiding occurs due to irritation and partial blockage, confirming ureteral stone involvement.
Choice B rationale
While some stones may pass spontaneously, timing varies widely depending on size, location, and hydration levels. Pain and obstruction may persist longer than a few hours, making this statement misleading without further assessment.
Choice C rationale
Bladder stones may cause lower abdominal pain, frequency, and hematuria but do not typically involve radiating pain to the groin or thigh. The described symptoms strongly suggest ureteral obstruction rather than bladder involvement.
Choice D rationale
While procedural removal is an option for large or immovable stones, initial approaches often include pain control, hydration, and medical expulsive therapy. Surgical intervention is not the first-line explanation unless conservative management fails.
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