The nurse is caring for patient with a history of atrial fibrillation who is prescribed warfarin. Sometimes I forget my medication, so l double up doses when I remember " The patient's PT and INR are highly elevated. The nurse anticipates the transfusion of which blood product?
Packed Red Blood Cells (PRBC's)
Platelets
Cryoprecipitate
Fresh Frozen Plasma (FFP)
The Correct Answer is D
A) Packed Red Blood Cells (PRBCs):
Packed Red Blood Cells are typically transfused when there is anemia or significant blood loss leading to low hemoglobin levels. In the case of warfarin overdose or elevated PT/INR, the problem is related to coagulation and not red blood cell count.
B) Platelets:
Platelets are typically transfused when there is thrombocytopenia or a need to address platelet dysfunction (e.g., in patients with bleeding due to low platelet counts). However, the elevated PT and INR in this case are related to the coagulation cascade being inhibited by warfarin, not platelet deficiency.
C) Cryoprecipitate:
Cryoprecipitate is primarily used to replace clotting factors such as fibrinogen, factor VIII, and von Willebrand factor. It is typically transfused in patients with hemophilia or bleeding disorders related to low fibrinogen levels. However, in this case, the issue is related to warfarin-induced inhibition of clotting factors (specifically the vitamin K-dependent factors: II, VII, IX, and X), not a deficiency in fibrinogen or specific clotting factors addressed by cryoprecipitate.
D) Fresh Frozen Plasma (FFP):
Fresh Frozen Plasma (FFP) is the most appropriate choice for this patient. FFP contains all the coagulation factors, including the vitamin K-dependent factors that warfarin inhibits. When a patient on warfarin presents with elevated PT and INR (which indicates impaired clotting ability), FFP is used to replace the clotting factors and help reverse the effects of warfarin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Provide honest answers to the client’s questions:
Providing honest answers to the client's questions is essential in promoting comfort, especially when they have a new diagnosis of bladder cancer. Patients often experience anxiety and uncertainty when facing a new diagnosis, so being open and transparent with information can help alleviate fears and build trust.
B) Avoid eye contact with the client during care:
Avoiding eye contact with the client can contribute to feelings of isolation and discomfort. Eye contact is an important form of non-verbal communication that can help establish a rapport and show empathy. Avoiding eye contact could make the client feel rejected or neglected, which would increase their anxiety and distress.
C) Provide limited explanations of procedures needed for care:
Providing limited explanations of procedures may leave the client feeling more confused or fearful about what is happening. While it's important to avoid overwhelming the patient with too much information, clear and concise explanations about procedures and treatments are essential to reduce anxiety and help the patient feel more in control of the situation.
D) Avoid giving the client choices regarding their care:
Avoiding giving the patient choices can make them feel powerless, which can increase feelings of anxiety and frustration. Offering choices when appropriate allows the patient to feel more in control of their care, which can reduce stress and enhance their sense of autonomy.
Correct Answer is A
Explanation
A) Insertion of a cardioverter-defibrillator:
Hypertrophic cardiomyopathy (HCM) is a condition characterized by abnormal thickening of the heart muscle, particularly the septum, which can lead to obstruction of blood flow and contribute to the development of arrhythmias. The most concerning arrhythmias in HCM include ventricular tachycardia and ventricular fibrillation, both of which can lead to sudden cardiac arrest. A cardioverter-defibrillator (ICD) is a device that monitors the heart's rhythm and can deliver a shock to restore normal rhythm in the event of a life-threatening arrhythmia.
B) A medication regimen that includes nitrates:
Nitrates are vasodilators commonly used in the treatment of conditions like angina and heart failure. However, nitrates are generally avoided in patients with hypertrophic cardiomyopathy because they can exacerbate the condition by decreasing preload and increasing the outflow tract obstruction due to the thickened heart muscle.
C) Immediate cardiac transplantation:
Cardiac transplantation is a treatment for end-stage heart failure, typically in patients who have not responded to medical or surgical treatments. While hypertrophic cardiomyopathy can lead to heart failure, it is not the first line treatment for dysrhythmias or complications from the disease.
D) Insertion of a drug-eluting stent:
Drug-eluting stents are used to prevent restenosis (narrowing) of coronary arteries after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). However, hypertrophic cardiomyopathy is not caused by coronary artery disease.
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