The nurse is obtaining the health history from a client who was admitted with a platelet defect.
Which of the following information should be a priority for the nurse to obtain?

Reports of ecchymosis or wet purpura.

Any upcoming dental or invasive procedure appointments.

Over-the-counter and prescription medication use.

Family and genetic history.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Ecchymosis and wet purpura indicate abnormal bleeding tendencies often observed in platelet defects. While these findings are relevant, they are secondary to identifying medications that could exacerbate platelet dysfunction. Medication history directly influences the management plan by addressing reversible causes of thrombocytopenia, emphasizing its priority over descriptive bleeding symptoms.

Choice B rationale

Upcoming dental or invasive procedures are relevant to thrombocytopenia risks due to potential bleeding complications. However, these appointments do not provide immediate insight into causative factors of the platelet defect. Determining medication use offers direct information regarding drug-related impacts on platelet function, prioritizing it for management and diagnostic purposes over procedural risks.

Choice C rationale

Over-the-counter and prescription medication use are critical to evaluate because certain drugs can induce or worsen platelet defects. For example, NSAIDs like aspirin inhibit platelet aggregation and contribute to bleeding risks. Establishing this information helps guide management by identifying reversible causes and reducing complications associated with defective platelet function.

Choice D rationale

Family and genetic history offer valuable insights into inherited platelet disorders but are less immediately actionable for addressing acute platelet defects. Medications causing or contributing to thrombocytopenia present modifiable factors, prioritizing their identification over hereditary predispositions. Addressing medication-induced platelet dysfunction provides practical management strategies for preventing bleeding complications. .

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Correct Answer is B

Explanation

Choice A rationale

Lower extremity edema is often associated with right-sided heart failure rather than left ventricular failure. Right-sided failure leads to systemic venous congestion, causing fluid accumulation in peripheral tissues like the legs. Left ventricular failure predominantly affects pulmonary circulation, making edema of the lower extremities a less expected finding.

Choice B rationale

Pulmonary crackles are a hallmark finding in left ventricular failure due to fluid accumulation in the alveoli. This occurs because reduced cardiac output causes blood to back up into pulmonary veins and capillaries, increasing hydrostatic pressure and leading to pulmonary congestion. Crackles indicate the presence of interstitial or alveolar fluid, a direct result of left-sided dysfunction.

Choice C rationale

Ascites results from portal hypertension and systemic venous congestion, typically seen in right-sided heart failure or advanced liver disease. Left ventricular failure impacts the pulmonary system rather than the abdominal cavity, making ascites an unlikely finding during assessment for this condition.

Choice D rationale

Jugular vein distention is indicative of systemic venous congestion caused by right-sided heart failure. In left ventricular failure, pulmonary congestion dominates, and jugular vein distention is not a primary finding. Assessments should focus on symptoms directly linked to pulmonary effects such as crackles or dyspnea.

A. I will decrease my caffeine intake down to one cup per day. B. I should drink grapefruit juice instead of orange juice in the morning. C. I will practice Kegel exercises regularly. D. I should have a fixed time schedule for going to the bathroom.

Correct Answer is B

Explanation

Choice A rationale

Decreasing caffeine intake is a proven method for managing urinary incontinence. Caffeine stimulates bladder activity, potentially worsening symptoms. Reducing caffeine to one cup per day can decrease urgency and frequency. This recommendation aligns with the scientific understanding that caffeine is a bladder irritant and is supported by clinical guidelines on managing urinary incontinence.

Choice B rationale

Grapefruit juice is acidic and can irritate the bladder lining, worsening urinary incontinence symptoms. Substituting orange juice with grapefruit juice does not address the problem, as both are acidic and contain bladder irritants. Citrus juices, including grapefruit and orange, are often advised against for patients managing urinary incontinence due to their potential to exacerbate symptoms.

Choice C rationale

Kegel exercises strengthen the pelvic floor muscles, enhancing bladder control and reducing incontinence episodes. This evidence-based practice is recommended for individuals with urinary incontinence. Regular Kegel exercise improves urinary sphincter function and supports the overall health of pelvic muscles, which is key for managing incontinence.

Choice D rationale

Establishing a fixed schedule for bathroom visits can prevent overdistension of the bladder and manage symptoms of urinary incontinence effectively. Timed voiding helps train the bladder and reduce episodes of urgency or leakage. It is widely supported as part of behavioral therapy for urinary incontinence management.

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The nurse is obtaining the health history from a client who was admitted with a platelet defect.Which of the following information should be a priority for the nurse to obtain?

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The nurse is obtaining the health history from a client who was admitted with a platelet defect.
Which of the following information should be a priority for the nurse to obtain?