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.
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. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Improved tolerance for daily activities suggests increased energy levels and improved oxygen delivery to tissues, both indicative of effective iron deficiency anemia treatment. Normal hemoglobin levels are 12-16 g/dL for females and 14-18 g/dL for males, supporting enhanced activity tolerance.
Choice B rationale
Decreased paresthesia indicates improved nerve function but is not directly linked to iron deficiency anemia treatment outcomes. Iron deficiency primarily impacts oxygen transport, and improvements in energy levels and activity tolerance are better indicators of therapeutic success.
Choice C rationale
Improved white blood cell count suggests better immune function but does not directly assess anemia treatment efficacy. Iron therapy aims to normalize hemoglobin and hematocrit levels rather than leukocyte parameters, which are unrelated to anemia management.
Choice D rationale
Enhanced balance may indicate improved neuromuscular function but is not directly correlated with anemia treatment. Balance is influenced by multiple factors, including neurological or musculoskeletal health, rather than oxygenation improvements specific to anemia.
Correct Answer is A
Explanation
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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