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 B
Explanation
Choice A rationale
Waiting one month before reevaluating blood pressure may overlook potential adherence issues or medication effects. Hypertension requires timely intervention because consistently high values can lead to complications such as stroke or heart attack. The readings of 145/92 mm Hg and 150/89 mm Hg are above the normal range (<120/80 mm Hg), necessitating immediate review of possible contributing factors rather than postponing evaluation.
Choice B rationale
Adherence to lifestyle modifications and prescribed therapies directly affects blood pressure control. Factors such as diet, exercise, and medication compliance significantly influence systolic and diastolic values. Poor adherence can lead to inadequate control of hypertension, which is evident in the readings of 145/92 mm Hg and 150/89 mm Hg. Exploring adherence helps identify reasons for high readings and can guide targeted interventions.
Choice C rationale
Increasing medication dosage without first reviewing adherence overlooks potential causes of suboptimal control such as missed doses, incorrect timing, or lifestyle factors. Adjusting doses may lead to overtreatment, causing complications like hypotension. Addressing adherence first ensures interventions are appropriate and prevents unnecessary medication changes.
Choice D rationale
Adding a calcium-channel blocker involves modifying therapy without investigating adherence to current medications and lifestyle changes. Such an approach risks complicating the treatment plan unnecessarily. It is scientifically prudent to first evaluate the effectiveness of existing treatments through adherence assessments, ensuring interventions are tailored to the individual's needs.
Correct Answer is B
Explanation
Choice A rationale
Teaching preventive measures is important for reducing recurrence of urinary tract infections (UTIs). These measures may include proper hydration, perineal hygiene, and urinating after intercourse. However, addressing preventive strategies is a long-term consideration and not the immediate priority for managing the active infection or preventing acute complications.
Choice B rationale
Preventing progression to complications is the priority in lower UTIs to avoid upper urinary tract involvement, such as pyelonephritis. This involves timely antibiotic administration and monitoring for signs like fever, flank pain, or worsening urinary symptoms. Pyelonephritis can lead to systemic complications like sepsis, making prevention critical to client safety.
Choice C rationale
Educating about treatment, such as the prescribed antibiotics and their potential side effects, ensures adherence and understanding. While valuable, it does not take precedence over immediate measures to halt disease progression or complications. Education supports long-term management but follows urgent clinical priorities.
Choice D rationale
Pain management is essential for comfort, addressing dysuria or pelvic pain associated with UTIs. Methods include analgesics like phenazopyridine. However, it is a supportive measure rather than a critical intervention for preventing complications, making it secondary to stopping the progression of the infection.
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