Which laboratory information will the nurse monitor to detect heparin-induced thrombocytopenia (HIT) in a patient who is receiving a continuous heparin infusion?
Erythrocyte count
Fibrinogen degradation products
Activated partial thromboplastin time (aPTT)
Prothrombin time (PT)
The Correct Answer is C
A. Erythrocyte count: The red blood cell count reflects oxygen-carrying capacity and anemia but does not indicate platelet destruction or immune-mediated reactions. HIT specifically affects platelets, so monitoring erythrocytes would not detect this complication.
B. Fibrinogen degradation products: Fibrinogen degradation products (FDPs) are elevated in disseminated intravascular coagulation or significant clot breakdown. While they reflect fibrinolytic activity, they are not specific or sensitive for heparin-induced thrombocytopenia.
C. Activated partial thromboplastin time (aPTT): Although aPTT is used to monitor therapeutic anticoagulation during heparin infusion, frequent platelet counts are the most direct laboratory marker for HIT. Monitoring aPTT ensures the patient is within the therapeutic range, but detection of a sudden drop in platelet count is crucial for early recognition of HIT.
D. Prothrombin time (PT): PT evaluates the extrinsic coagulation pathway and is primarily used to monitor warfarin therapy. It is not sensitive to heparin therapy or the development of HIT, which involves immune-mediated platelet activation and thrombocytopenia rather than changes in PT.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Ensure the pressure bag around the flush solution is inflated to 300 mm Hg: The flush solution pressure bag must be maintained at approximately 300 mm Hg to ensure continuous perfusion of the arterial line, prevent clot formation, and maintain accurate arterial pressure waveform readings. Proper inflation is essential for line patency and reliable hemodynamic monitoring.
B. Flush the line before administering antibiotics: Flushing the arterial line for medication administration is not standard practice because arterial lines are primarily for monitoring and blood sampling. Administering medications through an arterial line can be dangerous unless specifically ordered, and antibiotics are usually given via a venous route.
C. Instruct the patient to bear down when readings are obtained: Bearing down (Valsalva maneuver) can artificially alter arterial pressure readings and is not appropriate during hemodynamic monitoring. Accurate measurements require the patient to be relaxed and in a neutral position.
D. Position the patient in Trendelenburg to obtain readings: Trendelenburg positioning is not necessary for arterial line readings and may actually affect hemodynamic values. The patient should be positioned comfortably, with the transducer leveled to the phlebostatic axis for accurate pressure measurement.
Correct Answer is ["20"]
Explanation
- Identify the ordered infusion rate and available concentration
Infusion Rate: 9 mL/hr
Available Concentration: 1000 mg/100 mL = 10 mg/mL
- Calculate the total mg/hr being infused
Total mg/hr = 9 × 10
= 90 mg/hr
- Convert mg/hr to mcg/min
90 mg/hr × 1000 mcg/mg = 90,000 mcg/hr
90,000 ÷ 60 min = 1,500 mcg/min
- Calculate mcg/kg/min
Patient weight: 75 kg
Rate = 1,500 ÷ 75
= 20 mcg/kg/min
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