A 55-year-old patient with thrombocytopenia is scheduled for a venipuncture procedure. Which of the following actions should the nurse take to minimize the risk of bleeding?
Instruct the patient to elevate the arm above the heart immediately after the procedure.
Apply firm pressure to the site for at least 10 minutes after the procedure.
Avoid using a tourniquet during the procedure.
Use a larger gauge needle to ensure quicker blood flow.
The Correct Answer is B
Choice A: Instruct the patient to elevate the arm above the heart immediately after the procedure
Elevating the arm above the heart can help reduce blood flow to the area, potentially minimizing bleeding. However, this method alone is not sufficient to ensure proper hemostasis, especially in patients with thrombocytopenia. Applying direct pressure to the puncture site is more effective in stopping bleeding and preventing hematoma formation.
Choice B: Apply firm pressure to the site for at least 10 minutes after the procedure
Applying firm pressure to the venipuncture site is crucial in patients with thrombocytopenia to ensure proper clotting and prevent bleeding. This method helps in forming a stable clot at the puncture site, reducing the risk of prolonged bleeding and hematoma formation. Given the patient’s low platelet count, maintaining pressure for an extended period is essential to achieve hemostasis.
Choice C: Avoid using a tourniquet during the procedure
While avoiding a tourniquet might seem beneficial to reduce pressure on the veins, it is not a standard practice to minimize bleeding risk in thrombocytopenic patients. Tourniquets are typically used to make veins more prominent for easier access during venipuncture. The key to minimizing bleeding is proper post-procedure care, such as applying firm pressure to the site.
Choice D: Use a larger gauge needle to ensure quicker blood flow
Using a larger gauge needle is not advisable for patients with thrombocytopenia. Larger needles can cause more trauma to the vein, increasing the risk of bleeding and hematoma formation. Instead, using the smallest gauge needle that can effectively draw blood is recommended to minimize vein damage.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
Choice A Reason:
Administering diuretics to increase urine output is not appropriate in this scenario. Diuretics would exacerbate dehydration and further increase serum sodium levels by promoting additional water loss. This approach would worsen the patient’s condition rather than improve it.
Choice B Reason:
Administering desmopressin is a suitable intervention for this patient. Desmopressin is a synthetic analog of vasopressin (antidiuretic hormone) and is used to treat conditions like diabetes insipidus, which can cause symptoms such as excessive thirst, frequent urination, and dehydration. Desmopressin helps to reduce urine output and correct the imbalance of fluids and electrolytes.
Choice C Reason:
Administering intravenous hypotonic saline is appropriate for managing high serum sodium levels and dehydration. Hypotonic saline helps to lower serum sodium levels by diluting the blood and rehydrating the patient. This intervention addresses both the dehydration and the electrolyte imbalance effectively.
Choice D Reason:
Restricting fluid intake to reduce urine output is not appropriate in this case. Fluid restriction would worsen dehydration and could lead to further complications. The patient needs adequate fluid replacement to correct the dehydration and normalize serum sodium levels.
Choice E Reason:
Administering hypertonic saline is not suitable for this patient. Hypertonic saline would increase serum sodium levels further, exacerbating the hypernatremia. This intervention would be counterproductive and could lead to severe complications.
Correct Answer is B
Explanation
Choice A Reason:
Adrenal hyperplasia involves the enlargement of the adrenal glands, which can lead to an overproduction of adrenal hormones. However, it does not directly cause hyperpituitarism. Hyperpituitarism is related to the overactivity of the pituitary gland, not the adrenal glands.
Choice B Reason:
Pituitary adenoma is the most common cause of hyperpituitarism. These benign tumors in the pituitary gland lead to the overproduction of one or more pituitary hormones, causing symptoms such as severe headaches, visual disturbances, and joint pain. The pituitary gland’s overactivity due to the adenoma results in the excessive release of hormones, which can affect various bodily functions.
Choice C Reason:
Thyroid carcinoma is a type of cancer that affects the thyroid gland While it can cause hormonal imbalances, it does not typically lead to hyperpituitarism. The symptoms described are more consistent with a pituitary-related issue rather than a thyroid condition.
Choice D Reason:
Hypothalamic dysfunction can affect the pituitary gland’s function since the hypothalamus regulates pituitary hormone release. However, it is less likely to be the primary cause of hyperpituitarism compared to a pituitary adenoma. The direct overproduction of hormones by the pituitary gland is more commonly due to an adenoma.
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