A nurse in the emergency department is caring for a client.

Exhibits

Drag 1 condition and 1 client finding to fill in each blank in the following sentence.

The client is at risk for developing

Exhibits

due to

dropdown

A. The CD4-T-cell count is a critical indicator of immune function in individuals with HIV. CD4 cells are a type of white blood cell that HIV targets and destroys, leading to immune deficiency. A lower CD4 count indicates greater immunosuppression and increased susceptibility to opportunistic infections. Monitoring CD4 counts helps guide decisions regarding antiretroviral therapy (ART) initiation and monitoring response to treatment.
B. White blood cell (WBC) count measures the body's immune response and can fluctuate due to various factors. A WBC count of 5,000/mm3 is within the normal range, but it alone does not provide specific information about the client's HIV status or immune function compared to the CD4 count.
C. Platelets are involved in blood clotting, and a platelet count of 150,000/mm3 is within the normal range. Platelet counts are important for assessing bleeding risk but are not directly related to HIV progression or immune status.
D. A positive Western blot test confirms the presence of HIV antibodies in the blood. It is used for definitive HIV diagnosis after an initial positive screening test (such as ELISA). While important for diagnosis, once HIV is confirmed, ongoing monitoring of CD4 counts and viral load (not directly mentioned in the options) becomes more crucial for managing the disease.

A. This response addresses the timeframe for heparin to achieve therapeutic levels in the bloodstream, not its action on dissolving clots. Heparin works primarily by inhibiting the formation of new clots and preventing existing clots from enlarging or propagating, rather than directly dissolving existing clots.
B. This statement accurately describes the mechanism of action of heparin. Heparin is an anticoagulant that works by enhancing the activity of antithrombin III, which inhibits the clotting factors thrombin and factor Xa. This action prevents the formation of new clots and stabilizes existing clots, but it does not actively dissolve them.
C. While pharmacists are knowledgeable about medications, including their mechanisms of action, it is within the scope of nursing practice to provide information on how medications work to clients. The nurse should be prepared to explain the basic mechanism of heparin's action to the client in understandable terms.
D. This response is inaccurate regarding heparin's action. Heparin itself does not directly dissolve clots; it prevents further clot formation and allows the body's natural fibrinolytic (clot-dissolving) mechanisms to work on existing clots. Oral medications like warfarin or direct oral anticoagulants (DOACs) may be used after initial heparin therapy to continue anticoagulation, but they do not directly dissolve clots either.