A nurse is caring for a client who has a diagnosis of immune thrombocytopenic purpura (ITP). Despite medication therapy, the client's platelets are low. Which of the following procedures would reduce the destruction of platelets for a client who has ITP?
Transfusion of platelets
Replacement of ADAMTS-13
Administration of protamine sulfate
Laparoscopic splenectomy
The Correct Answer is D
A. While a platelet transfusion can temporarily increase platelet counts, it does not reduce the destruction of platelets in ITP and is generally not effective as a long-term solution.
B. Replacement of ADAMTS-13 is relevant in thrombotic thrombocytopenic purpura (TTP), not ITP. It is not used for reducing platelet destruction in ITP.
C. Protamine sulfate is an antidote for heparin overdose and does not address the platelet destruction in ITP.
D. A laparoscopic splenectomy is often considered for clients with ITP who do not respond to medication therapy. The spleen is a primary site for platelet destruction, and its removal can reduce the destruction of platelets, leading to increased platelet counts.
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Related Questions
Correct Answer is D
Explanation
A. Vitamin K is an antidote for warfarin, not heparin.
B. Enoxaparin is a low molecular weight heparin and is contraindicated in patients with a history of HIT.
C. Warfarin is an oral anticoagulant used for long-term anticoagulation therapy and is not used to neutralize heparin.
D. Protamine sulfate is the specific antidote for heparin and is used to neutralize its effects.
Correct Answer is B
Explanation
A. Plasmapheresis in TTP aims to remove abnormal blood components, not ADAMTS-13. In fact, plasmapheresis helps replenish ADAMTS-13.
B. The primary goal of plasmapheresis in TTP is to remove large von Willebrand factor molecules that are causing platelet aggregation and clot formation.
C. Removing macrophages from the spleen is not the objective of plasmapheresis.
D. Plasmapheresis is usually performed daily until clinical and laboratory parameters improve, not just once a week.
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