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. Romiplostim does not increase the production of ADAMTS-13; it is used to increase platelet counts.
B. Romiplostim does not prevent platelet destruction in the spleen; it works by stimulating platelet production.
C. Romiplostim does not prevent platelets from binding with heparin; it is not used for heparin-induced thrombocytopenia.
D. Romiplostim is a thrombopoietin receptor agonist that stimulates the bone marrow to increase platelet production, which is its primary mechanism of action in treating ITP.
Correct Answer is ["A","D","F","G"]
Explanation
A. Administering furosemide 40 mg via IV push once is appropriate for treating fluid overload, as evidenced by pitting edema and crackles in the lungs, common in heart failure.
B. An IV infusion of normal saline (NS) at 150 mL/hr is not appropriate for this client as it can exacerbate fluid overload and worsen heart failure symptoms.
C. Administering digoxin 0.25 mg via IV push NOW may be indicated, but considering the client's low pulse rate (55/min), caution is necessary due to the risk of digoxin toxicity and bradycardia.
D. Monitoring daily weights is crucial for assessing fluid balance in heart failure patients and detecting any changes in fluid status.
E. Calling a code STEMI is not appropriate as the client does not exhibit signs of a STEMI; troponin levels are not elevated, and there is no indication of an acute myocardial infarction.
F. Monitoring strict intake and output helps in managing fluid balance and ensuring accurate assessment of the client's fluid status.
G. Preparing the client for an echocardiogram is appropriate to assess cardiac function and evaluate the severity of heart failure.
H. Radiofrequency catheter ablation is not indicated for this client as it is typically used to treat arrhythmias, not heart failure or fluid overload.
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