A nurse is reviewing laboratory data from a client who has pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?
Platelets 74,000/mm3
White blood cell count 8,000/mm3
Partial thromboplastin time (PTT) 55 seconds
Hematocrit 45%
The Correct Answer is A
A. Platelets 74,000/mm: A platelet count of 74,000/mm³ is significantly lower than the normal range (typically 150,000 to 450,000/mm³). This could indicate heparin-induced thrombocytopenia (HIT), a serious adverse effect of heparin therapy where the immune system forms antibodies against heparin bound to platelet factor 4, leading to a decrease in platelets and increased risk of thrombosis. This is a critical finding and should be reported immediately to the provider for further evaluation and potential adjustment of the treatment plan.
B. White blood cell count 8,000/mm³: This is within the normal range (typically 4,000 to 11,000/mm³) and does not indicate an immediate problem related to heparin therapy or pulmonary embolism management.
C. Partial thromboplastin time (PTT) 55 seconds: While slightly elevated, this PTT is within the therapeutic range for a patient receiving IV heparin (typically 1.5 to 2.5 times the normal control value, or about 45 to 70 seconds). This indicates that the heparin is having the desired anticoagulant effect.
D. Hematocrit 45%: This is within the normal range for adults (typically 38-50% for men and 35-45% for women) and does not indicate an immediate concern related to heparin therapy or pulmonary embolism.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Reduced cardiac output: While liver disease can affect circulation in later stages, abnormal coagulation is a more immediate concern.
B. Abnormal coagulation: The liver plays a vital role in producing proteins essential for blood clotting. Liver damage can impair this function, leading to increased bleeding risk.
C. Electrolyte imbalance: The liver plays a role in some aspects of electrolyte balance, but abnormal coagulation is a more specific and critical complication in early liver damage.
D. Respiratory issues: While liver disease can progress to respiratory complications in severe cases, abnormal coagulation is a more immediate threat.
Correct Answer is C
Explanation
A. To prevent overuse of prescription medications: While some patients may use herbal therapies as an alternative to avoid overuse of prescription medications, this is not the primary reason for the widespread use of herbal therapies. People often turn to herbal remedies for their perceived natural benefits and to complement conventional treatments, rather than to prevent overuse.
B. Because herbal therapies are so much safer than manmade drugs: This is a common misconception. Herbal therapies are not necessarily safer than prescription drugs. They can have potent effects and interact with medications, potentially causing adverse reactions. The safety of herbal remedies varies widely depending on the specific herb and its use.
C. To increase feelings of wellness and promote holistic treatment: Many patients use herbal therapies as part of a holistic approach to health. They seek to improve overall wellness, balance, and harmony in their body, mind, and spirit. Herbal therapies are often integrated into a lifestyle that values natural and preventive health measures.
D. Because herbal therapies are much more regulated than prescription drugs: This statement is incorrect. Herbal therapies are generally less regulated than prescription drugs. In many countries, herbal supplements are not subject to the same rigorous testing and approval processes as prescription medications, leading to variability in quality and potency.
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