A nurse is reviewing the laboratory values of a client who is at risk for disseminated intravascular coagulopathy. Which of the following values should the nurse report to the provider?

Platelets 156,000/mm³

Fibrinogen 85 mg/dL

PT 12 seconds

PTT 64 seconds

Answer and Explanation

The Correct Answer is B

A. Platelets 156,000/mm³: This platelet count is within the normal range (normal range: 150,000 to 400,000/mm³). Although disseminated intravascular coagulopathy (DIC) can lead to thrombocytopenia (low platelet count), the platelet count in this scenario is not indicative of DIC.

B. Fibrinogen 85 mg/dL: This is the correct answer. A decreased fibrinogen level is often seen in DIC. Fibrinogen is consumed in the formation of microclots, and a low level may indicate ongoing coagulation.

C. PT 12 seconds: The prothrombin time (PT) is within the normal range. In DIC, the PT may be prolonged due to the consumption of clotting factors, but in this case, the PT is normal.

D. PTT 64 seconds: The partial thromboplastin time (PTT) is prolonged, which can be an indication of DIC. However, the more specific indicator in this scenario is the low fibrinogen level.

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Correct Answer is B

Explanation

Correct answer: B

A. "I will take my diuretic before sleep and drink fluids during the day": This statement is not correct. Diuretics are usually taken in the morning to avoid disrupting sleep with increased urination at night. Additionally, fluid intake is generally restricted in congestive heart failure to manage fluid balance.

B. "I plan to slow down if I am tired the day after exercising":This statement reflects an understanding of the need to manage activity levels and recognize the signs of overexertion, which is crucial for clients with congestive heart failure. Pacing activities and allowing for adequate rest can help prevent exacerbations of heart failure symptoms.

C. "I will read food labels and limit my sodium to 4 grams per day": This is incorrect. Limiting sodium intake is a key component of heart failure management. The recommended sodium intake for individuals with heart failure is often much lower than 4 grams per day, typically around 2 grams or less.

D. "I should use naproxen to manage discomfort": Using nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen can contribute to fluid retention and worsen heart failure symptoms. This statement is not indicative of effective teaching.

A. Carvedilol B. Captopril C. Isosorbide dinitrate D. Fluticasone

Correct Answer is A

Explanation

A. Carvedilol:Carvedilol is a non-selective beta-blocker that blocks both beta-1 and beta-2 adrenergic receptors. Beta-2 blockade can lead to bronchoconstriction, which can exacerbate asthma symptoms. Clarification is needed to see if a cardioselective beta-blocker (like metoprolol) would be safer.

B. Captopril:Captopril is an ACE inhibitor commonly used in heart failure to reduce blood pressure and decrease the workload on the heart. It does not have bronchoconstrictive effects and is safe for use in clients with asthma.

C. Isosorbide dinitrate:Isosorbide dinitrate is a nitrate used to manage heart failure by dilating blood vessels and reducing the workload of the heart. It has no effect on bronchial smooth muscle and is not contraindicated in asthma, so no clarification is needed.

D. Fluticasone:Fluticasone is an inhaled corticosteroid used to manage asthma by reducing inflammation in the airways. It is beneficial in clients with asthma and does not pose a risk to clients with heart failure. There is no need to clarify this medication.

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A nurse is reviewing the laboratory values of a client who is at risk for disseminated intravascular coagulopathy. Which of the following values should the nurse report to the provider?

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