A nurse is reviewing the medical record of a client who is to undergo open heart surgery. Which of the following findings should the nurse report to the provider as a contraindication to receiving heparin?
COPD
Thalassemia
Thrombocytopenia
Rheumatoid arthritis
The Correct Answer is C
Choice A Reason:
COPD (Chronic Obstructive Pulmonary Disease) - While COPD might influence the choice of anaesthesia and perioperative management, it is not a direct contraindication to heparin.
Choice B Reason:
Thalassemia - Thalassemia is a genetic blood disorder that affects haemoglobin production and the structure of red blood cells. It does not directly impact the ability to receive heparin.
Choice C Reason:
Thrombocytopenia. Thrombocytopenia, which is a low platelet count, is a contraindication to receiving heparin, an anticoagulant. Heparin works by preventing the formation of blood clots, but if a person has a low platelet count, their ability to form blood clots is already compromised. Administering heparin in this situation could increase the risk of bleeding and further reduce platelet count.
Choice D Reason:
Rheumatoid arthritis - Rheumatoid arthritis is an autoimmune condition affecting joints. It is not a contraindication to heparin use, but the client's overall health and medications should be considered when planning surgery and anticoagulant therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Confirming the correct position of the line by obtaining a blood sample is appropriate. Inserting a central venous catheter is a procedure that involves placing a catheter into a large vein, typically in the neck, chest, or groin. Confirming the correct placement is crucial to prevent complications such as pneumothorax (lung collapse) or catheter misplacement.
Choice B reason:
Instructing the client to cough as the catheter is inserted is not a standard practice during central venous catheter insertion and could lead to unnecessary complications.
Choice C reason:
Placing the head of the client's bed lower than the foot (Trendelenburg position) is not a standard practice during central venous catheter insertion and would not be helpful for this procedure.
Choice D reason:
Cleansing the site with hydrogen peroxide is not the recommended method for central venous catheter insertion. Typically, a sterile technique and appropriate antiseptic solution are used to reduce the risk of infection.
Correct Answer is B
Explanation
Choice A Reason:
Administer a sedative medication is incorrect. Administering a sedative can help the client feel more comfortable during the procedure, but ensuring allergy safety comes first.
Choice B Reason:
Determine whether the client has an allergy to local anaesthetics is correct. The priority intervention for the nurse is to determine whether the client has an allergy to local anaesthetics. Local anaesthetics are typically used to numb the area before a thoracentesis, and ensuring the safety of the client is essential. An allergy to local anaesthetics can result in serious adverse reactions, so it's crucial to identify any allergies before proceeding with the procedure.
Choice C Reason:
Describe the sensations the client will feel during the procedure is incorrect. Providing information about the sensations is important for client education and comfort, but verifying allergies is more critical.
Choice D Reason:
Reinforce the importance of lying still during the procedure - Encouraging the client to lie still is important for the procedure's success and client safety, but confirming allergies takes priority.
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