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 C
Explanation
Choice A reason:
"will keep my left arm flexed at the elbow as much as possible": This statement is incorrect because after a mastectomy, it's important to promote full range of motion in the affected arm to prevent complications like contractures and lymphedema.
Choice B reason:
“will have to wait 2 months before additional saline can be added to my breast expander" Typically, the process of adding saline to a breast expander begins much sooner, often within a few weeks after surgery, depending on the individual’s healing progress and the surgeon’s protocol.
Choice C reason:
"should expect less than 25 ml of secretions per day in the drainage devices":After a mastectomy, drainage devices are often placed to prevent fluid accumulation. The client should be aware that once the drainage decreases to less than 25 ml per day, it may be an indication that the drain can be removed. This shows an understanding of what to monitor postoperatively.
Choice D reason:
"will perform strength-building arm exercises using a 15-pound weight": This statement is not appropriate, especially shortly after surgery. Gradual and gentle strength-building exercises are recommended, and using a 15-pound weight could be too strenuous and potentially harmful.
Correct Answer is B
Explanation
Choice A Reason:
"Describe your daily medication schedule” is not the correct statement. Understanding the medication schedule is important for adherence to antiretroviral therapy.
Choice B Reason:
"Tell me why it's important to have your CD4+ count checked." Is the correct statement, the priority information for the nurse to review with the client is why it's important to have their CD4+ count checked regularly? The CD4+ count is a crucial marker of immune system health and function in individuals with HIV. Monitoring CD4+ counts help guides treatment decisions, assess the effectiveness of antiretroviral therapy, and evaluate the progression of the disease. Understanding the significance of CD4+ counts is essential for the client's overall management of HIV.
Choice C Reason:
"List some ways you can cope with the stress of your illness" is not the correct statement - Coping strategies are important for the client's emotional well-being and overall health.
Choice D Reason:
"Name a few things you will change about your diet" is not the correct statement. Nutrition is important for overall health, including maintaining a strong immune system, but it may not be the most immediate priority compared to understanding the importance of CD4+ counts.
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