A patient with acromegaly is being evaluated. Which clinical manifestation is most likely to be observed in this patient?

Choice A: Instruct the patient to elevate the arm above the heart immediately after the procedure

Elevating the arm above the heart can help reduce blood flow to the area, potentially minimizing bleeding. However, this method alone is not sufficient to ensure proper hemostasis, especially in patients with thrombocytopenia. Applying direct pressure to the puncture site is more effective in stopping bleeding and preventing hematoma formation.

Choice B: Apply firm pressure to the site for at least 10 minutes after the procedure

Applying firm pressure to the venipuncture site is crucial in patients with thrombocytopenia to ensure proper clotting and prevent bleeding. This method helps in forming a stable clot at the puncture site, reducing the risk of prolonged bleeding and hematoma formation. Given the patient’s low platelet count, maintaining pressure for an extended period is essential to achieve hemostasis.

Choice C: Avoid using a tourniquet during the procedure

While avoiding a tourniquet might seem beneficial to reduce pressure on the veins, it is not a standard practice to minimize bleeding risk in thrombocytopenic patients. Tourniquets are typically used to make veins more prominent for easier access during venipuncture. The key to minimizing bleeding is proper post-procedure care, such as applying firm pressure to the site.

Choice D: Use a larger gauge needle to ensure quicker blood flow

Using a larger gauge needle is not advisable for patients with thrombocytopenia. Larger needles can cause more trauma to the vein, increasing the risk of bleeding and hematoma formation. Instead, using the smallest gauge needle that can effectively draw blood is recommended to minimize vein damage.

Choice A Reason:

Encouraging a high-sodium diet is essential for patients with Addison’s disease because they often suffer from hyponatremia (low sodium levels) due to the lack of aldosterone, a hormone that helps regulate sodium and potassium balance. Increasing sodium intake helps to counteract this deficiency and maintain proper electrolyte balance.

Choice B Reason:

Administering potassium supplements is not recommended for patients with Addison’s disease because they already have hyperkalemia (high potassium levels) due to the lack of aldosterone. Adding more potassium could exacerbate this condition and lead to serious complications such as cardiac arrhythmias.

Choice C Reason:

Administering intravenous corticosteroids is a critical intervention for managing Addison’s disease, especially during an adrenal crisis. Corticosteroids like hydrocortisone help replace the deficient hormones and stabilize the patient’s condition by reducing inflammation and supporting metabolic functions.

Choice D Reason:

Monitoring blood glucose levels regularly is important because patients with Addison’s disease can experience hypoglycemia (low blood sugar levels) due to cortisol deficiency. Regular monitoring helps in timely detection and management of hypoglycemia, preventing potential complications.

Choice E Reason:

Administering diuretics is not appropriate for patients with Addison’s disease as it can lead to further electrolyte imbalances, particularly worsening hyponatremia and hyperkalemia. Diuretics increase the excretion of sodium and potassium, which is counterproductive in managing Addison’s disease.