An 82-year-old client who sustained a head injury in a motor vehicle crash while on warfarin therapy is admitted for observation. The nurse is providing teaching regarding the client's diagnosis of a subdural hematoma. Which of the following statements by the client indicates an understanding of teaching?
"I developed a hematoma because an artery burst in my brain when my head hit the windshield."
"I developed a bleed in my brain because my platelets were too high."
"I developed a hematoma because I take a blood thinner and my head hit the windshield."
"I developed a hematoma because my bleeding times were too low and I hit my head."
The Correct Answer is C
A. A subdural hematoma is typically caused by venous bleeding, not arterial bleeding. An arterial rupture would more likely cause an epidural hematoma, which is not the case here.
B. High platelet counts are not commonly associated with the formation of subdural hematomas. Subdural hematomas are usually due to bleeding related to anticoagulant use or trauma.
C. Taking a blood thinner like warfarin increases the risk of bleeding and hematoma formation, particularly when combined with head trauma. This statement correctly links the anticoagulant therapy and head injury as contributing factors to the subdural hematoma.
D. Low bleeding times are not a cause of hematomas. In fact, elevated bleeding times due to anticoagulant therapy would increase the risk of bleeding, not low bleeding times.
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Related Questions
Correct Answer is B
Explanation
B. In a disaster situation, prioritizing care for clients with life-threatening emergencies is crucial to ensure that those in the most critical condition receive immediate attention. This aligns with triage principles and ensures that limited resources are used effectively.
A. While addressing ADLs is important, it is secondary to addressing life-threatening emergencies in a disaster scenario.
C. Discharging stable clients can help increase bed availability but should be considered after addressing immediate life-threatening needs.
D. Stocking additional supplies is necessary but should follow after ensuring that life-threatening conditions are managed.
Correct Answer is B
Explanation
A. Epinephrine IM injection is not appropriate in this scenario, as it is typically reserved for treating anaphylactic shock. It is not used for septic shock where hypotension persists after fluid resuscitation.
B. Norepinephrine IV infusion is the correct choice. It is the first-line vasopressor in septic shock management when a fluid bolus does not adequately raise blood pressure. Norepinephrine works by constricting blood vessels, thereby increasing vascular resistance and blood pressure.
C. Dobutamine IV infusion might be considered if there is evidence of myocardial dysfunction or if additional inotropic support is necessary. However, it is not the immediate next step following fluid resuscitation when addressing persistent hypotension in septic shock.
D. Dexamethasone IV injection is not indicated for treating septic shock directly. It may be used in other contexts, such as treating adrenal insufficiency or reducing inflammation, but it does not play a role in immediate blood pressure management in septic shock.
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