The nurse is obtaining the health history from a client who was admitted with a platelet defect.
Which of the following information should be a priority for the nurse to obtain?

Reports of ecchymosis or wet purpura.

Any upcoming dental or invasive procedure appointments.

Over-the-counter and prescription medication use.

Family and genetic history.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Ecchymosis and wet purpura indicate abnormal bleeding tendencies often observed in platelet defects. While these findings are relevant, they are secondary to identifying medications that could exacerbate platelet dysfunction. Medication history directly influences the management plan by addressing reversible causes of thrombocytopenia, emphasizing its priority over descriptive bleeding symptoms.

Choice B rationale

Upcoming dental or invasive procedures are relevant to thrombocytopenia risks due to potential bleeding complications. However, these appointments do not provide immediate insight into causative factors of the platelet defect. Determining medication use offers direct information regarding drug-related impacts on platelet function, prioritizing it for management and diagnostic purposes over procedural risks.

Choice C rationale

Over-the-counter and prescription medication use are critical to evaluate because certain drugs can induce or worsen platelet defects. For example, NSAIDs like aspirin inhibit platelet aggregation and contribute to bleeding risks. Establishing this information helps guide management by identifying reversible causes and reducing complications associated with defective platelet function.

Choice D rationale

Family and genetic history offer valuable insights into inherited platelet disorders but are less immediately actionable for addressing acute platelet defects. Medications causing or contributing to thrombocytopenia present modifiable factors, prioritizing their identification over hereditary predispositions. Addressing medication-induced platelet dysfunction provides practical management strategies for preventing bleeding complications. .

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Correct Answer is C

Explanation

Choice A rationale

Hemorrhage is not a typical complication of extracorporeal shock wave lithotripsy (ESWL), as it is a non-invasive procedure targeting kidney stones using shock waves. The risk of significant bleeding is minimal, and monitoring focuses more on urinary changes or localized pain rather than hemorrhage.

Choice B rationale

ESWL does not involve surgical incisions, so there is no incision site to monitor for infection. This action is irrelevant to the procedure's mechanism, which uses external shock waves to fragment stones rather than invasive surgical methods.

Choice C rationale

Sand or gravel in the urine is a common finding after ESWL as the procedure fragments kidney stones into smaller particles. These fragments are excreted through the urinary system. Monitoring urine for these particles helps evaluate the procedure's effectiveness and ensure stones are adequately eliminated.

Choice D rationale

Percutaneous nephrostomy tubes are used for urinary drainage but are not a standard component of ESWL. Monitoring for tube obstruction applies to invasive procedures, whereas ESWL focuses on non-invasive stone fragmentation. This action is unrelated to the client's current treatment modality. .

A. Explain that the client should return in one month to be reevaluated. B. Assess the client's adherence to lifestyle modifications and medication therapy. C. Explain to the client that the health care provider will increase the dose of one of the medications already prescribed. D. Discuss adding a prescribed calcium-channel blocker to the client's medication regimen.

Correct Answer is B

Explanation

Choice A rationale

Delaying follow-up without immediate intervention may result in the client's blood pressure remaining uncontrolled, increasing the risk of complications like cardiovascular events. Reevaluation in one month without assessing adherence neglects the urgent need for optimizing management.

Choice B rationale

Assessing adherence to both lifestyle modifications and medication therapy is crucial as noncompliance may explain the suboptimal blood pressure control. Ensuring adherence and addressing any barriers are necessary steps in evaluating the effectiveness of treatment.

Choice C rationale

Increasing medication dosage without first assessing the client's adherence to current prescriptions or lifestyle modifications may be premature. Nonadherence to therapy could render dosage adjustments ineffective, leading to unnecessary changes to the regimen.

Choice D rationale

Adding a calcium-channel blocker without assessing adherence disregards the importance of compliance. Treatment should be optimized based on existing therapy before considering additional pharmacological interventions. .

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The nurse is obtaining the health history from a client who was admitted with a platelet defect.Which of the following information should be a priority for the nurse to obtain?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client after receiving extracorporeal shock wave lithotripsy (ESWL). Which of the following actions should the nurse take?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

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The nurse is obtaining the health history from a client who was admitted with a platelet defect.
Which of the following information should be a priority for the nurse to obtain?