Which finding about a patient with polycythemia vera is most important for the nurse to report to the health care provider?

Presence of plethora (excess body fluid)

Calf swelling and pain

Platelet count 450,000/microL

Hematocrit 55%

Answer and Explanation

The Correct Answer is B

A.   Presence of plethora is a common symptom of polycythemia vera and indicates increased blood volume but is not immediately life-threatening.
B.   Calf swelling and pain could indicate a deep vein thrombosis (DVT), which is a serious complication that requires immediate medical attention.
C.   A platelet count of 450,000/microL is elevated but not as critical as the possibility of a DVT.
D.   Hematocrit of 55% is high, which is expected in polycythemia vera, but it is not as immediately critical as the risk of thrombosis suggested by calf swelling and pain.

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Correct Answer is C

Explanation

A. Explain disease course and expected signs and symptoms to the family. While education is essential, it is not directly related to addressing the acute pain associated with thrombotic crisis.
B. Check peripheral pulses, color, and temperature of extremities every 30 hours. This intervention is important for assessing peripheral perfusion but may not directly address the acute pain associated with thrombotic crisis.
C. Reposition the client, paying close attention to proper body alignment. Repositioning the client to ensure proper body alignment can help alleviate pressure points and discomfort associated with thrombotic crisis.

D. Provide active range of motion (ROM) every 2 hours. While ROM exercises are important for preventing complications such as joint stiffness, they may not directly address the acute pain associated with thrombotic crisis.

A. Cystocele B. Fibroid C. Ovarian cyst D. Rectocele

Correct Answer is A

Explanation

A. Cystocele: A cystocele occurs when the bladder bulges into the vaginal canal, which can cause symptoms such as dyspareunia, backache, pelvic pressure, urinary tract infections, and urinary urgency.
B. Fibroid: Fibroids are benign tumors of the uterus and can cause pelvic pain and pressure, but they are not typically associated with urinary symptoms.
C. Ovarian cyst: Ovarian cysts can cause pelvic pain and pressure but are not usually associated with urinary symptoms like urinary urgency.
D. Rectocele: A rectocele occurs when the rectum bulges into the vaginal canal, which can cause symptoms like dyspareunia and pelvic pressure, but it is more likely to cause constipation than urinary urgency.

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Which finding about a patient with polycythemia vera is most important for the nurse to report to the health care provider?

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Naxlex Comprehensive Predictor Exams

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