CLINICAL REASONING CASES IN
NURSING 7TH EDITION HARDING SNYDER
TESTED QUESTIONS AND COMPLETE
SOLUTIONS
◉ ITP — mechanism and characteristic lab findings?
Answer: An autoimmune (IgG) disorder targeting platelet
membrane glycoproteins; presents as isolated thrombocytopenia
with NORMAL PT/PTT and INCREASED megakaryocytes in the
marrow
◉ ITP — can it be primary or secondary, and to what conditions?
Answer: Primary, or secondary to SLE, HIV, or B-cell neoplasms
◉ Drug-induced immune thrombocytopenia — notable example
and its key risk?
Answer: Heparin-Induced Thrombocytopenia (HIT type II) carries
a high risk of PARADOXICAL THROMBOSIS; other triggers include
quinine/quinidine and sulfa compounds
◉ Infectious causes of immune-mediated platelet destruction?
Answer: HIV, Hepatitis C, H. pylori, and infectious mononucleosis
◉ DIC — mechanism and coagulation study pattern?
, Answer: Systemic activation of coagulation leading to
consumption of platelets and factors; PT AND PTT are typically
PROLONGED
◉ TTP/HUS — mechanism, coagulation pattern, and smear
finding?
Answer: Excessive platelet activation into thrombi
(microangiopathic); PT/PTT are usually NORMAL (unlike DIC);
schistocytes seen on peripheral smear
◉ Sequestration (hypersplenism) — mechanism and percentage
of platelets trapped?
Answer: An enlarged spleen (often from portal hypertension/liver
disease) can trap 80-90% of the body's platelets, compared to the
normal 30-35%
◉ Dilutional thrombocytopenia — cause?
Answer: Massive blood transfusions of platelet-poor products
◉ Most common cause of thrombocytopenia in pregnancy?
Answer: Gestational thrombocytopenia (~70% of cases), typically
occurring in the third trimester
◉ What is pseudothrombocytopenia?
Answer: An artifactually low platelet count caused by platelet
clumping in EDTA-anticoagulated blood tubes
NURSING 7TH EDITION HARDING SNYDER
TESTED QUESTIONS AND COMPLETE
SOLUTIONS
◉ ITP — mechanism and characteristic lab findings?
Answer: An autoimmune (IgG) disorder targeting platelet
membrane glycoproteins; presents as isolated thrombocytopenia
with NORMAL PT/PTT and INCREASED megakaryocytes in the
marrow
◉ ITP — can it be primary or secondary, and to what conditions?
Answer: Primary, or secondary to SLE, HIV, or B-cell neoplasms
◉ Drug-induced immune thrombocytopenia — notable example
and its key risk?
Answer: Heparin-Induced Thrombocytopenia (HIT type II) carries
a high risk of PARADOXICAL THROMBOSIS; other triggers include
quinine/quinidine and sulfa compounds
◉ Infectious causes of immune-mediated platelet destruction?
Answer: HIV, Hepatitis C, H. pylori, and infectious mononucleosis
◉ DIC — mechanism and coagulation study pattern?
, Answer: Systemic activation of coagulation leading to
consumption of platelets and factors; PT AND PTT are typically
PROLONGED
◉ TTP/HUS — mechanism, coagulation pattern, and smear
finding?
Answer: Excessive platelet activation into thrombi
(microangiopathic); PT/PTT are usually NORMAL (unlike DIC);
schistocytes seen on peripheral smear
◉ Sequestration (hypersplenism) — mechanism and percentage
of platelets trapped?
Answer: An enlarged spleen (often from portal hypertension/liver
disease) can trap 80-90% of the body's platelets, compared to the
normal 30-35%
◉ Dilutional thrombocytopenia — cause?
Answer: Massive blood transfusions of platelet-poor products
◉ Most common cause of thrombocytopenia in pregnancy?
Answer: Gestational thrombocytopenia (~70% of cases), typically
occurring in the third trimester
◉ What is pseudothrombocytopenia?
Answer: An artifactually low platelet count caused by platelet
clumping in EDTA-anticoagulated blood tubes
