ECCO: Caring for Patients with Hematologic Disorders Questions and Answers Already Passed

ECCO: Caring for Patients with Hematologic Disorders Questions and Answers Already Passed A patient receiving warfarin with an elevated INR....admin of which reversal agent should nurse anticipate? - FFP - PCC - Vit K A patient being managed for atrial fibrillation develops sudden onset of chest pain with dyspnea. CT angio confirms a PE. Which intervention should the nurse next anticipate? Administration of subcutaneous Lovenox A nurse monitoring a patient who was bleeding and underwent platelet transfusion 18 hours earlier observes that the initially increased platelet count is now decreased. What are the nurse's initial priorities? Monitor for bleeding and/or changes in vital signs. In a patient with sepsis or trauma, which lab results...provider? - elevated.. - peripheral.. - low platelets A patient post-cardiopulmonary bypass (CPB) procedure is on VTE prophylaxis with UFH. Baseline postoperative platelet level is 175,000; on day 5, platelet count is 51,000. Which should the nurse anticipate? Discontinue heparin For which combination of patient conditions and labs should RN suspect DIC? - sepsis - viral - trauma A patient received 10 units RBCs and 6 units of FFP in the OR. The patient is dyspneic and remains hypotensive and hypovolemic. The patient's H&H is 6.9 and 21 platelets are 148,000, k 3.9, and ionized ca is 0.89. The nurse should anticipate administration of which treatment? - Packed RBCs - Platelets All heparin products have been stopped in a patient with HIT...before administering argatroban or bivalirudin? - assess.. - assess.. - draw.. Which condition puts a pt at greatest risk for developing a coagulopathy? Acute hepatic failure Which are accurate statements about coagulation diagnostic tests? - VTE - TEG - Use FSP A patient with a history of atrial fibrillation is receiving warfarin and has limited mobility. For which set of lab results should the nurse be concerned for risk of developing VTE? 1.5/25 seconds The hgb of a patient with acute coronary syndrome is 7...transfusing PRBC? - transfusion - immunosuppression - transfusion Why is iatrogenic anemia common among patients in critical care? - bleeding.. - phlebotomy.. - bleeding.. A patient admitted with acute STEMI who is dyspneic with chest pain should the nurse anticipating receiving transfusion with packed RBCs, based on the following assessment? Hgb 8.0, SpO2 88%, HR 118, BP 88/70 (75), RR 24 Which signs and symptoms should the nurse observe for during transfusion and in the first 24 hours after transfusion of packed RBCs, FFP, platelets, and/or cryoprecipitate? - Dyspnea - Chest or back pain - Tachycardia A patient with sepsis develops hematuria and hemoptysis. Bleeding precautions and orders for blood product transfusion are initiated. Which intervention is essential to manage the suspected secondary condition? Treat underlying cause A nurse notes ischemic changes in the legs of a patient who received heparin during CPB...interventions? - provider.. - 4 T score of 6-8 - platelet count decreased Which of these diagnosis put a patient at greatest risk for developing DIC? - sepsis - open head injury - hepatic failure A patient underwent CPB procedure...suspect HIT? - 120,000.. - positive.. - positive.. What treatment options are recommended as initial management for acute lower ... pulmonary emboli? - IV or subq UFH - subq fondaparinux - subq LMWH A patient with a mechanical heart valve is receiving IABP... hemolytic anemia? - elevated bilirubin - elevated LDH - elevated plasma free hgb A patient with a history of warfarin therapy was admitted with multitrauma.... FFP also? - greater than - active bleeding - need to reverse warfarin In a patient receiving anticoag therapy which additional meds... all but amio Which patient who is actively bleeding should the nurse .... fibrinigen level 140 For which should the nurse observe during transfusion... - Shortness of breath - changes in vital signs A patient with chronic atrial fibrillation managed with warfarin is suspected to have developed HIT 8 days after a cardiac catheterization. What interventions should the nurse initiate or anticipate before administering a direct thrombin inhibitor? Discontinue warfarin to prevent microthrombosis Two hours post-transfusion of one unit of PRBCs, a nurse assesses the patient and observes dyspnea and crackles throughout lung fields. Which should the nurse anticipate initially? IV diuretics A patient is receiving UFH at 15 u/kg/hr for treatment of a PE. Which set of lab parameters six hours after dose change should the nurse anticipate indicate UFH's intended therapeutic effect? aPTT 45 sec, PT unchanged, Anti-Xa 0.5 IU/mL (N) Which two are accurate statements about H&H, WBC, and platelet diagnostic test results? - Hct of a patient on aggressive fluid resuscitation may drop sharply - WBC less than 2,500 or greater than 30,000 is a critical value Within 1 week of admission, which cause of iatrogenic anemia results in 97% of critical- care patients? Phlebotomy practices A patient receiving warfarin with an elevated INR is to undergo emergency surgery vitamin K has been administered. The nurse should anticipate administration of which additional reversal agent to achieve a rapid decrease in the PT-INR? Prothrombin complex concentrate