Coagulation Disorders Exam Questions and Correct Answers Latest Update 2024 (Graded A+)

Coagulation Disorders Exam Questions and Correct Answers Latest Update 2024 (Graded A+) Thrombocytopenia results from - Answers -Decreased production of platelets -Increased sequestration -Accelerated destruction of platelets What is thrombopoietin produced by? - Answers Liver, kidney, smooth muscle, bone marrow Thrombocytes are responsible for - Answers Platelet production Organ responsible for platelet destruction and antibody production - Answers Spleen What would the platelet count be in someone with thrombocytopenia? - Answers Less than 100,000 per mL of blood Potentially fatal bleeding occurs when the platelet count is less than - Answers 10,000/mL A type of primary thrombocytopenia that is an autoimmune disorder in which platelet destruction is accelerated - Answers Immune Thrombocytopenic Purpura also known as Idiopathic Thrombocytopenic Purpura (ITP) In ITP, the proteins on the platelet cell membrane stimulate autoantibody production. These are usually what antibodies? - Answers IgG Due to the autoantibodies, which organ reacts to the platelets as being foreign and begins to destroy them after only 1-3 days of circulation? - Answers Spleen Risk factors for ITP include - Answers -Females (ages 20-40) -Autoimmune disorder -Recent virus (children only) Manifestations of ITP: - Answers -Insidious onset -Petechiae and purport develop on the anterior chest, arms, neck, and oral mucous membranes -Bruising -Spontaneous epistaxis and gum bleeding -Hematuria and excess menstrual bleeding -Weight loss -Fever -Headache -Tachycardia -Hypotension -Diaphoresis In a client with ITP, would their Hemoglobin increase or decrease? - Answers Decrease This is a rare thrombocytopenic disorder in which thrombi occlude arterioles and capillaries of the microcirculation - Answers Thrombotic Thrombocytopenic Purpura (TTP) What is the key feature of TTP? - Answers Platelet aggregation Why would the platelet count in TTP show a decrease? - Answers The platelets are being used to form clots Manifestations of TTP: - Answers -Purpura and petichiae -Neuro symptoms: headache, seizures, and altered consciousness (due to clotting) How to Diagnose Thrombocytopenia: - Answers -CBC -Measure antinuclear antibodies (ANA) for autoantibodies -Serologic studies -Bone marrow examination Medications for Thrombocytopenia: - Answers -Oral glucocorticoids such as prednisone to suppress the autoimmune response -Immunosuppressive drugs such as azathioprine, cyclophosphamide, and cyclosporine Acute bleeding related to thrombocytopenia can be treated by? - Answers Platelet transfusion What is the primary treatment for acute TTP? - Answers Plasmapheresis or plasma exchange therapy. The patient's plasma is removed and replaced with FFP to remove autoantibodies, immune complexes, and toxins If a patient with ITP relapses when glucocorticoids are discontinued what is the treatment of choice? - Answers Splenectomy A nurse is caring for a client who has idiopathic thrombocytopenic purpura (ITP). The nurse should notify the provider and report possible small-vessel clotting when which of the following is assessed? A. Petechiae on the upper chest B. Hypotension C. Cyanotic nail beds D. Severe headache - Answers C. Cyanotic nail beds Rationale: Cyanotic nail beds indicate microvascular clotting is occurring and should be immediately reported to avoid ischemic loss of the fingers or toes The client's CBC indicates an RBC 6.0, Hgb 14.2, Hct 42%, and platelets 69,000. Which intervention should the nurse implement? 1. Teach the client to use a soft-bristle toothbrush 2. Monitor the client for elevated temperature 3. Check the client's BP 4. Hold venipuncture sites for 1 minute - Answers 1. Teach the client to use a soft-bristle toothbrush Rationale: A low platelet count indicates thrombocytopenia Which sign would the nurse expect to assess in the client diagnosed with ITP? 1. Petechiae on the anterior chest, arms, and neck 2. Capillary refill of less than 3 seconds 3. An enlarged spleen 4. Pulse oximeter reading of 95% - Answers 1. Petechiae on the anterior chest, arms, and neck What is the normal range for PTT? - Answers 32-39 seconds The nurse is caring for the following clients. Which client should the nurse assess first? 1. Client whose PTT is 38 seconds 2. Client whose Hgb is 14 and Hct is 45% 3. Client whose platelet count is 75,000 per cubic millimeter of blood 4. Client whose RBC count is 4.8 - Answers 3. Client whose platelet count is 75,000 per cubic