ATI Learning Systems RN Medical-Surgical: Cardiovascular and Hematology

ATI Learning Systems RN Medical-Surgical: Cardiovascular and Hematology a nurse is caring for a patient who has hemophilia. the patient reports pain and swelling in a joint following an injury. which of the following actions should the nurse take? prepare for replacement of missing clotting factors -hemophilia is a hereditary bleeding disorder in which blood clots slowly and abnormal bleeding occurs -caused by a deficiency in most common clotting factor, factor VIII (hemophilia A) -aggressive factor replacement is initiated to prevent hemarthrosis that can result in long-term loss of range of motion in repeatedly affected joints -coagulation tests that measure platelet function, such as bleeding time, are used to Dx, not treat, hemophilia -aspirin and other NSAID's, and some herbal supplements should be avoided b/c they interfere w/ clotting function -affected joint should be elevated to allow blood to drain away from pt a nurse is completing a medication history for a patient who reports using fish oil as a dietary supplement. which of the following substances in fish oil should the nurse recognize as a health benefit to the patient? omega 3 fatty acids -helps lower risk of cardiovascular dz and stroke by decreasing triglyceride levels -antioxidants: substances naturally occurring in fruits and veggies, as well as in nuts, grains, and some meat, poultry, and fish -beta-carotene, vitamin A, C, E, and selenium are some of most commonly known antioxidants -can slow/prevent development of cancer -beta-carotene: precursor to vitamin A, functions as fat-soluble antioxidant which protects body from deleterious free-radical rxns A nurse is reviewing a patient's repeat lab results for hours after administering fresh frozen plasma. Which of the following lab results for the nurse review? prothrombin time (PT_ -FFP is plasma rich in clotting factors and is administered to treat acute clotting disorders -desired effect: decrease in PT -review WBC's if there's possible infection -review platelet count following admin of platelets -review HCT following admin of packed RBC's A nurse is assessing a patient who has right-sided heart failure. Which of the following findings should the nurse expect? dependent edema -blood return from venous system to R atrium is impaired by weakened R heart -consecutive systemic venous backup leads to development of dependent edema -Left-sided HF: pts w/ this disorder have decreased cardiac output which causes decreased capillary refill; blood returns from lungs via pulmonary vein is slowed, causing fluid buildup in lungs that results in SOB; dizziness can occur d/t decreased cardiac output A nurse is administering a unit of packed red blood cells to a patient who is postoperative. The patient reports itching and has hives 30 minutes after the infusion begins. Which of the following actions should the nurse take first? stop infusion -Priority: b/c pt has manifestations of allergic rxn -nurse should maintain IV access by initiating infusion of 0.9% sodium chloride solution using a new IV administration set -nurse should send blood container and tubing to blood bank for a repeat typing and culture -nurse should obtain urine sample from pt to determine if hemoglobin is in urine A nurse is monitoring a patient who had a myocardial infarction. For which of the following complications should the nurse monitor in the first 24 hours? ventricular dysrhythmias -after MI, electrical conduction system of heart can be irritable and prone to dysrhythmias -ischemic tissue caused by infarction can interfere w/ normal conduction patterns of heart's electrical system -infective carditis: occurs when bacteria invades endothelial surface of heart; usually seen in pts who have prosthetic heart valves or pacemakers -pericarditis: can occur 10 days to 2 months following MI; is an inflammation of pericardial sac that surrounds heart and usually results from infection, connective tissue disorders, or trauma The nurse is transfusing a unit of O-negative fresh frozen plasma to a patient with blood type is be positive. Which is the following findings should the nurse take? remove the unit of plasma immediately and start an IV infusion of NS -FFP that's not compatible can cause hemolytic transfusion rxn -stop transfusion and infuse 0.9% sodium chloride w/ new tubing -ABO compatibility is required for transfusion of FFP; blood type B can only receive type B or AB plasma -nurse shouldn't continue infusing plasma that's not compatible w/ pt; no indication that a repeat type and crossmatch is necessary -should admin. diphenhydramine IV only if pt manifests allergic txn A nurse is caring for a patient who has an abdominal aortic aneurysm and is scheduled for surgery. The patient's vital signs are blood pressure 160/98 mm Hg, heart rate 102/min, respirations 22/min, and SPO2 95%. Which of the following actions should the nurse take? admin. antihypertensive med for BP -b/c HTN can cause sudden rupture of aneurysm d/t pp on arterial wall -monitor that pt has adequate kidney profusion determined by urinary output of at least 30 mL/hr; oliguria can indicate rupture of aneurysm -administer pain med b/c pain occurs d/t pp from aneurysm on lumbar nerves; pain can cause HTN -take pt VS at least every 15 min in order to monitor fr sudden drop in BP, can indicate ruptured aneurysm A nurse is assessing a patient who has an abdominal aortic aneurysm. Which the following manifestations of the nurse expect? lower back discomfort -involves