UNIT 2 EXAM: CLOTTING Exemplars: Thrombocytopenia, Hemophilia A and B, Venous Thrombosis

1. A pt. is on heparin drip for DVT L leg. Which lab is a potential complication of heparin therapy? - K 3.6 - Hgb 14.5 - aPTT 65 seconds - Platelets 75,000 - Platelets 75,000 1. Which of the following interventions is appropriate with treating a child dx hemophilia with hemarthrosis? - Administering Tylenol rectal suppositories prn for pain - Administering the missing blood clotting factors - Administering ibuprofen prn for pain - Administering enoxaparin - Administering the missing blood clotting factors 1. A nursing intervention with a pt. with lymphoma whose platelet count is 18,000 due to chemo is: - Check all stools for occult blood - Provide oral hygiene every 2 hours - Encourage fluids to 3000ml/day - Check pt.'s temperature every 4 hours - Check all stools for occult blood 1. The client diagnosed with PE is in the ICU. Which data would need immediate intervention? - O2 sat of 88% - The client's telemetry occasionally exhibits PVCs - The client's ABGs are pH 7.36, PCO2 38, HCO3 24 - Urine output for the 12-hour shift is 800ml - O2 sat of 88% 1. A patient with a left femoral DVT is started on warfarin. What lab should the nurse monitor? - aPTT - Platelets - INR - Bleeding time - INR 1. The nurse is teaching a pt. with thrombocytopenia. Which of the following is appropriate? - Instruct pt. to dab his nose instead of blowing - Instruct pt. to continue with usual activities to prevent DVT - Tell the pt. to be careful when shaving with a razor - Encourage pt. to take aspirin which will mask fever that occurs w/low platelets - Instruct pt. to dab his nose instead of blowing1. A pt. is receiving continuous IV heparin for tx of a DVT, has a aPTT of 110 seconds. What should the RN do? - Continue the infusion no change - Re draw the aPTT stat - Increase the drip rate per protocol - Hold the infusion for 1 hour and decrease rate per protocol - Hold the infusion for 1 hour and decrease rate per protocol 1. The pt. is at risk for developing at DVT post-op. Which would the nurse NOT include in the pt's plan of care? - Encourage the pt. to eat all meals OOB in a chair - The nurse will administer enoxaparin subq in the abdomen - The nurse will apply SCDs to the pt's lower extremities at bedtime - The pt. will ambulate daily - The nurse will apply SCDs to the pt's lower extremities at bedtime 1. Based on Virchow's Triad, which patient is at risk for DVT due to endothelial damage? - 70 y/o pt. with severe sepsis - 65 y/o female post-op day 1 after joint replacement surgery - 25 y/o male who uses intravenous drugs - Post-partum pregnant pt. - 25 y/o male who uses intravenous drugs A lactating woman has developed thromboembolism. Which drug should be prescribed if she wishes to continue breast-feeding? 1.Aspirin 2.Heparin 3.Dicumarol 4.Phenindione - 2 Heparin is the drug of choice to treat thromboembolism in a lactating woman because it is not absorbed in the breast milk. Aspirin may cause severe bleeding so is not preferred. Dicumarol may cause a hemorrhage and therefore is not preferred. Phenindione may cause a bruising effect and therefore is not the drug of choice.