Assessment/
Diagnostics
Diagnostics
Which is a symptom of severe thrombocytopenia?
A. Dyspnea
B. Petechiae
C. Inflammation of the mouth
D. Inflammation of the tongue
Petechiae
patients with severe thrombocytopenia have petechiae, which are pinpoint hemorrhagic lesions, usually more prominent on the trunk or anterior aspects of the lower extremities.
Rejection of a transplanted kidney within 24 hours after transplant is termed
A. hyperacute rejection.
B. simple rejection.
C. chronic rejection.
D. acute rejection.
A. hyperacute rejection.
Hyperacute rejection may require removal of the transplanted kidney. Acute rejection occurs within 3 to 14 days of transplantation. Chronic rejection occurs after many years. The term simple is not used in the categorization of types of rejection of kidney transplants.
A patient with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells (RBCs). If the nurse hangs the blood at 12:00 pm, by what time must the infusion be completed?
A. 14:00:00
B. 16:00:00
C. 15:00:00
D. 18:00:00
16:00:00
When packed red blood cells (PRBCs) or whole blood is transfused, the blood should be administered within a 4-hour period because warm room temperatures promote bacterial growth.
The nurse treats a patient with end-stage kidney disease (ESKD). The nurse is concerned that the patient is developing renal osteodystrophy. Upon review of the patient's laboratory values, it is noted the patient has had a calcium level of 11 mg/dL for the past 3 days and the phosphate level is 5.5 mg/dL. The nurse anticipates the administration of which medication?
A. Calcium acetate
B. Calcium carbonate
C. Sevelamer hydrochloride
D. Mylanta
C. Sevelamer hydrochloride
: Hyperphosphatemia and hypocalcemia are treated with medications that bind dietary phosphorus in the gastrointestinal tract. Binders such as calcium carbonate or calcium acetate are prescribed, but there is a risk of hypercalcemia. If calcium is high or the calcium–phosphorus product exceeds 55 mg/dL, a polymeric phosphate binder such as sevelamer hydrochloride may be prescribed. This medication binds dietary phosphorus in the intestinal tract; one to four tablets should be administered with food to be effective. Magnesium-based antacids are avoided to prevent magnesium toxicity.
The nurse is caring for a patient who received a unit of packed red blood cell transfusion an hour ago. The patient reports shortness of breath and is very anxious. The patient's vital signs are BP 98/60, HR 110, temperature 99.4°F, and SaO2 88%. Auscultation of the lungs reveals posterior coarse crackles to the mid and lower lobes bilaterally. Based on the symptoms, the nurse suspects the patient is experiencing which problem?
A. Transfusion-related acute lung injury
B. Bacterial contamination of blood
C. Exacerbation of congestive heart failure
D. Delayed hemolytic reaction
A. Transfusion-related acute lung injury
Transfusion-related acute lung injury (TRALI) is a potentially fatal, idiosyncratic reaction that is defined as the development of acute lung injury within 6 hours after a blood transfusion. It is more likely to occur when plasma and platelets are transfused. Onset is abrupt (usually within 6 hours of transfusion, often within 2 hours). Signs and symptoms include acute shortness of breath, hypoxia (arterial oxygen saturation [SaO2] less than 90%; hypotension, fever, and eventual pulmonary edema.