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All patients with bleeding disorders demonstrate

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all patients with bleeding disorders demonstrate active bleeding.b.many patients have bleeding that is not obvious.c.mucous membranes have a high threshold for bleeding.d.capillaries in mucous membranes lie deep in the membrane.ANS: BTest Bank - Introduction to Critical Care Nursing 7e (Sole 2016)333Stuvia.com - The Marketplace to Buy and Sell your Study MaterialDownloaded by: briana1827 | [email protected]Distribution of this document is illegal
Stuvia.com - The Marketplace to Buy and Sell your Study MaterialAlthough many patients with bleeding disorders demonstrate active bleeding from body orifices, mucousmembranes, and open lesions or intravenous line sites, equal numbers of patients have less obvious bleeding.The most susceptible sites for bleeding are existing openings in the epithelial surfaces. Mucous membraneshave a low threshold for bleeding because the capillaries lie close to the membrane surface, and minor injurymay damage and expose vessels. Substantial blood loss can occur in any coagulopathy, resulting inhypovolemic shock.DIF: Cognitive Level: Comprehension REF: p. 492OBJevelop plans of care for the immunocompromised host and the patient who has a bleeding disorder.TOP:Nursing Process Step: AssessmentMSC: NCLEX: Physiological Integrity42. The nurse is caring for a patient diagnosed with anemia. This mornings hematocrit level is 24%. Plateletlevel is 200,000/microliter. The nurse can expect to:a.continue monitoring the patient, as this hematocrit is normal.b.administer platelets to help control bleeding.c.give fresh frozen plasma to decrease prothrombin time.d.provide RBC transfusion because this level is below the normal threshold.ANS: DTransfusion thresholds are established based on laboratory values and patient-specific variables. In general, athreshold for RBC transfusion is considered a hematocrit of 28% to 31%, based on the patients cardiovasculartolerance. If angina or orthostasis is present, a higher threshold may be maintained. The threshold fortransfusing platelets is usually between 20,000 and 50,000/microliter. Cryoprecipitate is usually infused if thefibrinogen level is less than 100 mg/dL. Fresh frozen plasma is used to correct a prolonged prothrombin timeand partial thromboplastin time or a specific factor deficiency.DIF: Cognitive Level: Analysis REF: p. 492OBJevelop plans of care for the immunocompromised host and the patient who has a bleeding disorder.TOP:Nursing Process Step: ImplementationMSC: NCLEX: Physiological Integrity43. The patient is admitted with anemia caused by blood loss and thrombocytopenia. His platelet count is22,000/microliter. The patient is scheduled for a transfusion of RBCs and a transfusion of platelets. The nurseshould:a.give the RBCs before the platelets.b.give the platelets before the RBCs.

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Nursing, Critical Care Nursing

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