The patient is admitted with anemia caused by blood loss and thrombocytopenia. His platelet count is 22,000/microliter. The patient is scheduled for a transfusion of RBCs and a transfusion of platelets. The nurse should:
a. give the RBCs before the platelets.
b. give the platelets before the RBCs.
c. use local therapies to stop the bleeding.
d. give the platelets and RBCs at the same time.
B
When the patient's blood does not clot because of thrombocytopenia, administration of RBCs before platelets will result in RBC loss from disrupted vascular structures. Platelets should be given first. Local therapies to stop bleeding are used when systemic anticoagulation is necessary for treatment of another health condition (e.g., myocardial infarction, ischemic stroke, or pulmonary embolism). Local procoagulants act by direct tissue contact and initiation of a surface clot.
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A 16-year-old client has a long leg cast secondary to a fractured femur. To effectively facilitate the adolescent's return to school,the school nurse should
1. meet with teachers andadministrators at the school to make sure entrances and classrooms are wheelchair accessible. 2. develop an individualized health plan(IHP) that focuses on long-term needs of the adolescent. 3. prior to the student's return toschool,meet with all of the other students to emphasize the special needs of the injured teen. 4. meet with parents of the injuredstudent to encourage homebound schooling until a short leg cast is applied.
While obtaining a detailed history from a woman who has recently emigrated from Somalia, the nurse recognizes that the woman has undergone female genital mutilation (FGM). The nurse's best response to this woman is:
a. "This is a very abnormal practice and rarely seen in the United States." b. "Do you know who performed this so that it can be reported to the authorities?" c. "We will be able to fully restore your circumcision after delivery." d. "The extent of your circumcision will affect the potential for complications."
Which is the single most important factor to consider when communicating with children?
a. Presence of the child's parent b. Child's physical condition c. Child's developmental level d. Child's nonverbal behaviors
The pigment that gives skin its color is called:
a. vitiligo c. melanin b. sebum d. nevi