The multiparous patient at 33 weeks has experienced an intrauterine fetal demise. What finding requires immediate intervention?
1. Temperature 99.0°F
2. Platelet count 210,000
3. Fibrinogen level 50 mg/dl
4. Family refusing fetal autopsy
3
Rationale 1: Women with intrauterine fetal demise can become infected, but this temperature is not high enough to indicate infection.
Rationale 2: Intrauterine fetal demise can lead to disseminated intravascular coagulation (DIC), but this is a normal platelet count.
Rationale 3: The normal fibrinogen level is 200–400 mg/dl. This is a very low fibrinogen level, and indicates that the patient is in disseminated intravascular coagulation (DIC) caused by intrauterine fetal demise.
Rationale 4: Some religious traditions prohibit autopsy. There is a higher priority.
You might also like to view...
Music therapy is aimed at
A) decreasing stress and anxiety. B) increasing strength and endurance. C) increasing appetite. D) increasing blood pressure.
You are discharging a 4-year-old boy from the emergency department. The boy was seen for an insect bite that became swollen and reddened and warm and painful to touch
The patient's vital signs are all within normal range for age. While giving discharge instructions to the patient's father, he asks why the child is not going to get antibiotics for the infected insect bite. What would be your best response? A) "This is a local inflammatory response to the insect bite; it is not an infection so antibiotics will not help." B) "In children who are previously healthy, inflammation and infections usually resolve without the need for drugs." C) "I'll make sure the doctor is made aware that you'd like your son to have a course of antibiotics." D) "Infection is not the same as inflammation. What your son has is inflammation."
Carotid endarterectomy should only be considered for symptomatic patients with greater than what percent stenosis?
a. Greater than 25% c. Greater than 75% b. Greater than 50% d. Only for 100% occlusion
The nurse is caring for a client who had a knee replacement completed 2 days ago. When changing the knee dressing, the nurse notes that the incision appears red and feels warm to the touch. The client's temperature is now 100.6 degrees F and the client states that the knee hurts worse now than it did the day after surgery. After calling the surgeon, the nurse anticipates which to be ordered for this client?
A. Keep the client NPO and prepare for the client to be returned to surgery. B. Restart the client's IV and give fluids and pain medication. C. Culture any drainage that is present and administer fluids and antibiotics. D. Provide anticoagulant therapy and place the client on oxygen.