Which problem reported by a patient with hemophilia is most ...

[itsmyluck]

Which problem reported by a patient with hemophilia is most important for the nurse to communicate to the physician?
 
  a. Leg bruises
  b. Tarry stools
  c. Skin abrasions
  d. Bleeding gums

Question 2

A 19-year-old woman with immune thrombocytopenic purpura (ITP) has an order for a platelet transfusion. Which information indicates that the nurse should consult with the health care provider before obtaining and administering platelets?
 
  a. The platelet count is 42,000/L.
  b. Petechiae are present on the chest.
  c. Blood pressure (BP) is 94/56 mm Hg.
  d. Blood is oozing from the venipuncture site.

[Ptupou85]

Answer to Question 1

ANS: B
Melena is a sign of gastrointestinal bleeding and requires collaborative actions such as checking hemoglobin and hematocrit and administration of coagulation factors. The other problems indicate a need for patient teaching about how to avoid injury, but are not indicators of possible serious blood loss.

Answer to Question 2

ANS: A
Platelet transfusions are not usually indicated until the platelet count is below 10,000 to 20,000/L unless the patient is actively bleeding. Therefore the nurse should clarify the order with the health care provider before giving the transfusion. The other data all indicate that bleeding caused by ITP may be occurring and that the platelet transfusion is appropriate.