A patient with idiopathic thrombocytopenia purpura continues to ...

[javeds]

A patient with idiopathic thrombocytopenia purpura continues to experience symptoms of the disease after completing several courses of prednisone therapy. The nurse anticipates that which treatment will most likely be recommended for this patient?
 
  1. lifelong prednisone therapy
  2. splenectomy
  3. aspirin therapy
  4. weekly platelet transfusions

Question 2

A patient with hemophilia is admitted with acute bleeding. Until the cause of the bleeding is determined, the nurse should be prepared to perform which intervention?
 
  1. infusing packed red blood cells
  2. infusing normal saline
  3. infusing heparin
  4. infusing fresh-frozen plasma

[brittanywood]

Answer to Question 1

Correct Answer: 2
A splenectomy is the treatment of choice if the patient with idiopathic thrombocytopenia purpura relapses when glucocorticoids are discontinued. The spleen is the site of platelet destruction and antibody production. This surgery often cures the disorder, although relapse may occur years after splenectomy. Aspirin therapy would likely result in bleeding and would be contraindicated in this situation. Platelet transfusions are ineffective with this disorder because the problem is that platelets are being produced adequately but are destroyed. Lifelong prednisone therapy is rarely prescribed and prednisone therapy has already proven ineffective for this patient.

Answer to Question 2

Correct Answer: 4
Fresh-frozen plasma replaces all clotting factors except platelets. When the cause of bleeding is not yet determined, fresh-frozen plasma may be administered intravenously until a definitive diagnosis is made. Red packed cells and normal saline would increase volume but would not replace the clotting factors. Heparin would be contraindicated as it would promote further bleeding.

[javeds]

Excellent

[recede]

TYSM