Author Question: A patient who has hemophilia A is scheduled for a minor surgical procedure. The patient states, I'm ... (Read 81 times)

mynx · **on:** Jul 23, 2018

A patient who has hemophilia A is scheduled for a minor surgical procedure. The patient states, I'm worried about this surgery. My doctor told me I had to come to the hospital for some kind of treatment a week before it.

What is that all about? How should the nurse respond?
1. You must have misunderstood the directions. Let me check with the health care provider.
2. Blood will be taken and banked in case you need to have it retransfused on the day of surgery.
3. You will be given a test dose of a medication used to increase your clotting factors.
4. This visit is related to your hemophilia and keeping you safe during the surgery.
5. Don't be worried about the testing. Nothing will hurt.

Question 2

A patient has been started on ticlopidine (Ticlid) after a myocardial infarction and stent placement. How should the nurse explain the action of this medication to the patient?

1. Ticlid will dissolve any clots that might form in your stent.
2. Ticlid will make the platelets in your blood less sticky.
3. Ticlid will change the way your platelets work their entire lives.
4. Ticlid decreases your blood's ability to clot.
5. Ticlid works just like the heparin you have been on in the hospital.

kxciann · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3,4
Rationale 1: The patient has not misunderstood the directions provided by the health care provider.
Rationale 2: Preparation for auto-transfusion is not the purpose of this visit.
Rationale 3: Desmopressin therapy can cause an increase in Factor VIII levels. A test dose is given one week prior to minor surgery to determine if the patient is responsive to the drug.
Rationale 4: Simple answers that assure the patient that his or her safety is being protected are useful when working with patients whose anxiety is elevated.
Rationale 5: The nurse has not answered the patient's concerns.

Answer to Question 2

Correct Answer: 2,3,4
Rationale 1: Ticlid does not act to dissolve clots.
Rationale 2: Ticlid is an adenosine diphosphate (ADP) receptor blocker that acts to make platelets unable to aggregate, thus rendering them less sticky.
Rationale 3: Ticlid causes irreversible changes in platelet plasma membranes.
Rationale 4: Ticlid does decrease the blood's ability to clot.
Rationale 5: The mechanisms of action of Ticlid and heparin are not alike.