Exam 19 - Disorders Associated with Plts, Clotting, Plasma

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Questions and Answers

Which of the following is a potential cause of decreased platelet production leading to thrombocytopenia?

Viral invasion

Antibody destruction

Aplastic anemia (correct)

Platelet sequestration in the spleen

What is the most common cause of thrombocytopenia purpura?

Acute form in children

Drug-induced

Idiopathic (ITP) (correct)

Chronic form in women

Which of the following clinical manifestations is specific to platelet disorders?

Gingival bleeding

Ecchymosis

Petechiae (correct)

Epistaxis

At what platelet count can spontaneous bleeding occur?

5,000/mm3 (A) Signup and view all the answers

Which of the following diagnostic tests would help identify abnormalities in platelet count and cell lines?

Peripheral blood smear (A) Signup and view all the answers

When monitoring a patient with thrombocytopenia, which assessment finding would indicate a potential complication?

Increased intracranial pressure (A) Signup and view all the answers

What is the therapeutic goal for anticoagulation therapy?

Prevent blood clots (A) Signup and view all the answers

What is the most common symptom associated with heparin therapy?

Hemorrhage (D) Signup and view all the answers

Which of the following is a potential cause of coagulation disorders?

All of the above (D) Signup and view all the answers

What is the initial step in the clotting mechanism?

Formation of a hemostatic plug (C) Signup and view all the answers

Which of the following is a skin and mucous membrane manifestation of coagulation disorders?

Petechiae (D) Signup and view all the answers

Which of the following is a potential clinical manifestation of circulatory hypovolemia due to coagulation disorders?

Tachycardia (B) Signup and view all the answers

What is a potential subjective finding in a patient with a coagulation disorder?

History of bleeding after surgery (D) Signup and view all the answers

Which blood test is used to evaluate the coagulation cascade?

Complete blood count (CBC) (C) Signup and view all the answers

What is a possible medical management option for a patient with a coagulation disorder?

Replacement transfusions (B) Signup and view all the answers

What is a key objective finding in a patient with a coagulation disorder?

Petechiae and ecchymosis (D) Signup and view all the answers

Which of the following is NOT a step in the clotting mechanism?

Hematomas (D) Signup and view all the answers

What diagnostic test is used to confirm the diagnosis of Multiple Myeloma?

Bone marrow biopsy (D) Signup and view all the answers

What is a key laboratory marker that can be used to monitor the extent of Multiple Myeloma?

Monoclonal protein (M protein) (D) Signup and view all the answers

Which of the following medications is commonly used to treat Multiple Myeloma?

Corticosteroids (C) Signup and view all the answers

Which of the following is an objective assessment finding that can be observed in a patient with Multiple Myeloma?

Increased body temperature (A) Signup and view all the answers

Which of the following is a nursing intervention related to the management of patients with Multiple Myeloma?

Monitoring vital signs (B) Signup and view all the answers

Which of the following is NOT a factor that is often involved in the etiology of Multiple Myeloma?

Autoimmune disease (D) Signup and view all the answers

What is a common clinical manifestation of Disseminated Intravascular Coagulation (DIC)?

Bleeding from unrelated sites (A) Signup and view all the answers

Which of the following is a primary medical management strategy for DIC?

Correction of the underlying cause (B) Signup and view all the answers

Which of the following is a primary nursing intervention in a patient with DIC?

Monitoring for signs of thrombosis and fibrinolysis (A) Signup and view all the answers

What is the purpose of administering Vitamin K in a patient with DIC?

To promote liver synthesis of clotting factors (C) Signup and view all the answers

What is the primary reason for the prolonged partial thromboplastin time (PTT) in patients with a deficiency of factors VIII and/or IX?

Abnormal coagulation process (C) Signup and view all the answers

What is the primary goal of medical management for patients with hemophilia?

Reduce bleeding and pain (D) Signup and view all the answers

Which of these nursing interventions is crucial in managing emergencies related to hemophilia?

Controlling hemorrhage using pressure and cold (D) Signup and view all the answers

What specific guidance should patients with hemophilia receive regarding potential risks?

Understanding of the importance of avoiding injury and aspirin (C) Signup and view all the answers

What is a common characteristic of Von Willebrand's Disease?

Abnormally slow coagulation and spontaneous bleeding (B) Signup and view all the answers

Which of the following treatments is commonly used for mild cases of Von Willebrand's Disease?

Desmopressin (DDAVP) administration (B) Signup and view all the answers

What is the primary underlying cause of Disseminated Intravascular Coagulation (DIC)?

Overstimulation of clotting and anti-clotting processes (B) Signup and view all the answers

Why is DIC considered a serious and potentially life-threatening condition?

It can lead to severe kidney failure and multi-organ dysfunction (B) Signup and view all the answers

Study Notes

Coagulation Disorders

Coagulation disorders are caused by trauma, vessel damage, inadequate vessel function, or irregularities in clotting factor or platelet function. Liver disease can also contribute
The clotting cascade involves three distinct reaction chains involving platelets, prothrombin, thrombin, fibrin, tissue factor (Factor III), and factors I-XIII. This process culminates in a hemostatic plug and blood clotting.
Vasoconstriction helps limit capillary leakage.
Disruptions can be congenital or arise from other diseases or medications

Clinical Manifestations

Skin and mucous membrane issues like petechiae, ecchymosis, epistaxis (nosebleeds), and gingival bleeding can occur.
Other symptoms include circulatory hypovolemia (hypotension, pallor, cool clammy skin), tachycardia, and gastrointestinal tract bleeding with abdominal pain.
Nervous system involvement may include altered responses, malaise, loss of consciousness, and speech changes.

Thrombocytopenia

Thrombocytopenia is characterized by a deficiency in circulating platelets or a change in platelet function impacting coagulation.
Low platelet counts (less than 150,000/mm³) can be caused by decreased platelet production or survival issues (antibody destruction, infections or viruses).
Other potential causes include altered platelet function and sequestration in the spleen.

Von Willebrand Disease

This inherited bleeding disorder involves abnormally slow coagulation and spontaneous episodes of bleeding (gastrointestinal, epistaxis, gingival).
It's common during pregnancy, menstruation, or after surgery.

Disseminated Intravascular Coagulation (DIC)

DIC is a severe coagulopathy resulting from excessive clotting and anti-clotting processes, often due to underlying disorders or injuries.
It is associated with significant morbidity and mortality (80-90%).

Multiple Myeloma

Multiple myeloma is a malignant plasma cell disease affecting the bone marrow.
It involves the rapid build-up of neoplastic plasma cells, which can cause bone destruction and the production of monoclonal proteins (M proteins).
Common clinical manifestations include skeletal symptoms, osteolytic lesions, and the spread of tumors to various organs.

Assessment (General)

Subjective data includes a comprehensive history of bleeding episodes, exposure to toxins or hazardous materials, medication use, and recent illnesses.
Objective data includes physical examination focusing on bleeding tendencies, skin and mucous membrane manifestations, and neurological status.
Diagnostic tests like complete blood counts, clotting factor assays, bone marrow biopsies, and imaging studies may aid in assessment and diagnosis.

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Description

Explore the intricate details of coagulation disorders and their clinical manifestations. Understand the clotting cascade, symptoms, and the impact of various conditions on hemostasis. This quiz will enhance your knowledge on blood clotting issues and related complications.