Page 448 - Critical Care Nursing Demystified

Chapter 9 CARE OF THE PATIENT WITH CRITICAL HEMATOLOGIC NEEDS 433

CORRECT ANSWERS AND RATIONALES

1. A. A shift-to-the-left refers to an increase in the band neutrophils or immature neutro-
phils greater than 5%.
2. D. This patient shows cardiac (hypotensive, tachycardia, low CO) respiratory (need for
mechanical ventilation) and renal involvement (minimal renal perfusion and need for
fluids), so at least three systems are involved with failing to maintain homeostasis with-
out intervention.
3. D. Xigris is the only medication that has properties to reverse inflammation and organ
damage in MODS.
4. B. Since platelets control clotting of the blood, any platelet level below 150,000 can
indicate bleeding potentials.
5. C. DIC is a syndrome of excessive clotting and then bleeding. It is indicated by decreased
platelets, decreased urinary output, increased PT, and increased FDP.
6. A. Plavix is known to prevent platelets from aggregating and therefore increases the
potential for bleeding in this patient.
7. D. The patient with sepsis is prone to develop DVT and PE, which can be life threaten-
ing. This is treated with turning, early ambulation, antiembolism stockings, sequential
compression stockings, and low molecular weight heparin.
8. C. This value is calculated by adding the bands to the neutrophils then multiplying the
sum by the total WBCs. This patient is neutropenic and you need to provide the correct Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
care. Now institute neutropenic precautions.
9. D. Hand washing is the single most important measure for a patient who is immuno-
compromised.
10. A. Flowers can contain organisms that thrive in the water like Pseudomonas. All other
actions are appropriate.