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A patient is recovering from CABG surgery. On postoperative day 3, the patient's laboratory values indicate thrombocytopenia and elevated liver function tests. The patient is scheduled for hemodialysis today. A nurse notifies the physician of the abnormal laboratory values. The nurse should next anticipate an order to
The patient has thrombocytopenia, which is a low platelet count that increases the risk of bleeding. Heparin is an anticoagulant that prevents clotting, but also increases the risk of bleeding. Therefore, heparin should be avoided in patients with thrombocytopenia. Hemodialysis can be performed without heparin by using alternative methods such as saline flushes, blood predilution, or specialized dialyzers that reduce clotting. Transfusing platelets during hemodialysis is not recommended, as platelets may be damaged by the extracorporeal circuit. Rescheduling hemodialysis may not be feasible, as the patient may have fluid overload, electrolyte imbalance, or uremia that require urgent dialysis.
Use and safety of heparin-free maintenance hemodialysis in the USA
A patient is admitted with a traumatic brain injury after being thrown from a horse. Despite numerous interventions, the patient is declared brain dead.
The parents have consented for organ donation, and the patient's mother requests to lay next to her daughter before being taken to the operating room.
Which of the following is the nurse's most appropriate response?
The nurse should respect the mother's request and facilitate the family's emotional needs during the end-of-life care. The nurse should also ensure the patient's safety and dignity by preparing and organizing the necessary equipment and monitoring before moving the mother next to the patient. The other options are not appropriate because they either deny the mother's request, imply that the patient is no longer alive, or delay the organ donation process.
Donor Family Care Service - NHS Blood and Transplant
Family-Centered Care to Improve Family Consent for Organ Donation
The purpose of administering a sodium nitroprusside (Nipride) drip after a carotid endarterectomy is to
Sodium nitroprusside (Nipride) is administered after a carotid endarterectomy to decrease mean arterial pressure (MAP) and reduce the risk of hemorrhage at the surgical site. By lowering the blood pressure, it minimizes the chance of bleeding while ensuring adequate cerebral perfusion through careful monitoring. Reference: = AACN Handbook for CCRN Certification, pp. 75-78.
When assessing a patient who has acute pancreatitis, which of the following findings require immediate notification to the provider?
The family member of a patient who is receiving mechanical ventilation is to be taught suctioning. When developing a teaching plan, the nurse should first
The first step in developing a teaching plan is to assess the learner's needs, knowledge, and readiness to learn. This will help the nurse tailor the teaching plan to the individual's learning style, preferences, and goals. Obtaining written information, determining a schedule, and encouraging observation are all strategies that can be used later in the teaching plan, but they are not the first step.
AACN Essentials of Critical Care Nursing, Fourth Edition, page 18.
