Case Study: Disorders of Hemostasis A nurse is caring for a 32-year-old pregnant woman who is admitted to the obstetric unit with the chief complaint of right-sided leg pain and swelling for 3 days. The patient is in her third trimester of pregnancy. When the nurse collects her history, she states she has been healthy, with no known medical problems in the past. She does not take medications at this time but gives a history of using oral birth control pills before she became pregnant. On physical exam, the nurse notes that the right leg is larger than the left with increased swelling and pain on palpation of the calf muscle. The admitting diagnosis is right-sided deep vein thrombosis. 1. Reviewing the information given, what risk factors does this patient have that could increase her chance of development of a clot? Are there other risk factors the nurse should consider? 2. This patient because she is pregnant is prescribed heparin intravenously as treatment for the clot. Describe how this drug works. How does heparin impact the normal clotting process? 3. Case Study: Disorders of Red Blood Cells A nurse is caring for an 18-year-old woman in an outpatient clinic who is complaining of increasing fatigue for 3 months. She denies other signs or symptoms. She is generally healthy with no pertinent past medical history. She takes no medications daily. A CBC was ordered by the physician and the following results came back the next day. Reference Values Hgb 10.6 11.1–15.7 g/dL Hct 30 34%–44% MCV Mean corpuscular volume 66 82–98 mm3 MCH Mean corpuscular Hgb 25 26–34 pg/cell 3. Evaluate each of the above results. What does each result tell you about this patient’s red blood cell function? 4. What are common signs and symptoms of anemia the nurse should monitor for in this patient? What is the physiological reason for each? 5. What are the two most common causes of anemia in this age female? Compare and contrast the pathophysiology of each.



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