Question

The CBC of a client with emphysema reveals a red blood cell count of \(8,000,000\) / cu mm. Based on the client's lab results, the nurse recognizes that the client has an increased risk for: A. Hemorrhagic stroke B. Thrombus formation C. Hospital-acquired pneumonia D. Prolonged bleeding

Short answer

A. Hemorrhagic stroke B. Thrombus formation C. Hospital-acquired pneumonia D. Prolonged bleeding Answer: B. Thrombus formation

Step-by-step solution

Analyze the given RBC count

The given red blood cell (RBC) count is \(8,000,000\) / cu mm. This is an elevated RBC count, as the normal range for RBC count is around \(4,000,000 - 6,000,000\) / cu mm for men and \(3,500,000 - 5,500,000\) / cu mm for women.

Understand the possible risks

Let's analyze the options given in the exercise to see which risk is associated with an increased RBC count: A. Hemorrhagic stroke - This occurs due to bleeding within the brain but is not directly related to elevated RBC counts. B. Thrombus formation - A thrombus is a blood clot that forms within a blood vessel. An elevated RBC count can lead to an increased risk of thrombus formation due to the increased blood viscosity. C. Hospital-acquired pneumonia - Pneumonia as a whole is not related to the elevated RBC count. D. Prolonged bleeding - This is related to the deficiency of clotting factors in the blood and is not directly related to an elevated RBC count.

Determine the correct risk

Based on the analysis in Step 2, we can determine that the client with an elevated RBC count of \(8,000,000\) / cu mm and emphysema has an increased risk for: B. Thrombus formation

Key concepts

Understanding Emphysema

Emphysema is a chronic respiratory condition characterized by damage to the alveoli, the tiny air sacs in the lungs where gas exchange occurs. This damage causes the alveoli to lose their elasticity, leading to an impaired exchange of oxygen and carbon dioxide, and trapping air within the lungs.

The condition is often caused by long-term exposure to irritants, such as tobacco smoke or air pollution, which trigger an inflammatory response in the lungs. Over time, this leads to the weakening and rupture of the alveolar walls. Emphysema is a subtype of chronic obstructive pulmonary disease (COPD) and can significantly affect a patient's quality of life by causing shortness of breath even during rest or light activities.

For NCLEX-RN exam preparation, it's important to understand the pathophysiology of emphysema, as well as its symptoms, diagnosis, treatment, and nursing interventions to manage the condition and support the patient's respiratory function.

Elevated Red Blood Cell Count

In the context of our case, the patient's red blood cell (RBC) count is reported as 8,000,000 / cu mm, which is higher than the normal range. A condition known as polycythemia is characterized by an increased number of RBCs and can occur as a compensatory mechanism in chronic lung diseases, such as emphysema, where the body attempts to enhance oxygen carrying capacity in response to reduced oxygen levels.

An elevated RBC count can consequently thicken the blood, leading to an increase in blood viscosity. This physiological change bears a risk for health complications, one being thrombus formation. It's essential for nurses and healthcare providers to monitor and manage high red blood cell counts in patients, ensuring that medications and therapies are in place to reduce the risk of complications.

Differentiating between primary polycythemia, a bone marrow disorder, and secondary polycythemia due to other underlying causes is also pivotal for correct treatment and is a critical aspect for students to grasp for exams like the NCLEX-RN.

Thrombus Formation

When the RBC count in the blood is elevated, it can affect the fluidity of the blood and increase the likelihood of thrombus formation. A thrombus is a blood clot that forms within a blood vessel and can be a serious medical issue if it blocks the flow of blood to vital organs.

Thrombi can lead to conditions such as deep vein thrombosis (DVT) or pulmonary embolism (PE), both of which can be life-threatening. The risk factors for thrombus formation include immobility, certain medications, surgery, and an imbalance in the natural clotting and anticoagulant mechanisms within the body. Prevention and early intervention are crucial, and healthcare providers often use anticoagulant therapy to prevent these events in high-risk patients.

For nursing students studying for exams like the NCLEX-RN, understanding the risk factors, signs and symptoms, and interventions for thrombus prevention is vital, as well as being equipped to educate patients about the conditions.