Which of the following conditions predispose a patient to venous thromboembolic disease? 1. Carcinoma 2. COPD 3. Trauma 4. Thrombocytosis
a. 1, 2, and 3 only
b. 1 and 4 only
c. 2 only
d. 1, 3, and 4 only
ANS: D
Several conditions enhance the intravascular coagulability of the blood and predispose to venous thromboembolic disease (Box 28-1). The most frequent causes of an inherited hypercoagulable state are the factor V Leiden mutation and the prothrombin gene mutation, which together ac-count for 50% to 60% of cases. The major acquired risk factors for VTE include recent major surgery, trauma, immobilization, antiphospholipid antibody syndrome, malignancy, pregnancy, oral contraceptives, and myeloproliferative disorders. Vessel wall abnormalities are found most often in patients who have sustained trauma or have undergone major surgery.
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Your patient is a 23-year-old female who is 6 hours postpartum after a traumatic delivery resulting in a massive blood transfusion. She is to be transferred from a community hospital to a specialty hospital for further care. She is unconscious and intubated, with a number of intravenous lines. Your physical examination reveals a purpuric rash over the chest and abdomen and mottling of the fingers and toes and all of the venous access sites are oozing blood. In addition, auscultation of the lung fields reveals rales to the dependent regions. HR = 112, BP = 82/60, RR = 12 via ventilator. Which of the following best describes the patient's condition and treatment needs, in addition to continued ventilation and fluid administration?
A) DIC; type O negative blood B) Idiopathic hemophilia; corticosteriods C) DIC; fresh frozen plasma and platelet administration D) Idiopathic hemophilia; factor VIIa administration
The provision of HIPAA that applies to the use and disclosure of protected health information is the:
A. Administrative Rule. B. Reimbursement Rule. C. Privacy Rule. D. Medical Records Rule.