Progressive Care Nursing Certification (PCCN) Practice Exam

Following CABG, a patient has a platelet count of 62,000. What is the best nursing action?

1. Continue to monitor, as platelet counts often decrease

2. Monitor for symptoms of increased ICP

3. Inform the patient about daily aspirin administration

4. Notify the physician and anticipate platelet transfusion

The correct answer is: Inform the patient about daily aspirin administration

In the context of a patient recovering from coronary artery bypass grafting (CABG) with a platelet count of 62,000, it is crucial to understand the implications of this finding. A platelet count below 150,000 is considered thrombocytopenic, which can increase the risk of bleeding. Therefore, while it might seem appropriate to inform the patient about daily aspirin administration, this option is less relevant in this scenario of low platelet count. Instead, the most appropriate nursing action in this situation would be to notify the physician and anticipate a platelet transfusion. Platelet transfusion is indicated for patients with significantly low counts to help reduce the risk of bleeding complications, especially following a surgical procedure like CABG, where maintaining hemostatic balance is critical. Monitoring is essential, but simply continuing to monitor without intervention does not address the critical nature of the low platelet count. Additionally, monitoring for symptoms of increased intracranial pressure (ICP) is not relevant in this case unless there are associated neurological symptoms. Therefore, while educating the patient on medications like aspirin is important for overall management post-CABG, the most immediate and clinically relevant action in the presence of thrombocytopenia is to ensure that measures are taken to address the low platelet count