Progressive Care Nursing Certification (PCCN) Practice Exam

In a patient with sepsis and elevated aPTT, which treatment is indicated?

1. Platelet transfusion

2. Cryoprecipitate

3. Vitamin K

4. Fresh frozen plasma (FFP)

The correct answer is: Fresh frozen plasma (FFP)

In a patient with sepsis and elevated activated partial thromboplastin time (aPTT), administering fresh frozen plasma (FFP) is indicated. FFP contains clotting factors that are essential for the coagulation cascade, which can be impaired in septic patients due to disseminated intravascular coagulation (DIC) or liver dysfunction. Elevated aPTT suggests a deficiency of certain coagulation factors, particularly those involved in the intrinsic pathway, which FFP can help correct by providing the necessary factors. When sepsis occurs, the body's response can lead to coagulation abnormalities, and FFP can quickly restore the factors that may be depleted or dysfunctional. This is crucial in preventing or treating bleeding complications, which can arise in such patients. In contrast, platelet transfusions are generally used when there is significant thrombocytopenia or active bleeding related to low platelet counts, which may not address the underlying issue of elevated aPTT. Cryoprecipitate, while useful for fibrinogen deficiencies, does not provide the full range of factors needed to address elevated aPTT associated with sepsis. Vitamin K is reserved for patients with coagulopathy due to warfarin therapy or deficiencies related to malabsorption, and it does not