The licensed practicalvocational nurse lpnvn is caring for a...

The licensed practical/vocational nurse (LPN/VN) is caring for a client with hemophilia. When reviewing the lab values, what should the LPN expect to find? Select all that apply. Prolonged activated partial thromboplastin time (aPTT) Decreased factor VIII or IX levels Normal platelet count Abnormal bleeding time Increased prothrombin time (PT)

Transcript

00:01 Not to answer the question is talk about coagulation.

00:04 It says that the evaluation of hemophilia indicate a test used to evaluate each anticoagulant in which coagulation pathway it affects.

00:12 So, hemophilia, remember, that is an inheritance or an inherited disease, and you can actually have a hemophilia a or hemophilia b.

00:20 You can have a hemophilia a or b, and they are going to affect factor 8 or factor 9, respectively.

00:27 So remember that you have an intrinsic, intrinsic pathway of coagulation, and also an extrinsic pathway population.

00:36 For example, in the intrinsic pathway, you have factor 12 that is going to convert to factor 12 activated.

00:50 Then this is going to convert factor 11 into its active form, and then it is going to activate factor 9, and it is going to activate it.

01:05 Then this factor 9 with factor 8 are going to activate factor 10, like this, okay? and then the common pathway is going to cure.

01:19 This is an intrinsic pathway.

01:21 The extrinsic pathway starts with factor 7.

01:28 It is going to be activated and it is going to directly going to convert factor 10 into factor 10, this is the extrinsic pathway.

01:43 Now, it says, or how do you test the intrinsic pathway? you test the intrinsic pathway with the ptt, or activated ptt, like this.

01:56 And the extrinsic pathway is activated by, or is tested with the protrombin time.

02:04 So here it says lab evaluation of hemophilia.

02:08 In this case, heparin.

02:09 Heparin is inhibits antithrombin 3.

02:15 Remember that after this happens, you're going to, it is going to convert plothrombin into thrombin.

02:29 Okay, and there is a molecule that inhibits thrombin, that is anti -trombin 3.

02:36 And heparin is going to inhibit this antithrombin 3.

02:42 Okay.

02:42 So if it inhibits this antithrombin 3, then thrombing is going to be inhibited, and there is not going to be coagulation cascade, or the coagulation cascade is going to be inhibited here, and there is going to be less plots form.

03:00 So this is the anti -coagulation mechanism of heparin.

03:04 So it is going to, or you're going to test, where heparin classically prolongs only the ptt, okay, the activated ptt.

03:14 But at high dosages, it can also prolong the pt, okay? so we have this, but with the last risk here, because it mainly blocks the activated pdd...

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