BLOOD / LYMPH / CIRCULATION Flashcards
The nurse analyzes the lab results of a child with haemophilia. The nurse understands that which result will most likely be abnormal in this child? A/ Platelet count B. Hematocrit level C/ Hemoglobin level D/ Partial Thromboplastin time
D/ pTT
Haemophilia is a group of bleeding disorders from a deficiency of specific coagulation proteins. Results will show normal platelet, hemoglobin and Hematocrit levels.
Partial thromboplastin time will be prolonged due to their inability to clot.
A child with Beta-Thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to use? A/ Fragmin B/ Meropenem C/ Metoprolol D/ Deferoxamine
D/ Deferoxamine
Beta-Thalassemia is an autosomal recessive disorder characterized by the reduced production of one of the globin chains in the syntheses of hemoglobin. The major complication of long-term transfusion hemosiderosis. To prevent organ damage from too much iron, chelation therapy with either Exjade or Deferoxamine may be used. Deferoaxmine if classified as an antidote for acute iron toxicity.
Fragmin and is anticoagulant
Meropenem is an antibiotic
Metoprolol is a Beta blocker used for Hypertension and rate control.
A 10-year-old child with haemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription?
A/ Injection of Factor X
B/ IV infusion of Iron
C/ IV infusion of Factor VIII
D/ Intramuscular injection of Iron using Z-track method
C/ Factor VIII
Haemophilia A suffers lack the coagulation factor VIII, therefore the primary treatment is replacement of the missing factor; additional medications, such as agents to relieve pain may be used depending on the source of bleeding.
Lab studied are performed for a child suspected to have Iron deficiency anemia. The nurse reviews the lab results, knowing that which result indicates this type of anemia?
A/ Elevated hemoglobin level
B/ decreased Reticulocyte count
C/ Elevated RBC count
D/ RBCs that are microcytic and hypochromic
D/ Microcytic and Hypocromic
Diminished Iron stores leads to decreased hemoglobin levels and mycrocytic and hypochromic RBCs, the RBC count is decreased.
A child with haemophilia A has fallen and badly bruised his knee. Which priority intervention should be done first by the nurse to manage the patient’s hemarthrosis?
A/ Use active ROM to prevent immobility
B/ Apply cold packs to promote vasoconstriction
C/ Apply pressure and immobilize the joint
D/ Notify the HCP of the injury
C/ Pressure
Pressure is used to stop the bleeding into the joint and affected tissues, and immobilization aids in reducing swelling and pain.
Active ROM is recommended after bleeding is controlled.
Cold packs can help diminish pain and swelling and promote vasoconstriction, which can help reduce bleeding. The HCP should also be informed.
Pressure is the MOST correct answer because it will stop further bleeding and enable you to enact the other interventions.
What is the most important teaching the nurse can provide to a client who has sclerotherapy for varicose veins?
A/ Limit activity until edema subsides
B/ Remove compression bandages when you’re in bed
C/ Place a pillow under the knees when lying in bed
D/ Walk for several minutes every hour when you’re awake
D/ Walk for several minutes every hour when you’re awake
Walking is encouraged to improve circulation and dilute sclerosing agent. Limiting activity is contraindicated as inactivity promotes venous stasis and engorgement of veins.
Which of the following is a clinical sign of primary hypertension?
A/ Mild but persistent diaphoresis
B/ Transient temporary memory loss
C/ Occipital headache in the mornings
D/ Cardiac palpitation during periods of stress
C/ Occipital headache in the mornings
Caused by increased vascular tension and damage to the vessels when HTN is prolonged. Transient temporary memory loss occurs in relation to TIA. Cardiac palpitations due to stress are associated with adrenaline release
The nurse provides teaching to a client who has a history of hypertension and recently underwent a femoropopliteal bypass graft. The nurse evaluates that the teaching is effective when the client says, I Should…
A/ Massage my calves everyday
B/ Keep my foot elevated when in bed
C/ Sit in a hot bath for 30 minutes every day
D/ Assess the colour and pulses in my legs every day
D/ Assess the colour and pulses in my legs every day
Presence of pulses and healthy skin colour indicate adequate arterial perfusion and graft viability. Massaging is contraindicated in peripheral vascular disease because it may traumatize vessels; thus causing a thrombus to become an embolus.
Elevated feet is more for veins than arteries.
For the first several hours after cardiac catheterization, it is imperative for the nurse to:
A/ Monitor apical pulse and BP
B/ Keep head of bed elevated
C/ Encourage client to deep cough and deep breathe q2h
D/ Check their temperature q1h until it returns to normal
A/ Monitor apical pulse and BP
Apical is taken to detect possible dysrhythmias related to cardiac irritability; blood pressure is monitored to detect hypotension which could indicate bleeding or shock.
A client has pancytopenia as a result of chemotherapy. What should the nurse plan to teach this client in an effort to minimize the risk of complications as a result of pancytopenia?
A/ Avoid traumatic injuries and exposures to infections
B/ Perform frequent mouth care with a firm tooth brush
C/ Increase oral fluid intake to 3L daily
D/ Report any unusual muscle cramps or tingling sensations in the extremities
A/ Avoid traumatic injuries and exposures to infections
Reduced platelets increases the likelihood of uncontrolled bleeding; reduced lymphocytes increases susceptibility to infection. Aggressive oral hygiene can precipitate bleeding. ALthough fluid increase can flush out toxic by=products of chemo, it has no effect on pancytopenia. D/ has no relation.
Remember Pancytopenia is a trifold state. Deficiency in WBC, RBC, and Platelets.
A client with extensive bone and soft tissue injuries to the right leg is on bed rest. When positioning the client, the nurse should:
A/ Keep the right leg resting straight on the bed, parallel to the left leg
B/ Elevate the entire right leg with pillows, keeping the foot higher than the knee
C/ Maintain both legs on the bed and use an abduction pillow to keep them separated
D/ Attache a padded knee ankle sling to a Balkan frame to support the right foot and elevate the leg.
B/ Elevate the entire right leg with pillows, keeping the foot higher than the knee
Elevating the entire leg with pillows, keeping the foot higher than the knee helps support the leg and promotes venous return; thus reducing edema and pain. A/ and B/ does not support this and would promote edema. D/ does elevate the foot, however; there is no support under the leg and can cause hyperextension of the knee.
