Hay- Blood

Question 1

The nurse is assessing a client with cyanotic heart disease. What lab result would the nurse expect?

a. anemia
b. polycythemia
c. normal
d. decreased HGB

Answer 1

b. polycythemia

Question 2

When does polycythemia occur?

Answer 2

results from hypoxia

Or high altitude or when O2 is not directed into the tissues like cyanotic heart disease

Question 3

Anemia?

Answer 3

Decreased RBC’s
Reduced hemoglobin content
Reduced volume of packed RBCs

Question 4

Anemia is caused by 1 of 2 problems:

Answer 4

1. too rapid loss of RBC’s (covert, overt or destruction) or too slow production of RBCs

Question 5

Anemias are classified according to the size of the RBC’s?

Answer 5

Macrocytic
Microcytic
Normocytic

*content of Hgb in RBCs (hypochromic or normochromic)

Question 6

For cyanotic heart disease

Answer 6

The hematology lab result will not be normal due to chronic hypoxia

Question 7

What is the best response to a parent who asks the nurse whether her 5 month old infant can have cows milk?

a. wait 8 months & eat solid foods
b. baby can eat meat to get the iron she needs
c. infants younger than 12 months need iron rich formula to get the iron they need
d. try it and see how she tolerates it

Answer 7

C. infants younger than 12 months old need iron fortified formula or breast milk.

Question 8

Infants who drink cows milk do not get enough iron & are at risk for?

Answer 8

iron def anemia

Question 9

Begin solos at?

Answer 9

4-6 months of age

Question 10

An assessment of a 7 yr old infant with a Hgb of 6.5 is likely to reveal which of the following?

a. lethargic, pale, irritable
b. infant thin, energetic & sleep little
c. anorexic, vomitting, watery stools
d. flushed, fussy, tired

Answer 10

a. lethargic, pale, irritable

** can sleep a lot

Question 11

pallor characteristics of

Answer 11

low Hgb level

Question 12

What should you do for iron supplementation for a child?

Answer 12

1. straw, medicine dropper back of the mouth can stain teeth
2. milk intake <24 ounces can encourage iron rich foods
3. take iron supplements btw meals
4. Food interfers with iron absorption
5. Take iron with foods rick in vitamin c

Question 13

What are some examples of iron rich foods?

Answer 13

-apricots
-dark green leafy vegetables
-egg yolks
-liver
-dried beans
-cream of wheat
-iron fortified cereal
-prunes

Question 14

Which is true about genetic transmission of sickle cell disease?

Answer 14

both parents must carry the sickle cell trait

autosomal recessive pattern

Question 15

What are the nursing priorities for a child with sickle cell disease in a vaso-occlusive crisis?

a. admin antibiotics & neb
b. hydration & pain management
c. blood transfusions & increased calorie diet
d. school work & diversion

Answer 15

hydration & pain management

Decrease the cells O2 demands & prevent sickling

Question 16

A child with sickle cell disease is seen in the emergency department for increasing back pain & leg pain for 2 days. what is the child most likely experiencing?

Answer 16

a. vaso-occlusive crisis- mild to severe pain. Can cause bone & joint pain

Question 17

erythroblastopenia sx’s?

Answer 17

pallor
lethargy
h/a
upper resp infection

Question 18

erthro blastopenia

Answer 18

decreased blood cell production in the bone marrow

Question 19

acute chest syndrome

Answer 19

chest pain, fever, cough

Question 20

sickle cell

Answer 20

admin penicillin post hospital increased risk for pneumonia

Question 21

How should the nurse respond when asked by the mother of a child with beta- thalassemia why the child is receiving deferoxamine

Answer 21

To prevent organ damage

Question 22

beta-thalassemia

Answer 22

multiple transfusions can cause hemosiderosis (accumulation of iron deposits)

deferoxamine Given to chelate iron to prevent organ damage & complications from repeated transfusions

Question 23

hemophilia is a lifelong hereditary blood disorder with no cure

Answer 23

avoid activities that cause bleeding

X-chromosome linked- risk with each pregnancy

Question 24

Von willebrands disease

Answer 24

prevent injury

Question 25

The child has a platelet count of 45,000 with petechiae & excessive bruising covering his body. The nurse is aware that these signs are a manifestation of

Answer 25

immune thrombocytopenia (ITP)

Question 26

What are some clinical manifestations of ITP (immune thrombocytopenia)

Answer 26

excessive bruising
petechiae
mucous membranes and gums in healthy kids

causes decreased platelets

autoimmune process

Question 27

What are the clinical manifestations of erythroblastopenia?

Answer 27

pallor
lethargy
h/a
fainting
h/o upper resp infection

Question 28

What is the priority in the discharge plan for a child with immune thrombocytopenia purport (ITP)

Answer 28

Prevention of injury (safe home environment)

Question 29

ITP associated with

Answer 29

low platelet levels

Question 30

DIC

Answer 30

a child is very sick

Question 31

The nurse is caring for a child with aplastic anemia. Which of the following nursing diagnoses would be appropriate?

a. acute pain related to vase-occlusion
b. risk for infection related to inadequate secondary defenses or immunosuppression
c. ineffective protection related to thrombocytopenia
d. infeffective tissue perfusion related to anemia

Answer 31

b. risk for infection related to inadequate secondary defenses or immunosuppression
c. ineffective protection related to thrombocytopenia
d. infeffective tissue perfusion related to anemia

Question 32

Aplastic anemia is a condition in which the bone marrow ceases production of cells it normally manufactures

Answer 32

pancytopenia

Question 33

Aplastic anemia

Answer 33

The child will have varying degrees of disease depending on how low the values are for absolute neutrophil count (affects body response to infection)

platelet count (at risk for bleeding)

Question 34

Nursing dx for sickle cell anemia

Answer 34

acute pain related to vase-occlusion

Question 35

A nurse is teaching home care instructions to parents of a child with sickle cell disease. Which instructions should the nurse include

Answer 35

penicillin as ordered
avoid cold or extreme heat
adequate rest periods