Review Q's

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In the ED you administer D5/.45 at 125 mL per hour administer oxygen at 6L/min via NC. Give morphine 2 mg IV, acetaminophen 650 mg which was the highest priority?

IV Fluids

For a patient with DIC, the primary goal of medical treatment is to?

Identify and treat the underlying conditions that lead to the development of DIC

Sickle cell do not

bend the knee

The parents of a patient diagnosed with hemophilia A ask what symptoms they should monitor for?

Nose bleeds Blood in the urine Painful and swollen joints Easy bruising Dark coloured tarry stools

The nurse is assessing a child receiving chemo for leukemia. Which side effect would the nurse anticipate?

Nose bleeds!

Hemophilia a results from lack of

factor 8

Hemophilia B results from lack of

factor 9

normal serum lactate

0.5-1 mmol/L

When preparing to administer a ordered blood transfusion, the nurse selects which of the following iv solutions?

0.9% NACL

The nurse is reviewing a health care providers prescription for a child with sickle cell anemia who was admitted to the hospital with a vaso-occlusive crisis. Which prescription documented in the childs health record should the nurse question? (SATA) 1. Restrict fluid intake 2. Position for comfort 3. Avoid strain on painful joints 4. Apply nasal oxygen at 2L/min 5. Provide a high calorie, high protein diet 6. Administer mependine (Demerol) 25 mg for pain

1. Restrict fluid intake 6. Administer mependine (Demerol) 25 mg for pain Demoral can cause seizures in pt's with renal disease

Before starting a blood transfusion a nurse should get a colleague to monitor other patients for?

15 minutes

Normal serum bicarbonate

22-26 mEq/L

Albumin

3.5-5

A nurse must hang a unit of packed blood cells within how long from receiving from the blood bank?

30 mins

The nurse from the med surg unit is assigned multiple patients. Which of the following patients is most at risk for a stroke? 62 year old patient who weighs 275lb with a-fib and sickle cell anemia A 77 year old patient who drinks a glass of wine nightly, smokes and had a previous MI A 40 year old patient who uses oral contraception and has chronic kidney disease A 50 year old patient with migraines whose father had a stroke

62 year old patient who weighs 275lb with a-fib and sickle cell anemia

Normal D-dimer

<250 ng/mL

Which of the following best describes DIC?

A disease process stimulates coagulation processes with resultant depletion of clotting factors leading to diffuse clotting and hemorrhage.

A nurse in a maternity unit is reviewing the records of the clients on the unit. Which client would the nurse identify as being at the greatest risk for DIC? A primagravida with mild preeclampsia A primagravida who delivered a 10lb baby 3 hours ago A gravida III who has just been diagnosed with dead fetus syndrome A gravida IV who has pre-eclampsia who delivered 8 hours ago and lost 500mL of blood.

A gravida IV who has pre-eclampsia who delivered 8 hours ago and lost 500mL of blood.

Clinical manifestations of AML

Anorexia Petechiae Irritability Listlessness

What is the priority nursing action when caring for a client with DIC? Monitor for homan sign? Avoid giving IM injections? Take temperatures via the rectal route? Apply sequential compression stockings?

Avoid giving intramuscular injections

In considering the genetics of sickle cell disease. You understand that VL's inheritance of scd occurred because?

Both of her parents carried HbS

SIRS vs. Sepsis

Both: whole body inflammatory response, increase in HR and respiration, abnormal WBC count, fever complications: fluid retention/tissue edema, low BP, impaired blood flow, hypovolemic shock, MODs SIRS- severe injury/trauma Sepsis- unresolved infection

Hodgkin disease first lymph nodes affected?

Cervical

Sores in mouth complication of

Chemo Not present in patient before chemo

As a nurse providing care to a client with DIC, what potential complication should you continually assess the client for?

Clotting Hemorrhage

An adolescent with acute hemophilia episode what does RICE promote?

Controlling bleeding and retaining joint function

Which medication is most beneficial to the client with sickle cell anemia on a blood transfusion regimen who has cardiac dysrhythmias due to iron overdose toxicity?

Deferoxamine

Sirs - Sepsis

Fever High BP

Common interventions for management of sickle cell crisis?

HYDRATION Electrolyte replacement Pain control Blood replacement Infection treatment

Sepsis tell tale sign?

High glucose in non-diabetic

The nurse receives a physicians order to transfuse fresh frozen plasma to a patient suffering from an acute blood loss. Which of the following procedures is most appropriate for infusing this blood product?

Infuse the FFP as rapidly as the patient will tolerate

hydroxurea for sickle cell

Makes RBC/s bigger Creates production of hemoglobin F

Multiple myeloma cancer of?

Mature plasma cell

Leukemis s/s young child?

Pallor Fatigue Multiple bruises

A client is receiving a unit of packed RBC's. Which findings lead the nurse to suspect a transfusion reaction caused by incompatible blood?

Respiratory distress Backache Chills

A client is receiving a unit of packed red blood cells. Which findings led the nurse to suspect a transfusion caused by incompatible blood?

Respiratory distress Backache Chills

Imatinib side effects

Signs of infection Bleeding tendencies

Imatinib side effects for cml

Signs of infection Bleeding tendencies

Which intervention is most appropriate to help control VL's pain? Obtain an order for a heating pad for her abdomen Teach her guided imagery and relaxation techniques Position her in a fowlers position with the knee elevated Divert het attention by asking what she would like to watch on tv

Teach her guided imagery and relaxation techniques

Multiple myeloma s/s

Typically discover by accident

Non-Hodgkin's Lymphoma

a malignant cancer that starts in the lymphocytes; includes any type of lymphoma except Hodgkin's lymphoma

Hodgkin's lymphoma

distinguished from other lymphomas by the presence of large, cancerous lymphocytes known as Reed-Sternberg cells

Hodgkin lymphoma diagnosed

during adolescence and young adulthood

What does albumin do?

maintains osmotic pressure


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