Saunders Hematology

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The pediatric nurse educator provides a teaching session to the nursing staff regarding hemophilia. Which statement regarding this disorder should the nurse plan to include in the discussion

Hemophilia A results from deficiency of factor VIII

The nurse is monitoring the lab values of a child with leukemia who is receiving chemo. The nurse prepares to implement bleeding precautions if the child becomes thrombocytopenic and the platelet count is less than how many cells/mm

150,000

The nursing student is presenting a clinical conference and discusses the cause of beta thalassemia. The nursing student informs the group that a child at greatest risk for developing this disorder is which of these

A child of mediterranean descent

An 11 year old child is admitted to the hospital in a vaso-occlusive sickle cell crisis. The nurse plans for which priority treatments in the care of the child

Adequate hydration, pain mgmt

The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents

Administer the iron through a straw

The pediatric nurse educator is providing a teaching session to nursing staff about hemophilia. Which statement should the nurse educator include

Affected prepubescent girls should be counseled concerning menorrhagia, which may be life-threatening

he nurse is caring for a child with a dx of hemophilia, and hemarthrosis is suspected b/c the child is complaining of pain in the joints. Which measure should the nurse expect to be rx'd for this child

Application of a bivalved cast for join immobilization

A child arrives at the ED with a nosebleed. On assessment, the nurse is told by the mother that the nosebleed began suddenly and for no apparent reason. What is the initial nursing action

Ask the child to sit down and lean forward, and apply pressure to the nose

The nurse provides instructions regarding home care to parents of a 3 year old child hospitalized with hemophilia. Which statement, if made by the parent, indicates a need for further instructions

We will avoid having our child receive immunizations

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 being prescribed

Deferoxamine

A 12 year old child with newly diagnosed thalassemia is brought to the clinic exhibiting delayed sexual maturation, fatigue, anorexia, pallor and complaints of headache. The child seems listless and small for age and has frontal bossing. What should the nurse expect to note on review of the results of the lab tests

Deficient production of functional hgb

The home care nurse is providing safety instructions to the mother of a child with hemophilia. Which instruction should the nurse include to promote a safe environment for the child

Eliminate any toys with sharp edges from the child's play area

The nurse provides instructions to the mother of a child with sickle cell disease. Which statement by the mother indicates a need for further teaching

I know my child must spend as much time as possible in the sun

The nurse is providing instructions to the mother of a 3 year old child with hemophilia regarding care of the child. Which statement by the mother indicates a need for further teaching

I need to cancel the upcoming dental appointment that I made for my child

A 10 year old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which rx

IV infusion of factor VIII

A nursing student is assigned to care for a child with sickle cell disease. The nursing instructor asks the student to describe the causative factors r/t this disease. Which statement by the student indicates a need for further research

If each parent carries the trait, the child will carry the trait and the probability of the child having the disease is 75%

The nurse is reviewing the lab results of a child with aplastic anemia and notes that the WBC is 2,000 and the platelet count is 150,000. Which intervention should the nurse incorporate into the plan of care

Maintain strict neutropenic precautions

A 2 year old boy with a dx of hemophilia is admitted to the hospital with bleeding into the joint of the right knee. Which intervention should the nurse plan to implement in this child

Measure the injured knee joint every shift

The nurse analyzes the lab results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child

PTT

The nurse is providing home care instructions to the mother of an infant who has just been found to have hemophilia. The nurse should tell the mother that care of the infant should include which appropriate measure

Pad crib rails and table corners

A child is brought to the ED after being accidentally struck in the lower back region with a baseball bat. When gathering assessment data, the nurse discovers that the child has hemophilia. The nurse should immediately assess for which data

Presence of hematuria

Lab studies are performed for a child suspected to have iron deficiency anemia. The nurse review the lab results, knowing that which results indicates this type of anemia

RBCs that are microcytic and hypochromic

The nurse on the pediatric unit is caring for a child with hemophilia who has been in a MVA. which assessment finding, if noted in the child, indicates the need for follow up

The child is drowsy and difficult to arouse; previously the child was able to respond to questions effectively

The nurse is reviewing a HCP's rx for a child with sickle cell anemia who was admitted to the hospital for the tx of vaso-occlusive crisis. Which rx document in the child's record should the nurse question SATA a) Restrict fluid intake b) Position for comfort c) Avoid strain on painful joints d) Apply nasal oxygen at 2L/min e) Provide a high calorie, high-protein diet f) Give meperidine 25 IV q4h for pain

a, f

The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of VWD SATA a) Easy bruising occurs b) Gum bleeding occurs c) It is a hereditary bleeding disorder d) Tx and care are similar to that for hemophilia e) It is characterized by extremely high creatinine levels f) The disorder causes platelets to adhere to damaged endothelium

a-d, f

Oral iron is rx'd for a child with iron deficiency anemia. The nurse provides instructions to the mother regarding the administration of the iron.the nurse should instruct the mother to administer the med in which way

b/w meals

A child with sickle cell anemia who is in vaso-occlusive crisis is admitted to the hospital. Which HCP rx would assist in reversing the vaso-occlusive crisis

begin IV fluids

A child is seen in the health care clinic for complaints of fever. On data collection, the nurse notes that the child is pale, tachycardic and has petechiae. Aplastic anemia is suspected. The nurse should prepare the child to obtain which specimen that will confirm the dx

bone marrow bx

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors r/t sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction

fluid overload

The pediatric nursing instructor asks a nursing student to prioritize for a child diagnosed with sickle cell disease. Which student response correctly identifies the priority of care

hypoxia

A child with a dx of sickle cell anemia and vaso-occlusive crisis is complaining of severe pain, selecting number 8 on the 1 to 10 pain scale. Which med would the nurse expect to be rx'd for pain control

morphine sulfate

Oral iron supplements are rx's for a 6 year old with iron deficiency anemia. Which beverage is the best option to recommend with iron administration

orange juice

The nurse is caring for a child with hemophilia and is reviewing the results that were sent from the lab. Which result should the nurse expect in this child

prolonged PTT

A child in whom sickle cell anemia is suspected is seen in a clinic and lab studies are performed. The nurse checks the lab results, knowing that which value would be increased in this disease

reticulocyte ocunt

The nurse is providing home care instructions to the parents of a 10 year old child with hemophilia. Which sport activity should the nurse suggest for this child

swimming

The nurse is collecting data on a 12 month old child with iron deficiency anemia. Which finding should the nurse expect to note in this child

tachycardia


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