CH 27 Peds-The child with a condition of the blood.....

Thalassemia major (Cooley's anemia) is treated primarily with: 1. a diet high in iron 2. multiple blood transfusion 3. bed rest until the sedimentation rate is normal 4. oxygen therapy

Correct answer: 2 Rationale: The mainstay of treatment for thalassemia major (Cooley's anemia) is frequent blood transfusions to maintain the hemoglobin level above 9.5 g/dL. Page reference: Page 627

Between which two ages does the highest incidence of iron-deficiency anemia occur? Birth and 4 weeks 9 and 24 months 3 and 5 years 12 and 16 years

9 and 24 months The highest incidence of iron-deficiency anemia occurs from the ninth to the twenty-fourth month. During this rapid growth period, the infant outgrows the limited iron reserve that was in the body; in addition, iron-fortified formula and infant cereals may have been eliminated from the diet.REF: Page 622

What is the classic symptom of idiopathic (immunological) thrombocytopenia purpura (ITP)? Bruising Fever Nosebleed Irregular pulse

Bruising The classic symptom of ITP is easy bruising, which results in petechiae and purpura. Approximately 30% of the patients also have nosebleeds. There may be recent history of rubella, rubeola, or viral respiratory infection.REF: Page 629

When the patient experience apprehension and urticaria while receiving a blood transition, the nurse: 1. slows the transfusion and takes the patient's vital signs 2.observe the child for further transfusion reactions. 3. stops the transfusion, allows normal saline solution to run slowly and notifies the charge nurse. 4. stops what he or she is doing and obtains the patient's history

Correct answer: 3 Rationale: If a reaction to the blood transfusion occurs, then stop the infusion, keep the vein open with normal saline solution, and notify the charge nurse. Take the patient's vital signs and observe closely. Page reference: Page 633; Nursing Tip

Which principle should the nurse teach the parent concerning administering liquid iron preparation to the child with iron-deficiency anemia? 1. allow the preparation to mix with saliva and bathe the teeth before swallowing 2. warm the medication before ministering 3. administer between meals 4. administer in the bottle of formula

Correct answer: 3 Rationale: Iron is given orally two or three times a day between meals. Vitamin C aids in the absorption of iron; therefore it is suggested that juice be given at the same time. Liquid preparations are taken through a straw to prevent the teeth from being temporarily discolored. Oral iron supplements should not be given with milk or milk products because milk interferes with iron absorption. Page reference: Page 623 Nursing Care Plan 27-1, Page 622 Nursing Tip

A child who is in the vasoocclusive crisis caused by sickle cell anemia is experiencing acute pain. The nurse understands that Demerol (meperidine) is not an appropriate pain medication to administer to this child because it: 1. is very addicting 2. is not very is not strong enough 3. may induce seizures 4. cannot be given by mouth

Correct answer: 3 Rationale: Meperidine (Demerol) is not recommended for children with sickle cell disease because of the risk of normeperidine-induced seizures. Page reference: Page 626

What is a characteristic manifestation of Hodgkin's disease? 1. petechiae 2. Erythematous rash 3. Enlarged lymph nodes 4. pallor

Correct answer: 3 Rationale: The presenting symptom of Hodgkin's disease is generally a painless lump along the neck. There are typically few other manifestations. Page reference: Page 633

What is the most common form of childhood cancer? Lymphoma A brain tumor Leukemia Osteosarcoma

Leukemia Leukemia is the most common form of childhood cancer. It was considered fatal in the past, but the prognosis has improved greatly with modern treatments and medication. Approximately 2000 new cases of childhood leukemia are diagnosed in the United States every year.REF: Page 630

The nurse is caring for a 5-year-old child with leukemia admitted to the hospital with the primary diagnosis of pneumonia. What does the nurse suspect as most likely cause of this child's pneumonia? Eosinophilia Neutropenia Thrombocytopenia Anemia

Neutropenia Four priority challenges in the care of leukemic children are complications of anemia from decreased RBC infection, infection from neutropenia, bleeding from decreased platelets, and fractures resulting from the involvement of the bone marrow.REF: Page 631

Which are characteristics of sickle cell anemia? Select all that apply. Clinical symptoms present around 1 year of life Chronic anemia Pale and tires easily Can be caused by severe hemorrhage Prevented by adequate intake of iron by mother during pregnancy Potentially fatal crises can occur

Sickle Cell disease symptoms do not appear until about year of life. The child will have the characteristic, chronic anemia, characterized by pale color and tiring easy. Sickle cell disease is a gentic defect, which cannot be prevented. It is identified early and symptoms treated. It is not caused by any trauma or hemorrhage.REF: Page 624

What should the nurse include when educating parents regarding care of their child following a lymphangiogram? The child may be lethargic. Slight hair loss may occur. Diarrhea is common. The skin and urine may take on a bluish color.

The skin and urine may take on a bluish color. After a lymphangiogram the skin and urine may take on a bluish color.REF: Page 633

What are the stages of dying as detailed by Kubler-Ross (1975)? Select all that apply. Bargaining Denial Remorse Anger Acceptance Depression

The stages of dying as detailed by Kubler-Ross (1975) include bargaining, denial, anger, acceptance, depression, and reaching out to help others.REF: Page 638

An 8-year-old boy diagnosed with hemophilia presents at the emergency department with hemarthrosis from a fall on the school playground. What would be included when following a traditional approach to care? Select all that apply. Warm compresses Compression Ice Continuous pulse oximetry Rest Elevation

When bleeding does occur in hemophilia, the traditional approach to care includes rest, ice, compression, and elevation (RICE).REF: Page 628