hematology/ immune part 2
a 6 yr old with HIV infection has been admitted to the hospital for pain management. the child asks the nurse if the pain will ever go away. the nurse should make which best response to the child?
" I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less."
the nurse provides home care instructions to the parent of a child with AIDS. which statement by the parent indicates the need for further teaching?
"I can send my child to day care if he has a fever, as long as it is a low-grade fever."
the home care nurse provides instructions regarding basic infection control to the parent of an infant with HIV infection. which statement if made by the parent, indicates the need for further instruction?
"I will clean up any spills, from the diaper with diluted alcohol."
the nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepped for discharge. which statement by a parent indicates a need for further instruction?
"We need to maintain droplet precautions and a quiet env. for at least 2 weeks."
a clinic nurse prepares a teaching pan for a client receiving an antineoplastic med. when implementing the plan, the nurse should make which statement to the client?
"You need to consult with the primary HCP before receiving immunizations."
the nurse is assessing a child admitted with a dx of rheumatic fever. which significant question should the child's parent during the assessment?
"has any family member had a sore throat within the past few weeks?"
tamoxifen citrate is prescribed for a client with metastatic breast carcinoma. the client asks the nurse if her family member with bladder cancer can also take this med. the nurse most appropriately responds by making which statement?
"this med can be taken to prevent and treat clients with breast cancer."
the nurse is conducting staff in-service training on von Willebrand's disease. which should the nurse include as characteristics of von Willebrand's disease
-easy bruising -gum bleeding -tx and care are similar to that for hemophilia -disorder causes platelets to adhere to damaged endothelium
Which home care instructions should the nurse provide to the parents of a child with acquired immunodeficiency syndrome (AIDS) (Select all that apply)?
-monitor child's weight -frequent hand-washing is important -the child should avoid exposure to other illnesses -clean up body fluid spills with bleach solution (10:1)
ketoconazole is prescribed for a client with a dx of candidiasis. which interventions should the nurse include when administering the med
-monitor liver function studies -instruct the client to avoid alcohol -instruct the client to avoid exposure to the sun
the nurse is caring for a client who has been taking a sulfonamide and monitor for s/s of which adverse effects of the med
-nephrotoxicity -bone marrow suppression -GI effects
the nurse caring for a client who is taking aminoglycoside should monitor the client for which adverse effects of the med
-ototoxicity -renal toxicity -dysrhythmias
the nurse is reviewing a HCP prescriptions for a child with sickle cell anemia who was admitted to the hospital for the tx of vaso-occlusive crisis. which prescriptions documented in the child's record should the nurse question
-restrict fluid intake -give meperidine, 25 mg IV, every 4 hours for pain
the nurse is monitoring the IV infusion of an antineoplastic med. during the infusion, the client complains of chest pain at the insertion site. on inspection of the site, the nurse notes redness and swelling and that the infusion of the med has slowed in rate. the nurse suspects extravasation and should take which action
-stop the infusion -prepare to apply ice or heat to the site -notify the primary HCP -prepare to administer a prescribed antidote into the site
the nurse is caring for a postrenal transplantation client taking cyclosporine. the nurse notes an increase in one of the client's VS, and the client is complaining of a headache. what VS is most likely increased
BP
a 10 yr old child with hemophilia A has slipped on the ice and bumped his knee. the nurse should prep to administer which prescription
IV infusion of factor V111
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
lab studies 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
RBC that are microcytic and hypochromic
the nursing student is presenting a clinical conference and discusses the cause of B-thalassemia. the nursing student informs the group that a child at greatest risk of developing this disorder in which of these
a child of mediterranean descent
the nurse is instructing the parents of a child with irone deficiency anemia regarding the administration of a liquid oral supplement. which instruction should the nurse tell the parents
administer iron through a straw
the nurse is caring for a child diagnosed with erythemia infectiosum (5th disease). which clinical manifestation should the nurse expect to note in the child?
an intense fiery red edematous rash on the cheeks
a client with metastatic lung cancer is receiving tamoxifen. the nurse specifically monitors which lab value while the client is taking this med?
ca level
An infant of a mother infected with human immunodeficiency virus (HIV) is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which sign? 1. Cough 2. Liver failure 3. Watery stool 4. Nuchal rigidity
cough
a client with non-Hodgkin's lymphoma is receiving daunorubicin. which finding would indicate to the nurse that the client is experiencing an adverse effect r/t the med?
crackles on auscultation of the lungs
A child with b-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 be prescribed? 1. Fragmin 2. Meropenem (Merrem) 3. Metoprolol (Toprol-XL) 4. Deferoxamine (Desferal)
deferoxamine (desferal)
the clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors r/t sickle cell crisis. what, if identified by the parents as a precipitating factor, indicates the need for further instruction
fluid overload
a client who is AIDS positive has been taking stavudine. the nurse should monitor which most closely while the client is taking this med
gait
amikan is prescribed for a client with a bacterial infection. the nurse instructs the client to contact the primary HCP immediately if which occurs
hearing loss
the nurse is providing med instructions to a client with breast cancer who is receiving cyclophosphamide. the nurse should tell the client to take which action?
increase fluid intake to 2000 to 3000 daily
the nurse is analyzing the lab results of a client with leukemia who has received a regimen of chemo. which lab value would the nurse specifically note as a result of massive cell destruction that occurred from the chemo
increased uric acid level
"Chemotherapy dosage is frequently based on total body surFace area (BSA), so it is important for the nurse to do which of the following before administering chemotherapy? "1. Measure abdominal girth 2. Claculate BMI 3. Ask the client about his/her height and weight 4. Weigh and measure the client on the day of medication administration"
measure the client's current weight and height
The mother with HIV infection brings her 10 month old infant to the clinic for a routine checkup. The health care provider has documented that the infant is asymptomatic for HIV infection. After the checkup the mother tells the nurse that she is so pleased that the infant will not get HIV. The nurse should make which most appropriate response to the mother? A. I am so pleased also that everything has turned out fine. B. Because symptoms have not developed, it is unlikely that your infant will develop HIV infection C. Everything looks great, but be sure that you return with your infant next month for the scheduled visit. D. Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are three years old.
most children with HIV develop symptoms within the first 9 mon of life, and some become symptomatic sometime before they are 3 years old.
The client with small cell lung cancer is being treated with etoposide (Toposar). The nurse assisting in caring for the client during its administration should understand that which side/adverse effect is specifically associated with this medication?
orthostatic hypotension
a pediatrician prescribes lab studies for an infant of a woman positive for HIV. the nurse anticipates that which lab study will be prescribed for the infant?
p24 antigen assay
the nurse is reviewing the hx and px exam of a client who will be receiving asparaginase, an antineoplastic agent. the nurse contacts the primary HCP before administering the med of which disorder is documented in the client's hx?
pancreatitis
The client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which adverse effect is specific to this medication?
peripheral neuropathy
the nurse is monitoring the lab results of a client receiving an antineoplastic med by the IV route. the nurse plans to initiate bleeding precautions if which lab result is noted?
platelet count of 50,000
The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?
pulmonary function tests
the nurse is reviewing the results of serum lab studies drawn on a client with AIDS who is receiving didanosine. the nurse interprets that the client may have medication discontinued by the HCP if which elevated result is noted
serum amylase level
the nurse is assigned to care for a client with cytomegalovirus retinitis and AIDS, who is receiving foscamet, an antiviral med. the nurse should monitor the results of which lab study while the client is taking this med
serum creatinine level
the nurse caring for a child diagnosed with rubeola notes that the pediatrician has documented the presence of Koplik's spots. on the basis of this documentation, which observation is expected?
small, blue-white spots with a red base found in the buccal mucosa
the nurse is providing home care instructions to the parents of a 10 yr old child with hemophilia. which sport activity should the nurse suggest for this child
swimming
the client with AIDs and pneumocystis jiroveci infection has been receiving pentamidine. the client develops a temp. of 101. the nurse continues to assess the client, knowing that this sign most likely indicates which condition
that the client has developed another infection caused by leukopenic effects of the med
the clinic nurse is instructing the parent of a child with AIDS regarding immunizations. the nurse should provide which instruction to the parent?
the inactivated influenza vaccine will be given yearly
a mother of a child with mumps calls the health care clinic to tell the nurse that the child has been lethargic and vomiting. what instruction should the nurse give to the mom?
to bring the child to the clinic to be seen by the pediatrician
a client with acute myelocytic leukemia is being tx with busulfan. which lab value would the nurse specifically monitor during tx with this med?
uric acid level
megestrol acetate, an antineoplastic med, is prescribed for a client with metastatic endometrial carcinoma. the nurse reviews the client's hx and should contact the primary HCP, if which dx is documented in the client's hx?
venous thromboembolism
