Hematology - The Point Questions

"It will help to decrease the amount of anemia."

A child with sickle-cell anemia is scheduled for a splenectomy. After the parents receive teaching about the rationale for this surgery, the nurse determines that the teaching was successful when the parents make which statement?

Hemoglobin electrophoresis

A nurse is caring for a newborn whose screening test result indicates the possibility of sickle cell anemia (SCA) or sickle cell trait. The nurse would expect the test result to be confirmed by which lab tests?

"We will plan to give the drug on the same day each week."

A child with congenital hypoplastic anemia who has been receiving transfusions of packed red blood cells over the long term has developed hemosiderosis. The child is prescribed deferoxamine. After teaching the parents how to administer the drug, the nurse determines that the parents need additional teaching when they make which statement?

sickle cell disease.

A nurse in the emergency department is examining a 6-month-old with symmetrical swelling of the hands and feet. The nurse immediately suspects:

"Would you help me dilute this and mix it up?"

A nurse is caring for a 7-year-old boy with hemophilia who requires an infusion of factor VIII. He is fearful about the process and is resisting treatment. How should the nurse respond?

Widely fluctuating blood pressure

A nurse is providing care for a child with disseminated intravascular coagulation (DIC). What would alert the nurse to possible neurologic compromise?

Infection

A nurse is teaching the parents of a child with sickle cell disease about factors that predispose the child to a sickle cell crisis. The nurse determines that the teaching was successful when the parents identify what as a factor?

Maintaining a fluid intravenous line

A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care care should be given priority?

Iron-chelating drugs

The child with thalassemia may be given which classification of medication to prevent one of the complications frequently seen with the treatment of this disorder?

petechiae.

The nurse is assessing a child and notices pinpoint hemorrhages appearing on several different areas of the body. The hemorrhages do not blanch on pressure. The nurse documents this finding as:

Baseball

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend?

Ensure neutropenic precautions are in place.

The nurse is caring for a child who had a stem cell transplant and is being monitored for engraftment. Which nursing action is priority?

"These values will help us monitor the disease."

The nurse is caring for a child with aplastic anemia. The nurse is reviewing the child's blood work and notes the granulocyte count is about 500, platelet count is over 20,000, and the reticulocyte count is over 1%. The parents ask if these values have any significance. Which response by the nurse is appropriate?

Initiate intravenous access.

The nurse is caring for a child with sickle-cell anemia admitted to the pediatric unit. The child reports severe pain and fever. The nurse notes the following laboratory values: white blood cells 18,000 mm3, hemoglobin 6.6 mg/dL (66.00 g/L), and bilirubin 8 mg/dL (136.83 μmol/L). Which nursing action is priority?

"She has been down, but playing in soccer camp will cheer her up."

The nurse is preparing a child for discharge following a sickle cell crisis. Which statement by the mother indicates a need for further teaching?

Swimming

The parents of a child with a bleeding disorder ask the nurse about appropriate activities and sports that they should encourage the child to participate in. What activity would be the safest for the nurse to suggest?

notify a health care provider if the child develops an upper respiratory infection.

To prevent further sickle cell crisis, the nurse would advise the parents of a child with sickle cell anemia to:

Ensure all side rails are padded.

When providing care for a toddler with hemophilia who is being prepped for an elective procedure, which nursing action is priority?

red blood cells 3.0 mm3 hemoglobin 8 mg/dL (80 g/L) bilirubin 10 mg/dL (17 μmol/L)

Which lab values will the nurse expect to observe in a child with a hemolytic blood transfusion reaction? Select all that apply.

200ml/hr

The nurse is caring for a child who weighs 44 lb (20 kg). The health care provider has prescribed a transfusion of 1 unit of packed red blood cells. The nurse transfuses the blood at what rate?