Cellular Regulation- Sickle Cell, Leukemia, Hemophilia, Lymphoma, Skin Cancer

A 6 year-old is admitted with sickle cell crisis. The patient has a FACE scale rating of 10 and the following vital signs: HR 115, BP 120/82, RR 18, oxygen saturation 91%, temperature 101.4'F. Select all the appropriate nursing interventions for this patient at this time? A. Administer IV Morphine per MD order B. Administer oxygen per MD order C. Keep NPO D. Apply cold compresses E. Start intravenous fluids per MD order F. Administer iron supplement per MD order G. Keep patient on bed rest H. Remove restrictive clothing or objects from the patient

The answers are A, B, E, G, and H. When a patient is in sickle cell crisis, the abnormal RBCs are sickling and sticking together, which blocks blood flow. To help alleviate the RBCs from clumping together and sickling, oxygen and hydration are priority. This will help dilute the blood (hence decrease the sticking of RBCs) and help supply oxygen to the RBCs (remember abnormal RBCs with hemoglobin S are very sensitive to low oxygen levels and will sickle when there is low oxygen). In addition, pain needs to be addressed. Opioid medication is the best on a scheduled basis rather than PRN (as needed). Avoid keeping patient NPO unless needed (remember patient needs hydration). Avoid cold compresses (can lead to more sickling) but instead use warm compresses. The patient will need FOLIC ACID supplements to help with RBC creation rather than iron (iron can actually build up in the body and collect in the organs in patients with sickle cell disease). Patients definitely need to be on bedrest, and restrictive clothing or objects (blood pressure cuff etc.) should be removed to help blood flow.

Identify the patients below who are at a HIGH risk for developing skin cancer. Select all that apply: A. A 22-year-old female who reports using a tanning bed three times per week. B. A 55-year-old male with dark skin that reports always wearing sunscreen while outdoors. C. A 35-year-old female with light-colored skin and eyes that reports frequent sunburns as a child. D. A 29-year-old who reports a family history of melanoma.

The answers are A, C, and D. Risk factors for skin cancer include too much exposure to the sun, usage of tanning beds, family history, light-colored skin and eyes, exposure to toxic chemicals on the skin, and frequent sunburns as a child.

You're assessing a patient's understanding about how to prevent skin cancer. Select all the statements that demonstrate the patient understood the education provided to them: A. "I will try to avoid direct sun exposure at 11 am-5pm when the sunrays are the strongest." B. "I will use a broad-spectrum sunscreen that has an SPF of 15 or higher." C. "I will limit my tanning bed usage to two times per week." D. "It is very important I wear a hat, sunglasses, and long-sleeves to avoid too much sun exposure."

The answers are B and D. Option A is wrong because the sunrays are the strongest from 10 am - 4 pm, and option B is wrong because tanning beds should be avoided all together to prevent skin cancer.

A 14 year-old female has sickle cell anemia. Which factors below can increase the patient's risk for developing sickle cell crisis? Select all that apply: A. Shellfish B. Infection C. Dehydration D. Hypoxia E. Low altitudes F. Hemorrhage G. Strenuous exercise

The answers are B, C, D, F and G. Sickle cell crisis can occur when the body experiences low amounts of oxygen in the body (so think about something that increases the body's need for oxygen or affects how oxygen is being transported). Therefore, infection (especially respiratory infections), dehydration, hypoxia, HIGH (not low) altitudes, hemorrhage (blood loss), or strenuous exercise can lead to a sickle cell crisis.

You're providing an in-service on skin cancer prevention to a local group of parents and grandparents. One topic you discuss is the identification of melanoma. Select all the characteristics of this type of skin cancer you will educate the participants about: A. Diameter of 8 mm or higher B. Red, purple, and black color C. Dissimilar borders D. Uniform appearance E. Increase in size, shape, color

The answers are B, C, and E. When educating about how to identify melanoma using the ABCDE acronym. A: asymmetrical, B: borders uneven (dissimilar), C: color dark or multiple colors, D: diameter greater than 6 mm (NOT 8 mm). E: evolution (lesion increases in size, shape, color)

Why might a skeletal X-ray be ordered for a client with sickle cell?

To detect bone and joint abnormalities.

Why might Hydroxyurea be given to a client with sickle cell?

To reduce frequency of sickling episodes

True or False: Basal and squamous cell carcinoma are both considered nonmelanoma types of skin cancer. True False

True

Dactylitis is a complication associated with sickle cell crisis. What is this?

Typically occurs in infants when there is painful swelling of the fingers and toes

"The most common signs and symptoms of leukemia related to bone marrow involvement are which of the following? "A. Petechiae, fever, fatigue B. Headache, papilledema, irritability C. Muscle wasting, weight loss, fatigue D. Decreased intracranial pressure, psychosis, confusion"

"Answer A is Correct. Signs of infiltration of the bone marrow are petechiae from lowered platelet count, fever related to infection from the depressed number of effective leukocytes, and fatigue from the anemia."

"What nursing diagnosis is seen with acute lymphocytic leukemia and thromocytopenia? "A. potential for injury B. self-care deficit C. potential for self harm D. alteration in comfort"

"Answer: A potential for injury Low platelet increases risk of bleeding from even minor injuries. Safety measures: shave with an electric razor, use soft tooth brush, avoid SQ or IM meds and invasive procedures (urinary drainage catheter or a nasogastric tube), side-rails up, remove sharp objects, frequently assess for signs of bleeding, bruising, hemorrhage.

"When caring for a client with a diagnosis of thrombocytopenia, the nurse should plan to: a. Discourage the use of stool softeners b. Assess temperature readings every six hours c. Avoid invasive procedures d. Encourage the use of a hard, brittle toothbrush

"Answer: C Rationale: Thrombocytopenia is a deficiency of platelets, and leaves the patient more prone to hemorrhage. For this reason, avoiding invasive procedures will limit the risk of hemorrhage. Stool softeners should be encouraged, while hard brittle toothbrushes should be avoided. Temperature is not the most important vital to track in this patient"

"In formulating a nursing diagnosis of risk for infection for a client with chronic lymphoid leukemia (CLL), nursing measures should include: (Select all that apply.) "A. Maintaining a clean technique for all invasive procedures. B. Placing the client in protective isolation. C. Limiting visitors who have colds and infections. D. Ensuring meticulous handwashing by all persons coming in contact with the client."

"Correct Answers: B, C, D Rationale: Chronic lymphoid leukemia (CLL) is characterized by a proliferation and accumulation of small, abnormal mature lymphocytes in bone marrow, peripheral blood, and body tissues. Infections and fever are frequent complications of CLL."

"A client diagnosed with leukemia is being admitted for an induction course of chemotherapy. Which laboratory values indicate a diagnosis of leukemia? 1. A left shift in the white blood cell count differential. 2. A large number of WBCs that decrease after the administration of antibiotics. 3. An abnormally low hemoglobin (Hb) and hematocrit (Hct) level. 4. Red blood cells that are larger than normal."

"Correct answer is 1. 1. A left shift indicates immature white blood cells are being produced and released into the circulating blood volume. This should be investigated for the malignant process of leukemia."

"A child with leukemia is complaining of nausea. A nurse suspects that the nausea is related to the chemotherapy regimen. The nurse, concerned about the child's nutritional status, most appropriately would offer which of the following during this episode of nausea? "1. Cool, clear liquids 2. Low protein foods 3. Low-calorie foods 4. The child's favorite food

"Correct: 1. With nausea, cool and clear liquids are better tolerated. Do not offer foods when the child is nauseated so he doesn't associate if with being sick. Support nutrition with oral supplements and foods high in proteins and calories"

A 4 yo is admitted for abdominal pain. She has been pale and excessively tired and is bruising easily. On physical exam, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed on the child because acute lymphocytic leukemia is suspected. Which diagnostic study would confirm this diagnosis 1. Platelet count 2. Lumbar puncture 3. bone marrow biopsy 4. wbc count"

"Correct: 3. 3 leukemia is a malignant increase in the number of leukocytes, usually at an immature stage, in the bone marrow. The confirmatory test is microscopic exam of bone marrow obtained by bone marrow aspirate and biopsy. a lumbar puncture may be done to look for blast cells in the fluid that indicate CNS disease. The wbc count may be normal, high or low in leukemia an altered platelet count occurs as a result of the disease but also may occur as a result of chemotherapy and does not confirm the diagnosis"

"The nurse is caring for a client diagnosed with acute myeloid leukemia. Which assessment data warrant immediate intervention? 1.T 99, P 102, R 22, and BP 132/68. 2.Hyperplasia of the gums. 3.Weakness and fatigue. 4.Pain in the left upper quadrant."

"Correct: 4 1.These vital signs are not alarming. The vital signs are slightly elevated and indicate monitoring at intervals, but they do not indicate an immediate need. 2.Hyperplasia of the gums is a symptom of myeloid leukemia, but it is not an emergency. 3.Weakness and fatigue are symptoms of the disease and are expected. 4.Pain is expected, but it is a priority, and pain control measures should be implemented."

After a client with a potential diagnosis of leukemia is admitted to the hospital, the nurse should assess for which of the following? (Select all that apply.)" " A. Reports of fatigue and weakness B. An elevation in the leukocytes especially neutrophils C. Signs of bruising easily D. Recent weight gain"

"Correct: A, C ANSWER: Reports of fatigue and weakness Signs of bruising easily Rationale: General manifestations of leukemia result from anemia, infection, and bleeding. The client would complain of fatigue and weakness and show signs of bruising. Leukemic cells replace normal hematopoietic elements preventing the formation of mature leukocytes. Neutrophil count would be decreased. Because of an increased metabolism, weight loss may occur. Strategy: It is important to read every word in the question. Do not speed-read.

"Which medication is contraindicated for a client diagnosed with leukemia? 1. Bactrim, a sulfa antibiotic 2. Morphine, a narcotic analgesic 3. Epogen, a biologic response modifier 4. Gleevec, a genetic blocking agent"

"Correct: C 1. Because of the ineffective or nonexistent WBCs characteristic of leukemia, the body cannot fight infections, and antibiotics are given to treat infections. 2. Leukemic infiltrations into the organs or the CNS cause pain. Morphine is the drug of choice for most clients with cancer. 3. Epogen is a biologic response modifier that stimulates the bone marrow to produce RBCs. The bone marrow is the area of malignancy in leukemia. Stimulating the bone marrow would be generally ineffective for the desired results and would have the potential to stimulate malignant growth. 4. Gleevec is a drug that specifically works in leukemic cells to block the expression of the BCR-ABL protein, preventing the cells from growing and dividing."

The nurse is teaching a group of parents whose children have sickle cell anemia. When a parent asks the cause of the symptoms, the nurse responds with which of the following?

"Sickled cells clump in the smaller blood vessels and obstruct blood flow."

What is Von Willebrand? What factor does it affect?

- A bleeding disorder -Factor VIII/8 Occurs even though the factor is present in normal amounts in the plasma

What are 4 safe analgesics for hemophilia?

- Acetaminophen -Oxycodone -Propoxyphene -Pentazocine

What are 3 key things the nurse should keep in mind when caring for a client with sickle cell?

- Hydration - Oxygenation -Pain Management

List the 4 different types of sickle cell crisis.

- Vasoocclusive -Splenic Sequestration -Aplastic -Hyperhemolytic

A good way to remember the s/s of Leukemia is to think of "ANT", what does this stand for?

-Anemia, decreased Hgb -Neutropenia, R/F infection -Thrombocytopenia, bleeding

What 2 things might be given for the treatment of acute leukemia?

-Antineoplastic -Chemotherapy

A patient with hemophilia should avoid _________________ sports however, bowling is encouraged.

-Avoid contact sports

Acquired hemophilia can result from _____________________ _______________ causing the formation of antibodies to clotting factors in the blood. Client with _______________________ vascular disease are also at risk, as well as clients who had a ______________ reaction.

-Blood transfusions -Collagen Vascular Disease -Drug reaction

With sickle cell the ______________________ is unable to keep up with the production of RBCs that are being depleted so quickly. The _______________ becomes overworked and is unable to keep up with recycling of old RBCs.

-Bone Marrow -Spleen

Hemophilia B is also known as _____________________ __________________ and results from a deficiency in factor ____________________. It affects 1 in _______________________ male births in the US.

-Christmas Disease -IX -Affects 1 in 30,000

An abnormality in chromosome ____________ or the presence of the __________________ chromosome have ben linked to Leukemia.

-Chromosome 22 -Philadelphia

Hemophilia A is known as the __________________ ________________________. It is a deficiency in factor ________________ and affects 1 in ___________________ male births in the US.

-Classic Hemophilia -VII/8 -Affects 1 in 5,000

Remission Induction Therapy is initiated at the time of _________________ and consists of an intensive combination of _______________ aimed at achieving a complete remission of symptoms.

-Diagnosis -Chemotherapy

Tranexamic acid and aminocaproic acid are administered to inhibit _____________________ by increasing ______________ stability.

-Fibrinolysis -Clot stability

What is the lifespan of and RBC with hemoglobin A? What about and RBC with hemoglobin S?

-Hemoglobin A= 120 days -Hemoglobin S= 20 days

Since hemophlia results in a delay of coagulation, it is possible for the client to experience bleeding. If bleeding occurs in the intercranial spaces, this can result in ______________________ _____________________. This could potentially cause ____________________ and brain damage. Can be fatal.

-Increased ICP -Convulsions

What might the nurse do for an infant with hemophilia? List 3.

-Limit heal sticks -Limit injections -Delay circumcision

Malignant production of __________________ is thought to be the cause of the disease; the DNA becomes _____________ resulting in abnormal cell production.

-Malignant production of WBCs -DNA becomes damaged

What class of medications should be avoided in clients with hemophilia? especially what specific medication?

-NSAIDS -Especially avoid aspirin, causes GI bleed

What are the main s/s of hemarthrosis? List 4.

-Pain -Warmth -Swelling -Limited ROM

Actinic keratosis (solar keratosis) is ______________________ and can develop into squamous cell carcinoma. It tends to affect older white adults and forms in areas exposed to _______________. It will appear as scaly, reddened patches.

-Precancerous -The sun

Drug therapy for acute leukemia is divided into 3 phases. What are these 3 phases?

-Remission Induction -Consolidation -Maintenance

If a client is experience pain or inflammation in a joint the nurse should perform RICE. What does this stand for?

-Rest -Ice -Compression -Elevation

An easy way to remember triggers for a sickle cell crisis is to remember the word "SICKLE", what does this stand for?

-Significant blood loss/trauma -Illness/Infection -Climbing/high altitudes -Keeping a high stress level -Low fluid intake-Dehydration -Extreme temp changes

How long is a client with sickle cell expected to live? What is the common cause of death?

-Tend to live until their mid 40's -Organ failure

At birth the nurse might see abnormal bleeding at the ____________ _____________. The nurse may also see this after a male receives a _______________________. This is indicative of hemophilia

-Umbilical cord -Circumcision

Extreme weight __________________ and _________________ or wasting are common nutritional problems in those with leukemia.

-Weight Loss -Cachexia

Describe Aplastic sickle cell crisis. What is the common cause?

-When the bone marrow stops producing RBCs -Typically caused by an infection

Which of the following assessments in a child with hemophilia would lead the nurse to suspect early hemarthrosis? 1. Child's reluctance to move a body part 2. Cool, pale, clammy extremity 3. Eccymosis formation around a joint 4. Instability of a long bone in passive movement

1

Which sign/symptom should the nurse expect to assess in the client diagnosed with hemophilia A? 1. Epistaxis. 2. Petechiae. 3. Subcutaneous emphysema. 4. Intermittent claudication.

1

Which measures would the RN know to avoid when planning care for a child with hemophilia? (Select all that apply) 1. Frequent blood pressures 2. Rectal suppositories 3. Rectal temperatures 4. Administering aspirin for pain 5. Carbonated beverages

1, 2, 3, 4

The female client recently diagnosed with Hodgkin's lymphoma asks the nurse about her prognosis. Which is the nurse's best response? 1. Survival for Hodgkin's disease is relatively good with standard therapy. 2. Survival depends on becoming involved in an investigational therapy program. 3. Survival is poor, with more than 50% of clients dying within six (6) months. 4. Survival is fine for primary Hodgkin's, but secondary cancers occur within a year.

1. Up to 90% of clients respond well to standard treatment with chemotherapy and radiation therapy, and those who relapse usually respond to a change of chemotherapy medications. Survival depends on the individual client and the stage of disease at diagnosis.

The nurse and an unlicensed assistive personnel (UAP) are caring for clients in a bone marrow transplantation unit. Which nursing task should the nurse delegate? 1. Take the hourly vital signs on a client receiving blood transfusions. 2. Monitor the infusion of antineoplastic medications. 3. Transcribe the HCP's orders onto the Medication Administration Record. 4. Determine the client's response to the therapy.

1. After the first 15 minutes during which the client tolerates the blood transfusion, it is appropriate to ask the UAP to take the vital signs as long as the UAP has been given specific parameters for the vital signs. Any vital sign outside the normal parameters must have an intervention by the nurse.

The nurse is admitting a client with a diagnosis of rule-out Hodgkin's lymphoma. Which assessment data support this diagnosis? 1. Night sweats and fever without "chills." 2. Edematous lymph nodes in the groin. 3. Malaise and complaints of an upset stomach. 4. Pain in the neck area after a fatty meal.

1. Clients with Hodgkin's disease experience drenching diaphoresis, especially at night; fever without chills; and unintentional weight loss. Early-stage disease is indicated by a painless enlargement of a lymph node on one side of the neck (cervical area). Pruritus is also a common symptom.

If a client is in crisis the nurse should do what 3 things?

1. Management of Pain 2. Administration of oxygen 3. Promoting Hydration to decrease blood viscosity

The client with hemophilia A is experiencing hemarthrosis. Which intervention should the nurse recommend to the client? 1. Alternate aspirin and acetaminophen to help with the pain. 2. Apply cold packs for 24 to 48 hours to the affected area. 3. Perform active range-of-motion exercise on the extremity. 4. Put the affected extremity in the dependent position.

2

Maintenance Therapy consist of oral chemotherapy and is taken for ____________ to ___________ years to maintain remission.

2 to 5 years

Which nursing interventions should the nurse implement when caring for a client diagnosed with hemophilia A? Select all that apply. 1. Instruct the client to use a razor blade to shave. 2. Avoid administering enemas to the client. 3. Encourage participation in noncontact sports. 4. Teach the client how to apply direct pressure if bleeding occurs. 5. Explain the importance of not flossing the gums

2,3,4

The client diagnosed with non-Hodgkin's lymphoma is scheduled for a lymphangiogram. Which information should the nurse teach? 1. The scan will identify any malignancy in the vascular system. 2. Radiopaque dye will be injected between the toes. 3. The test will be done similar to a cardiac angiogram. 4. The test will be completed in about five (5) minutes.

2. Dye is injected between the toes of both feet and then scans are performed in a few hours, at 24 hours, and then possibly once a day for several days.

Which information about reproduction should be taught to the 27-year-old female client diagnosed with Hodgkin's disease? 1. The client's reproductive ability will be the same after treatment is completed. 2. The client should practice birth control for at least two (2) years following therapy. 3. All clients become sterile from the therapy and should plan to adopt. 4. The therapy will temporarily interfere with the client's menstrual cycle.

2. The client should be taught to practice birth control during treatment and for at least two (2) years after treatment has ceased. The therapies used to treat the cancer can cause cancer. Antineoplastic medications are carcinogenic, and radiation therapy has proved to be a precursor to leukemia. A developing fetus would be subjected to the internal conditions of the mother.

In mild cases of hemophilia the deficient factor is between _________________ to _______________%.

25 to 50%

Which of the following disorders is a deficiency of factor VIII? 1. Sickle cell disease 2. Christmas disease 3. Hemophilia A 4. Hemophilia B

3

To help prevent sickle cell crisis a client should drink __________ to _______Liters of fluid per day.

3 to 4

Which client is at the highest risk for developing a lymphoma? 1. The client diagnosed with chronic lung disease who is taking a steroid. 2. The client diagnosed with breast cancer who has extensive lymph involvement. 3. The client who received a kidney transplant several years ago. 4. The client who has had ureteral stent placements for a neurogenic bladder.

3. Clients who have received a transplant must take immunosuppressive medications to prevent rejection of the organ. This immunosuppression blocks the immune system from protecting the body against cancers and other diseases. There is a high incidence of lymphoma among transplant recipients.

Client is experiencing vaso-occlusive sickle cell crisis secondary to infection. which medical tx should the nurse anticipate 1. administer demerol 2. admit the client to a private room 3. Infuse D5W 4. Insert a 22-french foley

3. Infuse D5W

Which s/s will the nurse expect to assess in the client diagnosed with a vaso-occlusive sickle cell crisis 1. lordosis 2.epistaxis 3. hematuria 4. petechia

3. Vaso-occlusive crisis, the most frequent crisis, is characterized by organ infarction, which will result in bloody urine secondary to kidney infarction.

A child with hemophilia wishes to participate in sports. Which sport should the nurse recommend as the most appropriate for the child? 1. Basketball 2. Biking 3. Baseball 4. Swimming

4

The physician has ordered several laboratory tests to help diagnose an infant's bleeding disorder. Which of the following tests, if abnormal, would the nurse interpret as most likely to indicate hemophilia? 1. Bleeding time 2. Tourniquet test 3. Clot retraction test 4. Partial thromboplastin time (PTT)

4

he unlicensed assistive personnel (UAP) asks the primary nurse, "How does someone get hemophilia A?" Which statement would be the primary nurse's best response? 1. "It is an inherited X-linked recessive disorder." 2. "There is a deficiency of the clotting factor VIII." 3. "The person is born with hemophilia A." 4. "The mother carries the gene and gives it to the son."

4

The client asks the nurse, "They say I have cancer. How can they tell if I have Hodgkin's disease from a biopsy?" The nurse's answer is based on which scientific rationale? 1. Biopsies are nuclear medicine scans that can detect cancer. 2. A biopsy is a laboratory test that detects cancer cells. 3. It determines which kind of cancer the client has. 4. The HCP takes a small piece out of the tumor and looks at the cells.

4. A biopsy is the removal of cells from a mass and examination of the tissue under a microscope to determine if the cells are cancerous. Reed-Sternberg cells are diagnostic for Hodgkin's disease. If these cells are not found in the biopsy, the HCP can rebiopsy to make sure the specimen provided the needed sample or, depending on involvement of the tissue, diagnose a non-Hodgkin's lymphoma.

The nurse writes the problem of "grieving" for a client diagnosed with non-the lymphoma. Which collaborative intervention should be included in the plan of care? 1. Encourage the client to talk about feelings of loss. 2. Arrange for the family to plan a memorable outing. 3. Refer the client to the American Cancer Society's Dialogue group. 4. Have the chaplain visit with the client.

4. Collaborative interventions involve other departments of the health-care facility. A chaplain is a referral that can be made, and the two disciplines should work together to provide the needed interventions. TEST-TAKING HINT: The stem of the question asks for a collaborative intervention, which means that another health-care discipline must be involved. Options "1," "2," and "3" are all interventions the nurse can do without another discipline being involved.

Which test is considered diagnostic for Hodgkin's lymphoma? 1. A magnetic resonance image (MRI) of the chest. 2. A computed tomography (CT) scan of the cervical area. 3. An erythrocyte sedimentation rate (ESR). 4. A biopsy of the cervical lymph nodes.

4. Cancers of all types are definitively diagnosed through biopsy procedures. The pathologist must identify Reed-Sternberg cells for a diagnosis of Hodgkin's disease.

The nurse is caring for a client in a sickle cell crisis. which is the pain regiment of choice to relieve the pain? 1. Frequent aspirin 2. Motrin 3. Demerol 4. Morphine

4. Morphine

The student nurse asks the nurse, "what is sickle cell anemia?" which statement by the nurse would be the best answer to the student's question? 1. There is some written material at the desk 2. it is a congenital disease of the blood 3. the client has decreased synovial fluid 4. the blood becomes thick when the client is deprived of oxygen

4. sickle cell anemia is a disorder of the client rbcs characterized by abnormally shaped red cells that sickle or clump together, leading to oxygen deprivation and resulting in crisis and severe pain.

Idiopathic hemophilia may be seen in clients aged ________________.

50+

The client has squamous call carcinoma removed from the lip. Which discharge instructions should the nurse provide? A. Notify the HCP if a non healing lesion develops around the mouth B. Squamous call carcinoma tumors do not metastasize C. Limit foods to liquid or soft consistency for 1 month D. Apply heat to the area for 20 minutes q4h

A

The client is admitted to the outpatient surgery center for removal of a malignant melanoma. Which assessment data indicate the lesion is a malignant melanoma? A. The lesion is asymmetrical and has irregular boarders B. The lesion has a waxy appearance with pearl-like boarders C. The lesion has a thickened and scaly appearance D. The lesion appeared as a thickened area after injury

A

The nurse is caring for clients in an outpatient surgery clinic. Which client should be assessed first? A. The client scheduled for a skin biopsy who is crying B. The client who had surgery 3 hours ago and is sleeping C. The client who needs to void prior to discharge D. The client who has received discharge instructions and is ready to go home

A

The Hodgkin's disease patient described in the question above undergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin's disease were correct, which of the following cells would the pathologist expect to find? A Reed-Sternberg cells. B Rieder's cells C Gaucher's cells. D Lymphoblastic cells.

A Reed-Sternberg cells.

One of the symptoms for lymphatic disease is swelling of the lymph nodes; however, this symptom may be easily overlooked because the enlargement does not cause any pain. A True B False

A True

What is Leukemia? What causes it? How does this disease affect Leukocytes?

A group of malignant diseases of both the bone marrow and the lymphatic system. The cause is unknown, it is idiopathic. Leukocytes are abnormal and nonfunctional.

Which of the following are considered s/s of leukemia? A. Bone pain B. Pallor C. Headache D. Tachypnea E. Urinary stones/obstruction F. Fever G. Weight gain

A, B, C, E, F -Bone Pain -Pallor -Headache -Urinary stones -Fever -Weight gain

"The nurse and the unlicensed assistive personnel (UAP) are caring for clients in a bone marrow transplantation unit. Which nursing task should the nurse delegate? "A. Take the hourly vital signs on a client receiving blood transfusions. B. Monitor the infusion of antineoplastic medications. C. Transcribe the HCP's orders onto the Medication Administration Record. D. Determine the client's response to the therapy."

A. After the first 15 minutes during which the client tolerates the blood transfusion, it is appropriate to ask the UAP to take the vital signs as long as the UAP has been given specific parameters for the vital signs. Any vital sign outside the normal parameters must have an intervention by the nurse.

People infected with HIV are more likely to develop lymphatic disease. A True B False

A. True

A patient is being tested for sickle cell disease. As the nurse, you know the ________ will assess for abnormal hemoglobin on the red blood cell, but will not differentiate between sickle cell disease and sickle cell trait. Therefore, the patient will need to have what other test to determine this? A. dithionite test; hemoglobin electrophoresis B. hemoglobin electrophoresis; sickledex C. edrophonium test, dithionite test D. sickledex; edrophonium test

A. dithionite test; hemoglobin electrophoresis

The goal of consolidation therapy is to ______________.

Achieve a cure

What is hemophilia?

An inherited X-linked disorder characterized by a delay in blood coagulation.

Describe a vasoocclusive sick cell crisis.

An obstruction of blood flow causing great pain

____________________ and _________________ may be given to treat joint inflammation and pain.

Analgesics and corticosteroids

"A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire? a. "Have you noticed a change in sleeping habits recently?" b. "Have you had a respiratory infection in the last 6 months?" c. "Have you lost weight recently?"" d. "Have you noticed changes in your alertness?""

Answer B is correct. The client with leukemia is at risk for infection and has often had recurrent respiratory infections during the previous 6 months. Insomnolence, weight loss, and a decrease in alertness also occur in leukemia, but bleeding tendencies and infections are the primary clinical manifestations; therefore, answers A, C, and D are incorrect.

"A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment? "a. The client collects stamps as a hobby. b. The client recently lost his job as a postal worker. c. The client had radiation for treatment of Hodgkin's disease as a teenager. d. The client's brother had leukemia as a child."

Answer C is correct. Radiation treatment for other types of cancer can result in leukemia. Some hobbies and occupations involving chemicals are linked to leukemia

The acronym ABCDE can be used to help identify melanoma. What does this stand for?

Asymmetrical, Borders irregular Color is dark Diameter is greater than 6mm Evolution

Clients with chronic leukemias are typically ____________ and are only detected with a physical exam and routine CBC.

Asymptomatic

"A 68-year-old woman is diagnosed with thrombocytopenia due to acute lymphocytic leukemia. She is admitted to the hospital for treatment. The nurse should assign the patient: "A. To a private room so she will not infect other patients and healthcare workers B. To a private room so she will not be infected by other patients and healthcare workers C. To a semiprivate room so she will have stimulation during her hospitalization D. To a semiprivate room so she will have the opportunity to express her feelings about her illness"

B

A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client? A. Taking hourly blood pressures with mechanical cuff B. Encouraging fluid intake of at least 200mL per hour C. Position in high Fowler's with knee gatch raised D. Administering Tylenol as ordered

B

A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client? A. Taking hourly blood pressures with mechanical cuff B. Encouraging fluid intake of at least 200ml per hour C. Position in high fowlers with ne gatch raised D. Administering acetaminophen as ordered

B

A 25-year-old pregnant female and her partner both have sickle cell trait. What is the percentage that their offspring will develop sickle cell anemia? A. 50 % B. 25 % C. 75 % D. 100 %

B

The female client admitted for an unrelated dx asks the nurse to check her back because "it itches all the time in that one spot". When the nurse assesses the clients back, the nurse notes an irregular-shaped lesion with some scabbed over areas surrounding the lesion. Which action should the nurse implement first? A. Notify the HCP to check the lesion on rounds B. Measure the lesion and note the color C. Apply lotion to the lesion D. Instruct the client to make sure the HCP checks the lesion

B

The male client diagnosed with AIDS states that he has developed a purple-brown spot on his calf. Which action should the nurse do first? A. Refer the client to an HCP for a biopsy of the area B. Assess the lesion for size, color, and symmetry C. Discuss end-of-life decisions with the client D. Report the STD to the health department

B

A newly admitted client is diagnosed with Hodgkin's disease undergoes an excisional cervical lymph node biopsy under local anesthesia. What does the nurse assess first after the procedure? A Incision site B Airway C Vital signs D Level of consciousness

B Airway Assessing for an open airway is the priority. The procedure involves the neck, the anesthesia may have affected the swallowing reflex or the inflammation may have closed in on the airway leading to ineffective air exchange.

Hodgkin lymphoma may be cured with chemotherapy with almost no incidence of secondary acute nonlymphocytic leukemia within 10 years. A True B False

B False

Non-Hodgkin lymphoma can spread to almost any part of the body, including the liver, bone marrow, and spleen. A False B True

B True

The nurse understands that Hodgkin's disease is suspected when a client presents with a painless, swollen lymph node. Hodgkin's disease typically affects people in which age group? A Teenagers (ages 13-20 years) B Young adults (ages 21-40 years) C Children (ages 6-12 years) D Older adults (ages 41-50 years)

B Young adults (ages 21-40 years)

A 14-year-old female has sickle cell anemia. Which factors below can increase the patient's risk for developing sickle cell crisis? Select all that apply: A. Shellfish B. Infection C. Dehydration D. Hypoxia E. Low altitudes F. Hemorrhage G. Strenuous exercise

B, C, D, F, G

When sickle cell results in a blockage of circulation, the client may experience what s/s? A. Ecchymosis B. Lethargy C. Aphasia D. Pain E. Pallor

B, D, E -Lethargy -Pain -Pallor

Hodgkin lymphoma only occurs in a group of lymph nodes, not in a single lymph node or in other parts of the lymphatic system, such as the bone marrow and spleen. A True B False

B. False

_________________________ is the MOST common type of skin cancer

Basal cell carcinoma

___________________________________ and features pearly, waxy appearance with a slight depressed center and raised edges.

Basal cell carcinoma

Exposure to THIS chemical has the potential to increase ones risk of developing Leukemia.

Benzene

A pregnant woman tells the nurse that there is a history of sickle cell disease in her family and she is afraid that the baby will have the disease. The nurse provides the client with which of the following information?

Both the mother and father must carry the gene for the baby to be affected. Rationale: Sickle cell is inherited as an autosomal recessive disorder. Both parents must carry the gene for the baby to be affected. The other statements are inaccurate.

Terms in this set (19) Original A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 89. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. a. Adjust the room temperature b. Give a bolus of IV fluids c. Start O2 d. Administer meperidine (Demerol) 75mg IV push

C

The nurse and he AP are caring for clients in a dermatology clinic. Which task should not be delegated to the AP? A. Stock the rooms with the equipment needed B. Weigh the clients and position the clients for the examination C. Discuss problems the client has experienced since the previous visit D. Take the biopsy specimens to the lab

C

The school nurse is preparing to teach a health promotion class to high school seniors. Which information regarding self-care should be included when teaching? A. Wear sunscreen with a protection factor of 10 or less when in the sun B. Try to stay out of the sun between 0300 and 0500 daily C. Perform a thorough skin check monthly D. Remember caps and long sleeves do not help prevent skin cancer

C

Which client physiological outcome (goal) is appropriate for a client diagnosed with skin cancer who has had surgery to remove the lesion? A. The client will express feelings of fear B. The client will ask questions about the diagnosis C. The client will state a diminished level of pain D. The client will demonstrate care of operative site

C

Which of the following foods would the nurse encourage the client in sickle cell crisis to eat? A. Peaches B. Cottage cheese C. Popsicles D. Lima beans

C

Which statement about how sickle cell anemia is passed to offspring is correct? A. This disease is an X - linked recessive disease. B. Sickle cell anemia is an autosomal dominant disease. C. This condition is an autosomal recessive disease. D. Sickle cell anemia is rarely passed to offspring and is an autosomal x - linked dominant disease.

C

A 22-year-old with stage I Hodgkin's disease is admitted to the oncology unit for radiation therapy. During the initial assessment, the client tells you, "Sometimes I am afraid of dying." Which response is most appropriate at this time? A "Perhaps you should ask the doctor about medication." B "Many individuals with this diagnosis have some fears." C "Tell me a little bit more about your fear of dying." D "Most people with stage I Hodgkin's disease survive."

C "Tell me a little bit more about your fear of dying." Most assessment about what the client means is needed before any interventions can be planned or implemented. All of the other statements indicate a conclusion that the client is afraid of dying of Hodgkin's disease. Focus: Prioritization

The nurse is aware that the following symptoms is most commonly an early indication of stage 1 Hodgkin's disease? A Splenomegaly B Persistent hypothermia C Night sweat D Pericarditis

C Night sweat In stage 1, symptoms include a single enlarged lymph node (usually), unexplained fever, night sweats, malaise, and generalized pruritis. Although splenomegaly may be present in some clients, night sweats are generally more prevalent. Pericarditis isn't associated with Hodgkin's disease, nor is hypothermia. Moreover, splenomegaly and pericarditis aren't symptoms. Persistent hypothermia is associated with Hodgkin's but isn't an early sign of the disease.

A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding? A. Place the client in a sitting position with the head hyperextended B. Pack the nares tightly with gauze to apply pressure to the source of bleeding C. Pinch the soft lower part of the nose for a minimum of 5 minutes D. Apply ice packs to the forehead and back of the neck

C. Pinch the soft lower part of the nose for a minimum of 5 minutes The client should be positioned upright and leaning forward. to prevent aspiration of blood. Answers A. B. and D are incorrect because direct pressure to the nose stops the bleeding. and ice packs should be applied directly to the nose as well. If a pack is necessary. the nares are loosely packed.

Typical clotting takes a few minutes, where as a client with hemophilia will take up to ________________ to clot.

Can take up to an hour to clot

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy . The nurse notes that the platelet count is 20,000/ul. Based on the laboratory result, which intervention will the nurse document in the plan of care? 1 Monitor closely for signs of infection 2. Monitor the temperature every 4hours 3. Initiate protective isolation precautions 4. Use soft small toothbrush for mouth care

Correct Ans 4 If a child is severely thrombocytopenic and has a platelet count less than 20,000/ul, bleeding precautions need to be initiated because of increased risk of bleeding or hemorrhage. Options 1,2,3 are related to the prevention of infection rather than bleeding

A 14 year old girl has been hospitalized with Sickle Cell Anemia in vasoocclusive crisis. Which of these Nursing diagnoses should receive priority in the Nursing plan of care? A. Impaired social interaction B. Alteration in body image C. Pain D. Alteration in tissue perfusion

D

A 43 - year - old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use? A. Body temperature of 99 ° F or less B. Toes moved in active range of motion C. Sensation reported when soles of feet are touched D. Capillary refill of < 3 seconds

D

A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use? A. Body temperature of 99°F or less B. Toes moved in active range of motion C. Sensation reported when soles of feet are touched D. Capillary refill of < 3 seconds

D

The male client with sickle cell anemia comes to the emergency room with a temperature of 101.4 F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency room doctor ordering for the client? A. Spinal tap. B. Hemoglobin electrophoresis. C. Sickle-turbidity test (Sickledex). D. Blood cultures.

D

The nurse participating in a health fair is discussing malignant melanoma with a group of clients. Which information regarding the use of sunscreen is important to include? A. Sunscreen is only needed during the hottest hours of the day B.Toddlers should not have sunscreen applied to their skin C. Sunscreen does not help prevent skin cancer D. The higher the number of the sunscreen, the more it blocks UV rays

D

Which client is at greater risk for the development of skin cancer? A. The African American male who lives in the northeast B. The elderly Hispanic female who moved from Mexico as a child C. The client who has a family history of basal cell carcinoma D. The client with fair complexion who cannot get a tan

D

You're assisting with a sickle cell anemia screening. As the nurse you know that which patient population listed below is at an increased risk for sickle cell disease? A. Native American B. Pacific Islander C. Caucasian D. African American

D

You have developed the nursing diagnosis Risk for Impaired Tissue Integrity related to effects of radiation for a client with Hodgkin's lymphoma who is receiving radiation to the groin area. Which nursing activity is best delegated to a nursing assistant caring for the client? A Apply alcohol-free lotion to the area after cleaning. B Check the skin for signs of redness or peeling. C Explain good skin care to the client and family. D Clean the skin over daily with a mild soap.

D Clean the skin over daily with a mild soap. Skin care is included in nursing assistant education and job description. Assessment and client teaching are more complex tasks that should be delegated to registered nurses. Use of lotions to the irradiated area is usually avoided during radiation therapy. Focus: Delegation

A male client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment findings would the nurse expect to note specifically in the client? A Fatigue B Weight gain C Weakness D Enlarged lymph nodes

D Enlarged lymph nodes

A 21-year-old male with Hodgkin's lymphoma is a senior at the local university. He is engaged to be married and is to begin a new job upon graduation. Which of the following diagnoses would be a priority for this client? A Fatigue related to chemotherapy B Anticipatory grieving related to terminal illness C Tissue integrity related to prolonged bed rest D Sexual dysfunction related to radiation therapy

D Sexual dysfunction related to radiation therapy Radiation therapy often causes sterility in male clients and would be of primary importance to this client. The psychosocial needs of the client are important to address in light of the age and life choices. Hodgkin's disease, however, has a good prognosis when diagnosed early.

___________________________ _______________________ may be given for mild hemophilia a to stimulate an increase in factor VII.

Desmopressin acetate

A client with sickle cell should take ______________ regularly.

Folic Acid

The nurse should include which of the following in client teaching for someone with sickle cell? A. Avoid High Altitudes B. Stop smoking C. Avoid Alcohol D. Avoid extreme temp changes E. Increase fluid intake F. Encourage client to receive all vaccinations G. All the above

G

______________________ is bleeding in the joints and is a primary problem for most clients with hemophilia.

Hemarthrosis

What test CAN differentiate between sickle cell trait and sickle cell disease?

Hemoglobin Electrophoresis

Why do we not administer Meperidine to children with sickle cell disease?

Increases the Risk For seizures

In severe cases of hemophilia the deficient factor is _________________________.

Less than 1%

Lymphoid Leukemia originates in the _____________________ _______________.

Lymphatic System

Who is typically affected with Hemophilia?

Males are typically affected and it is genetically transferred from the mother.

Can maternal factor VII cross the placenta and be transferred to the fetus?

NO

Can a sickling test (Sickledex) differentiate between sickle cell trait and sickle cell anemia?

NO it cannot

Describe Splenic Sequestration sickle cell crisis.

Occurs when blood pools in both the spleen and liver

Narcotics may be given for pain and are usually given via a ________________.

PCA Pump

THIS test allows for visualization of stained RBC's

Peripheral Blood Smear

To help prevent infection a client with leukemia should be placed in a ______________ ______________.

Private room

Describe Hyperhemolytic sickle cell crisis.

Rapid rate of hemolysis

When will we see s/s in a client with sickle cell?

S/s will arise if there is a blockage inhibiting blood flow. As long as there is NO blockage there will be NO s/s.

_______________________________________ has a crusty, scaly appearance and is raised.

Squamous cell carcinoma

Myeloid Leukemia arises from ________________ __________________.

The Bone Barrow

A mother brings in her 8 month-old child to the ER. The mother reports the baby has recently started being extremely fussy, has a fever, and swelling in the hands and feet. The child is diagnosed with sickle cell disease. As the nurse you know that the swelling in the hands and feet in the infant is termed? A. Dactylitis B. Erythromelaglia C. Dyshidrotia D. Phalitis

The answer is A. Dactylitis (also called hand-foot syndrome) occurs mainly in infants who are newly diagnosed with sickle cell anemia.

You're providing teaching to a patient diagnosed with squamous cell carcinoma on the face. In your teaching, you are providing education on how this type of skin cancer develops. What information will you include in your patient education? A. "Squamous cell skin cancer develops in the stratum spinosum layer of the epidermis and occurs due to mutated keratinocytes." B. "Squamous cell skin cancer develops in the stratum corneum layer of the epidermis and occurs due to mutated basal cells." C. "Squamous cell skin cancer develops in the stratum basale layer of the epidermis and occurs due to mutated melanocytes." D. Squamous cell skin cancer develops in the stratum granulosum layer of the epidermis and occurs due to mutated squamous cells."

The answer is A. Squamous cell skin cancer develops in the stratum spinosum layer of the epidermis and occurs due to mutated keratinocytes.

A 25 year-old pregnant female and her partner both have sickle cell trait. What is the percentage that their offspring will develop sickle cell anemia? A. 50% B. 25% C. 75% D. 100%

The answer is B. If both parents have the sickle cell trait it means they each have normal hemoglobin A and abnormal hemoglobin S on their RBCs....so both present with hbg AS. Remember they don't have sickle cell disease just the abnormal gene that can be passed to their child. Sickle cell anemia is autosomal recessive, therefore there is a 25% chance their child will obtain both abnormal genes (the Hbg S) from EACH parent and develop sickle cell anemia.

Which type of hemoglobin is present in a patient who has sickle cell TRAIT? A. Hemoglobin AA B. Hemoglobin AS C. Hemoglobin SS D. Hemoglobin AC

The answer is B. Sickle cell TRAIT is heterozygous, which means the patient has one NORMAL allele (which is Hemoglobin A...this is NORMAL hemoglobin) and one ABNORMAL allele (which is Hemoglobin S).....this is the abnormal hemoglobin that leads to the abnormal construction of the RBC). However, most patients with sickle cell trait don't show signs and symptoms related to sickle cell anemia because they have just enough of the normal hemoglobin A to prevent sickling of the RBC.

You're assisting a physician with sickle cell anemia screening. As the nurse you know that which patient population listed below is at risk for sickle cell disease? A. Native Americans B. African-Americans C. Pacific Islanders D. Latino

The answer is B. Sickle cell anemia is most common in African-Americans along with Middle Eastern, Asian, Caribbean, and Eastern Mediterranean. WHY? According to the CDC, 1 in 12 African-Americans have the sickle cell trait, so it can easily be passed to their offspring. Remember if both parents have sickle cell trait there is a 25% chance they will pass it to their child.

Which statement is true regarding the pathophysiology of melanoma? A. "Melanoma develops when keratinocytes mutate in the stratum germinativum." B. "Melanoma of the skin originates from melanocytes found in the stratum basale." C. "Melanoma only occurs on the skin and is the most aggressive type of skin cancer." D. Melanoma arises from the squamous cells in the stratum spinosum."

The answer is B. This is the only correct statement about melanoma. It can occur anywhere in the body where there are melanocytes (example: middle layer of the eyes (uvea), epidermis etc.) and it originates from the melanocytes.

You're providing education to a patient with sickle cell anemia who is taking Hydroxyurea. You will make it priority to tell the patient to? A. Consume foods high in calcium and potassium B. Avoid sick people and maintain strict hand hygiene C. Take this medication with at least 8 oz of water D. Monitor your blood glucose level daily

The answer is B. This medication can lower the white blood cell count. Therefore, the nurse should make it priority to tell the patient to avoid infection by avoiding sick people and performing hand hygiene regularly.

You're educating the parents of a 12 year-old, who was recently treated for sickle cell crisis, on ways to prevent further sickle cell crises in the further. Which statement by the parents demonstrates they understood your instructions? A. "We will limit fluid intake during the day to 1-2 L a day." B. "Cold showers are best to help with pain associated with sickling." C. "We will avoid traveling to high altitude locations." D. "It is important we refuse all future vaccinations unless absolutely necessary."

The answer is C. Remember sickle cell crisis can be caused by blood loss, illness (it's important the patient is up-to-date with all vaccinations), high altitudes, stress, dehydration, elevated temperature, or extreme cold temperatures. All options are wrong except C.

Which statement about how sickle cell anemia is passed to offspring is CORRECT? A. This disease is an x-linked recessive disease. B. Sickle cell anemia is an autosomal dominant disease. C. This condition is an autosomal recessive disease. D. Sickle cell anemia is rarely passed to offspring and is an autosomal x-linked dominant disease.

The answer is C. SCA is an autosomal recessive disease in that the offspring must receive TWO hemoglobin S genes (one for each parent). The parents usually don't have the disease but are carriers. For the disease to occur in the offspring they must receive both of those genes (Hbg SS). On the contrary, with autosomal dominant the offspring has to only receive an abnormal gene from one parent, who probably has signs and symptoms of the disease too.

Which type of hemoglobin is present in a patient who has sickle cell anemia? A. Hemoglobin AA B. Hemoglobin AS C. Hemoglobin SS C. Hemoglobin AC

The answer is C. SCA is homozygous and the patient must have two abnormal alleles present to have sickle cell anemia. The patient receives each abnormal allele for each parent (hence one from each parent which is Hemoglobin SS). If a patient has Hemoglobin AS (normal allele (A) and abnormal allele (S)) this is known as sickle cell trait, which most patients with this don't present with signs and symptoms of the disease...it's rare because they usually have just enough hemoglobin A to prevent the RBCs from sickling.

A patient has an electrodessication and curettage (EDC) performed to remove a skin cancer lesion. How will the nurse educate the patient on how to care for the surgical site? A. Apply dry, sterile gauze with a nonstick bandage. B. Apply a saline sterile gauze with a bandage. C. Apply petroleum jelly to the site with a nonstick bandage. D. Allow the site to stay open to air.

The answer is C. The site should be covered with petroleum jelly and nonstick bandage.

The epidermis consists of ________ layers with the innermost layer of the epidermis being known as the __________. A. five, stratum lucidum B. three, stratum spinosum C. five, stratum basale D. three, stratum granulosum

The answer is C. The epidermis consists of FIVE layers with the innermost layer of the epidermis being known as the stratum basale.

During an outpatient well visit with a patient who has sickle cell anemia, you make it PRIORITY to assess the patient's? A. hemoglobin A1C level B. heart rate C. reflexes D. vaccination history

The answer is D. Patients will sickle cell anemia are at risk for infection because of spleen compromise. Many patients with SCA experience splenomegaly because blood flow is compromised to the spleen due to sickling of RBCs and the spleen is overworked from recycling the old RBCs (remember a patient with sickle cell anemia does NOT have long-living RBCs...the RBCs tend to die in 20 days rather than 120 days). Therefore, vaccination history is very important. The patient should be up-to-date with the flu, pneumococcal, and meningococcal vaccines.

You're providing seminar teaching to a group of nurses about sickle cell anemia. Which of the following is NOT a treatment for this condition? A. Blood transfusion B. Stem cell transplant C. Intravenous fluids D. Iron supplements E. Antibiotics F. Morphine

The answer is D. Iron supplements are not prescribed (rather Folic Acid) because this type of anemia is not caused by low iron levels, and patients who take iron supplements with sickle cell disease are at risk for building up too much iron in the body, which will damage the organs.

An 18 year-old male is taking Hydroxyurea for treatment of sickle cell anemia. Which options below indicate this medication is working successfully? Select all that apply: A. The patient needs fewer blood transfusions. B. The patient experiences diuresis. C. The patient experiences an increase in fetal hemoglobin (Hbg F). D. The patient experiences a decrease in hemoglobin S.

The answers are A and C. This medication doesn't actually treat cancer, but it will help with SCA in that it will help create fetal hemoglobin hgb F (this helps decrease sickling episodes) and helps with anemia (decreasing the need for so many blood transfusions).