NUR 410 PREPU

A child with hypoplastic anemia develops hemosiderosis. The therapy for this is:

deferoxamine.

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

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

A 5-year-old girl with sickle cell disease has had a temper tantrum in the office waiting room, and the mother has dealt with it inadequately. How should the nurse address the girl's apparent lack of discipline when the pair is in the examination room?

"How did feel about your daughter's behavior in the waiting room?"

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with sickle cell anemia. The nurses in the group make the following statements. Which statement is most accurate regarding sickle cell anemia?

"If the trait is inherited from both parents the child will have the disease."

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

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

A couple is expecting a child. The fetus undergoes genetic testing and the couple discover the fetus has sickle cell anemia. The couple ask the nurse how this happened. Which statement is accurate for the nurse to provide?

"Sickle cell anemia is passed to a fetus when both parents have the gene."

A 3-year-old child is hospitalized with a diagnosis of sickle cell anemia. The child's condition has improved, and the child is much more active and eager to play. Which toy should the nurse offer the child?

Large piece puzzle

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

Ensure all side rails are padded.

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

Maintaining fluids through an intravenous line

A 3-year-old child is hospitalized with a diagnosis of sickle cell anemia and is experiencing a pain crisis. Using the FACES scale, the nurse assesses the child's pain to be a 10 on a scale of 1 to 10. The child is receiving intravenous fluids and oxygen at 2 L/min via nasal cannula. The parent is at the bedside holding the child's hand and has a concerned look. What is the nurse's priority in caring for the child?

Implement strategies to address the child's pain.

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?

Iron-chelating drugs

When developing the postoperative plan of care for a child with sickle cell anemia who has undergone a splenectomy, which would the nurse identify as the priority?

Risk for infection

A health care provider has prescribed hydroxyurea 20 mg/kg to a child as part of a treatment regimen for sickle cell disease. The child weighs 27 lb (12.2 kg). How many milligrams should the nurse administer?

244

A child is hospitalized with complications related to hemophilia. The health care provider has discussed the child's plan of care with the parents, but they continue to ask questions. What action will the nurse take?

Answer the parents' questions as completely as possible.

The nurse is presenting a program on HIV and children for a nursing students. The nurse determines that more teaching is needed when the students identify which of the following as a mode of transmission?

Skin contact

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching?

"We should administer desmopressin as often as needed."

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?

Baseball

A nurse caring for an 8-year-old child with a bleeding disorder documents the following nursing diagnosis: Ineffective tissue perfusion related to intravascular thrombosis and hemorrhage. This nursing diagnosis would be most appropriate for a child diagnosed with which condition?

Disseminated intravascular coagulation

A child is diagnosed with sickle cell anemia. Which test will the nurse expect the primary health care provider to prescribe for this client?

Hemoglobin level

A home care nurse is teaching a parent how to administer a clotting factor infusion to their child. How can the nurse best evaluate the effectiveness of the teaching?

Observe the parent set up and administer the infusion.

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:

petechiae.

A 5-year-old girl with sickle-cell disease has had a temper tantrum in the office waiting room, and the mother has dealt with it inadequately. How should the nurse address the parent's apparent lack of discipline when the pair is in the examination room?

"How did feel about your daughter's behavior in the waiting room?"

The nurse is teaching an 8-year-old child and his family how to manage cancer pain using nonpharmacologic methods. Which parent statement signifies successful client teaching?

"I will begin using the technique before he experiences pain."

A parent calls the pediatric clinic and tells the nurse "I think my child is having a sickle cell crisis. Should I bring the child to the office?" What is the nurse's best response?

"Tell me about the symptoms your child is experiencing"

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?

"These values will help us monitor the disease."

The nurse is caring for a pediatric client experiencing mild to moderate pain related to a recent bone marrow biopsy procedure. The child is receiving chemotherapy treatments for a cancer diagnosis. The child has several prn pain medication options on the medication administration record. Which medication should the nurse administer?

Acetaminophen

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

Ensure neutropenic precautions are in place.

A 15-year-old client diagnosed with von Willebrand disease has reached menarche. Based on this fact, what information is most important for the nurse to convey to the client?

Expect menstrual bleeding to be heavy.

When caring for a 7-year-old client diagnosed with sickle cell anemia, which clinical manifestation will the nurse report to the health care provider first?

Hyperactive bowel sounds

The nurse is caring for a 6-year-old sickle-cell client in an acute care setting. A high priority for this client's plan of care is pain relief. The nurse understands that untreated acute pain can lead to which physiological effects?

Impaired mobility, anorexia, anxiety, sleep disturbances, and developmental regression

A nurse is providing teaching on the medication regimen for beta-thalassemia to an adolescent. What is the best way for the nurse to determine if the teaching was successful?

Request that the adolescent teach the information to the nurse.

The nurse is providing care at a local clinic that treats children with hemophilia. The nurse understands that if bleeding is not treated effectively, the children are at high risk for development of chronic disabling disease involving the:

joints.

The nurse is administering meperidine as ordered for pain management for a 10-year-old boy in sickle cell crisis. The nurse would be alert for:

seizures.

The parents of a 2-month-old infant have learned that their infant has hemophilia. The parents are visibly upset and ask how this could have happened to them. What is the nurse's bestresponse?

"News like this is difficult to hear. Let's talk about what this means for your child."

A nurse is providing teaching to the parents of a child diagnosed with sickle cell anemia. The discussion is focused on precipitating factors for sickle cell crisis. Which statement by the parents requires the nurse to reinforce the teaching?

"Our family is taking a fun hiking trip up in the mountains next week."

A nurse is providing care for a child diagnosed with beta-thalassemia. The child requires a blood transfusion of packed red blood cells (PRBCs). The health care provider has prescribed a transfusion volume of 10 mL/kg. The child weighs 37 lb (16.8 kg). How many milliliters should the nurse infuse?

168

A nurse is conducting a class to a group of parents on sickle cell anemia. Which statement by a parent indicates teaching has been effective?

"The sickle shape of red blood cells decreases oxygen to tissues."

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?

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

A nurse is providing care to a child who is to receive a blood transfusion. The health care provider has prescribed the infusion to run at a rate of 5 mL/kg/hour. The child weighs 55 lb (25 kg). At what rate should the nurse set the infusion pump? Record your answer using a whole number.

125

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor?

Factor VIII

A nurse is providing care for a child diagnosed with beta-thalassemia who is receiving a blood transfusion. The child reports being bored and asks to go to the playroom. What is the bestaction for the nurse to take?

Have a child-life specialist find an appropriate activity to occupy the child during the transfusion.

A child diagnosed with hemophilia presents with warm, swollen, painful joints. Which action will the nurse take first?

Prepare to administer factor replacement medication

The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first?

a child with hemophilia reporting knee pain and edema

The nurse is caring for a 4-year-old with sickle cell anemia. A physical finding the nurse might expect to see in him is:

slightly yellow sclerae.