Chapter 24: The Child with Hematologic or Immunologic Dysfunction ANS

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. Which is appropriate for the nurse to explain about narcotic analgesics?

Rarely cause addiction because they are medically indicated

Several complications can occur when a child receives a blood transfusion. Which is an immediate sign or symptom of an air embolus?

Sudden difficulty in breathing

Parents of a school-age child with hemophilia ask the nurse, "Which sports are recommended for children with hemophilia?" Which sports should the nurse recommend? (Select all that apply.)

Swimming Golf Bowling

Which statement best describes -thalassemia major (Cooley anemia)?

Increased incidence occurs in families of Mediterranean extraction.

The nurse is conducting a staff in-service on sickle cell anemia. Which describes the pathologic changes of sickle cell anemia?

Increased red blood cell destruction occurs.

The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breast-fed infant. Which should be suggested?

Iron-fortified infant cereal by age 4 to 6 months

The nurse is teaching parents about the importance of iron in a toddler's diet. Which explains why iron deficiency anemia is common during toddler-hood?

Milk is a poor source of iron.

Parents of a child with sickle cell anemia ask the nurse, "What happens to the hemoglobin in sickle cell anemia?" Which statement by the nurse explains the disease process?"

Normal adult hemoglobin is replaced by abnormal hemoglobin.

Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease? (Select all that apply.)

Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs. Give penicillin as prescribed. Notify the health care provider if your child begins to develop symptoms of a cold.

Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vasoocclusive crisis?

Painful swelling of hands and feet; painful joints

The nurse is conducting a staff in-service on inherited childhood blood disorders. Which statement describes severe combined immunodeficiency syndrome (SCIDS)?

There is a deficit in both the humoral and cellular immunity with this disease.

Which immunization should be given with caution to children infected with human immunodeficiency virus (HIV)?

Varicella

Parents of a hemophiliac child ask the nurse, "Can you describe hemophilia to us?" Which response by the nurse is descriptive of most cases of hemophilia?

X-linked recessive inherited disorder in which a blood-clotting factor is deficient

When both parents have sickle cell trait, which is the chance their children will have sickle cell anemia?

25%

The nurse is planning care for an adolescent with AIDS. Which is the priority nursing goal?

Preventing infection

The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child?

Puppet play in the child's room

The nurse has initiated a blood transfusion on a preschool child. The child begins to exhibit signs of a transfusion reaction. Place in order the interventions the nurse should implement sequencing from the highest priority to the lowest.

Stop the transfusion. Take the vital signs. Maintain a patent IV line with normal saline. Notify the practitioner.

Several blood tests are ordered for a preschool child with severe anemia. The child is crying and upset because of memories of the venipuncture done at the clinic 2 days ago. The nurse should explain:

topical application of local anesthetic can eliminate venipuncture pain.

Meperidine (Demerol) is not recommended for children in sickle cell crisis because it:

may induce seizures.

The school nurse is informed that a child with human immunodeficiency virus (HIV) will be attending school soon. Which is an important nursing intervention?

Carefully follow universal precautions.

Which is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T cells?

Acquired immunodeficiency syndrome (AIDS)

Which should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?

Adequate dosage will turn the stools a tarry green color.

The nurse is conducting a staff in-service on childhood blood disorders. Which describes the pathology of idiopathic thrombocytopenic purpura?

An excessive destruction of platelets

Iron dextran is ordered for a young child with severe iron deficiency anemia. Nursing considerations include to:

inject deeply into a large muscle.

The nurse is reviewing first aid with a group of school nurses. Which statement made by a participant indicates a correct understanding of the information?

"If a child has a nosebleed, I should have the child sit up and lean forward."

Which child should the nurse document as being anemic?

1-year-old child with a hemoglobin of 13 g/dl

In which of the conditions are all the formed elements of the blood simultaneously depressed?

Aplastic anemia

The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child? (Select all that apply.)

Avoidance of IM injections Acetaminophen (Tylenol) for mild pain control Soft tooth brush for dental hygiene

The nurse is teaching parents of an infant about the causes of iron deficiency anemia. Which statement best describes iron deficiency anemia in infants?

Clinical manifestations are similar regardless of the cause of the anemia.

A school-age child is admitted in vasoocclusive sickle cell crisis. The child's care should include:

adequate hydration and pain management.

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of:

circulatory overload.

A possible cause of acquired aplastic anemia in children is:

drugs.

Chelation therapy is begun on a child with -thalassemia major. The purpose of this therapy is to:

eliminate excess iron.

A young child with human immunodeficiency virus (HIV) is receiving several antiretroviral drugs. The purpose of these drugs is to:

delay disease progression.