Exam 3 Hematology
The parents of a 6-year-old child with idiopathic thrombocytopenic purpura (ITP) ask the nurse conducting an assessment of the child what causes the disease. What is the nurse's best response?
"ITP is primarily an autoimmune disease in which the immune system attacks and destroys the body's own platelets, for an unknown reason."
A nurse is teaching parents of a child with iron-deficiency anemia how to administer ferrous sulfate. The nurse determines that the teaching was successful when they make which statements? Select all that apply. -"He has to make sure that he brushes his teeth well." -"We'll have him take the liquid medicine with some orange or -pineapple juice." -'We'll give him the medicine before he eats his meals." -"He might get constipated, so we'll try to get him to eat some more fiber." -"We can mix the liquid form of the drug with milk."
-"He has to make sure that he brushes his teeth well." -"We'll have him take the liquid medicine with some orange or -pineapple juice." -'We'll give him the medicine before he eats his meals." -"He might get constipated, so we'll try to get him to eat some more fiber."
The nurse is caring for a 10-year-old child dying of leukemia. The parent requests that the nurse allow the parent to bathe the child. The child has multiple IV lines, electrodes, oxygen tubing, and a nasogastric tube. How will the nurse respond?
"I think that would be a great idea. Would you like some help with all the tubes?"
The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate?
"My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."
A 5-year-old girl is diagnosed with iron-deficiency anemia and is to receive iron supplements. The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement, which statement by the parents indicates the need for additional teaching?
"We will place the liquid in the front of her gums, just below her teeth."
A nurse is teaching a school-aged child with iron-deficiency anemia and her parents about dietary measures to increase iron intake. The nurse determines that the teaching was successful when they state which food is high in iron? Select all that apply. -Milk -Citrus fruits -Green leafy vegetables -Eggs -Fortified cereal
-Green leafy vegetables -Eggs -Fortified cereal
Which risk factors will the nurse identify when screening infants for iron-deficiency anemia? Select all that apply. -frequent vomiting and regurgitation -birth prior to 37 weeks' gestation -maternal anemia during pregnancy -recurrent constipation and colic -drinking 48 oz milk in a bottle daily
-frequent vomiting and regurgitation -birth prior to 37 weeks' gestation -maternal anemia during pregnancy -drinking 48 oz milk in a bottle daily
The nurse is assessing a 10-year-old girl with acute lymphoblastic leukemia. What information would lead the nurse to suspect that the cancer has infiltrated the central nervous system?
Child reports facial palsy and vision problems
The nurse is assisting with the circumcision of a male infant. What assessment finding, 1 hour after the circumcision, indicates the greatest need for further assessment?
The infant has frank bleeding at the circumcision site.
A child has a history of sickle cell anemia, and is brought to the emergency department with reports of generalized pain for several hours. The nurse completes an assessment with the above results. The nurse suspects the child is experiencing a vaso-occlusive crisis. Which assessment finding best supports the nurse's suspicion?
dactylitis
The nurse is providing care for a 13-year-old child diagnosed with iron-deficiency anemia. The client's current hemoglobin level is 11 g/dL (110 g/L). Which intervention will the nurse anticipate including in the client's care?
giving ferrous sulfate with orange juice between meals
A child with hemophilia A has had repeated episodes of hemarthrosis. Which assessment finding is most important to consider?
Decreased range of motion
The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management?
Initiate pain assessment with a standardized pain scale.
After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections?
Neutrophils
The nurse is caring for a child with idiopathic thrombocytopenic purpura with a platelet count of 24,000/mm3. Which health care provider prescription will the nurse question?
Provide ibuprofen as needed for pain.
A 5-year-old client has been diagnosed with leukemia and is currently on chemotherapy and radiation. The child is having difficulty due to mucositis. Which is the most appropriate nursing diagnosis for this child?
Risk for imbalanced nutrition, less than body requirements, related to inflammation
The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron-deficiency anemia. Which additional finding would help provide additional evidence for this suspicion?
Spooned nails
The nurse is caring for a child admitted to the hospital for an open fracture of the femur following a motor vehicle accident. The nurse notes the following lab values: white blood cells 10,000/mm3, hemoglobin 7.9 g/dl (79 g/L), hematocrit 28%, platelets 151,000/mm3. Which nursing action is priority?
Transfuse 1 unit of packed red blood cells.
The nurse will select which meal as the best choice for a child with iron-deficiency anemia?
cheeseburger, broccoli, and fresh strawberries
