HEmatology EAQS PEDS Test 3
The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measure should the nurse do until factor replacement therapy can be instituted?
Elevate area above the level of the heart
Jacob is a 2-year-old outpatient with hemophilia A. He will be coming to the emergency department (ED) for an outpatient infusion after a tumble from his high chair. There are a number of bleeding disorders that may require infusion w/ clotting factors or blood products. Which blood component will Jacob need replaced?
Factor VIII
The parent of a 6-month old infant asks the nurse about the food that can be included in the child's diet. What does the nurse suggest?
Include cereals in the diet
Which approaches can be used to classify anemia?
-etiology -morphology
Which of the following are characteristics of von Willebrand disease?
-gum bleeding occurs -easy bruising occurs -it is a hereditary bleeding disorder -the disorder causes platelets to adhere to damaged endothelium -treatment and care are similar to those implemented for hemophilia
A nurse is reviewing a physician's orders for a child w/ sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which orders documented in the child's record should the nurse question?
-restrict fluid intake -Give meperidine (Demerol), 25 mg IV, every 4 hrs for pain
The nurse is caring for a child w/ epistaxis. The parent asks how nosebleeds can start. What does the nurse understand about the common causes of epistaxis in children? Select all that apply.
-they can be caused by nose picking -they can be caused by trauma to nose -they can be caused by inflammation from allergies -they can be caused by foreign bodies lodged in nostrils
A pediatric nursing instructor asks a nursing student to describe the cause of the clinical manifestations that occur in sickle cell anemia. The student responds correctly by telling the instructor that:
sickled cells are unable to flow easily through the microvasculature and their clumping obstructs blood flow
What is the most common manifestation of SCID?
susceptibility to infection
The nurse finds that a child is pale, gets easily fatigues, and has lack of energy. The nurse asks the parents to get a CBC test. What does the nurse suspect from these symptoms?
Anemia
A nurse is providing home care instructions to the mother of a 10 year old child w hemophilia. Which of the following activities should the nurse suggest that the child could participate safely w/ peers?
swimming
Which statement best describes the onset of clinical manifestations in thalassemia major?
Clinical manifestations may be insidious and not recognized until early toddlerhood
The nursing instructor is teaching a student how to administer iron dextran injections to a child w/ severe anemia. Which instruction does the nurse give after the student administers the injection?
Do not massage the injection site
A child w b-thalassemia is receiving long-term blood transfusion therapy for the treatment of this disorder. Chelation therapy is prescribed to prevent organ damage from the presence of too much iron in the body as a result of the transfusions. Which of the following meds would the nurse anticipate to be prescribed in chelation therapy?
Deferoxamine (Desferal)
A child is prescribed oral iron for iron deficiency anemia. What intervention does the nurse implement to ensure the absorption of iron in the child?
Gives citrus juice with the oral iron
A 10 year old child w/ hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer an:
IV infusion of factor VIII
Which is an ideal treatment for a child after splenectomy?
Prophylactic antibiotics
Laboratory studies are performed for a child suspected of having iron deficiency anemia. The nurse reviews the laboratory results, knowing that which of the following results would indicate this type of anemia?
Red blood cells that are microcytic and hypochromic
The nurse suspects that a child is having an adverse reaction to a blood transfusion. What should be the first action by the nurse?
Stop transfusion and maintain a patent IV line w/ normal saline and new tubing
The parents of a child taking oral iron supplements report that the child's stools are a tarry green color. What is the best response the nurse provides to the parents?
Tarry green color is expected w/ oral iron supplements
What is the most important nursing consideration when caring for a child w/ sickle cell?
Teach parents and child how to minimize crises
The parents of a child w/ leukemia are anxious during a nose bleeding episode and request platelet transfusions for the child. What action does the nurse take?
Tries to stop bleeding by applying pressure at the site
A nursing student is presenting a clinical conference and discusses the cause of b-thalassemia. The nursing student informs the group that the child at greatest risk of developing this disorder is:
a child of Mediterranean descent
A home care nurse is instructing the parents of a child w/ iron deficiency anemia regarding the administration of a liquid oral iron supplement. The nurse tells the mother to:
administer the iron through a straw
Which term is used to describe the removal of blood from an individual, separation of the blood into its components, retention of one or more of these components, and reinfusion of the remainder of the blood back into the individual?
apheresis
The nurse is assessing an adolescent w/ hemophilia A who has also experienced several episodes of joint bleeding. Which condition will be evident in the adolescent?
bony changes
A clinic nurse instructs the mother of a child w/ sickle cell anemia about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions?
fluid overload
Which condition in a child indicates a deficiency of one of the factors (proteins) necessary for blood coagulation?
hemophilia
Which symptom is seen in a child with DIC?
increased tendency to bleed
A nurse analyzes the laboratory results of a child w/ hemophilia. The nurse understands that which of the following would most likely be abnormal in this child?
partial thromboplastin time
What is the objective of managing anemia?
reversing it by treating the underlying cause
