Peds chapter 24 anemias only- Tinky

The nurse is assessing a child with aplastic anemia. What would the nurse expect to assess? Select all that apply. A)Ecchymoses B)Tachycardia C)Guaiac-positive stool D)Epistaxis E)Severe pain F)Warm tender joints

A, B, C, D Assessment findings associated with aplastic anemia include ecchymoses, epistaxis, guaiac-positive stools, and tachycardia. Severe pain and warm tender joints are most often associated with sickle cell crisis.

The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply. A)Tuna B)Salmon C)Tofu D)Cow's milk E)Dried fruits

A, B, C, E Foods high in iron include red meats, tuna, salmon, eggs, tofu, enriched grains, dried beans and peas, dried fruits, leafy green vegetables, and iron-fortified breakfast cereals.

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type? A)Hemoglobin A B)Hemoglobin F C)Hemoglobin A2 D)Hemoglobin S

A. Hemoglobin A. Three types of normal hemoglobin are present at any given time in the blood: A, F, and A2. By 6 months of age, hemoglobin A is the predominant type. Hemoglobin S is associated with sickle cell disease.

The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults? A)Most childhood cancers affect the tissues rather than organs. B)Childhood cancers are usually localized when found. C)Unlike adult cancers, childhood cancers are less responsive to treatment. D)The majority of childhood cancers can be prevented.

A. Most childhood cancers affect the tissues rather than organs. Childhood cancers usually affect the tissues, not the organs, as in adults. Metastasis often is present when the childhood cancer is diagnosed. Childhood cancers, unlike adult cancers, are very responsive to treatment. Unfortunately, little is known about cancer prevention in children.

When providing care to a child with aplastic anemia, which nursing diagnosis would be the priority? A)Risk for injury B)Imbalanced nutrition, less than body requirements C)Ineffective tissue perfusion D)Impaired gas exchange

A. Risk for injury For the child with aplastic anemia, safety is of the utmost concern, with injury prevention essential to prevent hemorrhage. Nutrition, tissue perfusion, and gas exchange may or may not be associated with the child's condition.

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? A)Spooned nails B)Negative splenomegaly C)Oxygen saturation: 99% D)Bradycardia

A. Spooned nails Spooning or concave shape of the nails suggests iron-deficiency anemia. Other findings would include decreased oxygen saturation levels, tachycardia, and possible splenomegaly.

A child is prescribed monthly injections of vitamin B12. When developing the teaching plan for the family, the nurse would focus on which type of anemia? A)Aplastic anemia B)Pernicious anemia C)Folic acid anemia D)Sickle cell anemia

B. Pernicious anemia Monthly injections of vitamin B12 are used to treat pernicious anemia. Aplastic anemia is characterized by a decrease in all blood cells necessitating a bone marrow transplant. Folic acid deficiency anemia is treated with dietary measures and possible folic acid supplementation. Sickle cell anemia is treated supportively with a focus on preventing sickling crisis, infection, and other complications.

The nurse is evaluating the laboratory test results of a 7-year-old child with a suspected hematologic disorder. Which finding would cause the nurse to be concerned? A)WBC: 5.6 X 103/mm3 B)RBC: 2.8 X 106/mm3 C)Hemoglobin: 11.4 mg/dL D)Hematocrit: 35%

B. RBC: 2.8 X 106/mm3 The RBC listed is below the normal range for a child between the ages of 6 and 16 years (4.0 to 5.2 X 106/mm3). The WBC count, hemoglobin, and hematocrit are within acceptable parameters for a child this age

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 indicates the need for additional teaching? A)"She needs to eat foods that are high in fiber so she doesn't get constipated." B)"We'll try to get her to drink lots of fluids throughout the day." C)"We will place the liquid in the front of her gums, just below her teeth." D)"We need to measure the liquid carefully so that we give her the correct amount."

C. "We will place the liquid in the front of her gums, just below her teeth." When giving liquid iron supplements, the liquid should be placed behind the teeth because it can stain the teeth. Iron can lead to constipation, so increased fluid and fiber intake is appropriate. The dosage needs to be measured carefully to prevent overdosing the child, leading to iron toxicity.

A nurse is conducting a physical examination of a 5-year-old with suspected iron-deficiency anemia. How would the nurse evaluate for changes in neurologic functioning? A)"Open your mouth so I can look inside your cheeks and lips." B)"Do you have any bruises on your feet or shins?" C)"Will you show me how you walk across the room?" D)"Let me see the palms of your hands and soles of your feet."

C. "Will you show me how you walk across the room?" Neurologic effects of iron deficiency may be demonstrated when the child's ability to sit, stand, and walk are impaired. Inspecting the mouth, looking for bruises, and checking the hands and feet provide information about signs of petechiae, purpura, or pallor.

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? A)Administer a nonsteroidal anti-inflammatory drug (NSAID) as ordered. B)Use guided imagery and therapeutic touch. C)Administer meperidine as ordered. D)Initiate pain assessment with a standardized pain scale.

D. Initiate pain assessment with a standardized pain scale. The nurse should first initiate pain assessment with a standardized pain scale upon admission and provide frequent evaluations of pain. Administering NSAIDs or meperidine and the use of nonpharmacologic pain management techniques are all appropriate. However, the first action is to assess the child's pain to provide a baseline for future comparison.