Hematologic PrepU (ch 44)

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with sickle cell disease. The nurses in the group make the following statements. Which statement is most accurate regarding this condition? "The disease is most often seen in individuals of Asian decent." "The trait or the disease is seen in one generation and skips the next generation." "Males are much more likely to have the disease than females." "If the trait is inherited from both parents the child will have the disease."

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

The nurse is concerned that a school-aged child has iron-deficiency anemia. What did the nurse assess in this client? Craving for ice cubes Asking many questions Thumb-sucking Shyness

Craving for ice cubes

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

Hemoglobin level

Which nursing diagnosis should the nurse identify as being the most appropriate for a child with idiopathic thrombocytopenic purpura? Ineffective breathing pattern related to decreased white blood count Risk for altered urinary elimination related to kidney impairment Risk for bleeding related to insufficient platelet formation Risk for infection related to abnormal immune system

Risk for bleeding related to insufficient platelet formation

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." "ITP is a serious bleeding disorder characterized by a decreased, absent, or dysfunctional procoagulant factor." "ITP is characterized by the loss of surface area on the red blood cell membrane." "ITP occurs when the body's iron stores are depleted due to rapid physical growth, inadequate iron intake, inadequate iron absorption, or loss of blood."

"ITP is primarily an autoimmune disease in which the immune system attacks and destroys the body's own platelets, for an unknown reason." Idiopathic thrombocytopenic purpura (ITP) is primarily an autoimmune disease, which is an acquired, self-limiting disorder of hemostasis characterized by destruction and decreased numbers of circulating platelets. The child will exhibit symptoms of excessive petechiae, purpura, and bruising. Hemophilia A and hemophilia B are distinguished by the particular procoagulant factor that is decreased, absent, or dysfunctional. Iron-deficiency anemia occurs when the body's iron stores are depleted. Hereditary spherocytosis (HS) is characterized by loss of surface area on the red blood cell membrane.

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." "I make sure our child is up to date on all immunizations." "We always take water along when we are on an outing." "I make sure my child wears a good warm coat and gloves during winter."

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

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? "This is a hereditary disease that is transmitted by one affected gene." "Fluid restriction is necessary to control sickle cell anemia." "Sickle cell anemia is common in people of Asian descent." "The sickle shape of red blood cells decreases oxygen to tissues."

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

The nurse is assessing children in an ambulatory clinic. Which child would be most likely to have iron-deficiency anemia? An 8-year-old child who carries lunch to school A 15-year-old adolescent who has heavy menstrual periods A 3-month-old infant who is totally breastfed A 7-month-old infant who has started table food

A 15-year-old adolescent who has heavy menstrual periods

The nurse is instructing the parents of a child with sickle cell anemia on safety precautions. What should the nurse emphasize during this teaching? Treat upper respiratory infections with over-the-counter medication. Ensure a consistent and daily intake of adequate fluids to prevent dehydration. Remind parents that the child should avoid immunizations to prevent the introduction of bacteria into the body. Suggest the child participate in sports activities without restriction.

Ensure a consistent and daily intake of adequate fluids to prevent dehydration.

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 Encouraging the child to take deep breaths hourly Seeing that the child ingests a protein-rich diet Beginning active range-of-motion exercises

Maintaining fluids through an intravenous line

The parents of a child with a bleeding disorder ask the nurse about appropriate activities and sports that they should encourage the child to participate in. What activity would be the safest for the nurse to suggest? Soccer Gymnastics Swimming Rugby

Swimming

A 9-month-old infant with iron-deficiency anemia is given ferrous sulfate therapy. Which assessment would best help the nurse determine that the infant is actually taking it daily? The infant will be more irritable than at the last visit. The stools will appear black. The reticulocyte count will have decreased. The infant will develop diarrhea.

The stools will appear black.

After teaching a group of students about hemophilia, the instructor determines that the students have understood the information when they identify hemophilia A as involving a problem with: factor VIII. factor IX. plasmin. platelets.

factor VIII. In hemophilia A, the problem is with factor VIII, and in hemophilia B the problem lies with factor IX. Platelets are problematic in idiopathic thrombocytopenic purpura (ITP). Plasmin is involved in the pathophysiologic events of disseminated intravascular coagulation

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: ecchymosis. poikilocytosis. purpura. petechiae.

petechiae.