Review Q's
In the ED you administer D5/.45 at 125 mL per hour administer oxygen at 6L/min via NC. Give morphine 2 mg IV, acetaminophen 650 mg which was the highest priority?
IV Fluids
For a patient with DIC, the primary goal of medical treatment is to?
Identify and treat the underlying conditions that lead to the development of DIC
Sickle cell do not
bend the knee
The parents of a patient diagnosed with hemophilia A ask what symptoms they should monitor for?
Nose bleeds Blood in the urine Painful and swollen joints Easy bruising Dark coloured tarry stools
The nurse is assessing a child receiving chemo for leukemia. Which side effect would the nurse anticipate?
Nose bleeds!
Hemophilia a results from lack of
factor 8
Hemophilia B results from lack of
factor 9
normal serum lactate
0.5-1 mmol/L
When preparing to administer a ordered blood transfusion, the nurse selects which of the following iv solutions?
0.9% NACL
The nurse is reviewing a health care providers prescription for a child with sickle cell anemia who was admitted to the hospital with a vaso-occlusive crisis. Which prescription documented in the childs health record should the nurse question? (SATA) 1. Restrict fluid intake 2. Position for comfort 3. Avoid strain on painful joints 4. Apply nasal oxygen at 2L/min 5. Provide a high calorie, high protein diet 6. Administer mependine (Demerol) 25 mg for pain
1. Restrict fluid intake 6. Administer mependine (Demerol) 25 mg for pain Demoral can cause seizures in pt's with renal disease
Before starting a blood transfusion a nurse should get a colleague to monitor other patients for?
15 minutes
Normal serum bicarbonate
22-26 mEq/L
Albumin
3.5-5
A nurse must hang a unit of packed blood cells within how long from receiving from the blood bank?
30 mins
The nurse from the med surg unit is assigned multiple patients. Which of the following patients is most at risk for a stroke? 62 year old patient who weighs 275lb with a-fib and sickle cell anemia A 77 year old patient who drinks a glass of wine nightly, smokes and had a previous MI A 40 year old patient who uses oral contraception and has chronic kidney disease A 50 year old patient with migraines whose father had a stroke
62 year old patient who weighs 275lb with a-fib and sickle cell anemia
Normal D-dimer
<250 ng/mL
Which of the following best describes DIC?
A disease process stimulates coagulation processes with resultant depletion of clotting factors leading to diffuse clotting and hemorrhage.
A nurse in a maternity unit is reviewing the records of the clients on the unit. Which client would the nurse identify as being at the greatest risk for DIC? A primagravida with mild preeclampsia A primagravida who delivered a 10lb baby 3 hours ago A gravida III who has just been diagnosed with dead fetus syndrome A gravida IV who has pre-eclampsia who delivered 8 hours ago and lost 500mL of blood.
A gravida IV who has pre-eclampsia who delivered 8 hours ago and lost 500mL of blood.
Clinical manifestations of AML
Anorexia Petechiae Irritability Listlessness
What is the priority nursing action when caring for a client with DIC? Monitor for homan sign? Avoid giving IM injections? Take temperatures via the rectal route? Apply sequential compression stockings?
Avoid giving intramuscular injections
In considering the genetics of sickle cell disease. You understand that VL's inheritance of scd occurred because?
Both of her parents carried HbS
SIRS vs. Sepsis
Both: whole body inflammatory response, increase in HR and respiration, abnormal WBC count, fever complications: fluid retention/tissue edema, low BP, impaired blood flow, hypovolemic shock, MODs SIRS- severe injury/trauma Sepsis- unresolved infection
Hodgkin disease first lymph nodes affected?
Cervical
Sores in mouth complication of
Chemo Not present in patient before chemo
As a nurse providing care to a client with DIC, what potential complication should you continually assess the client for?
Clotting Hemorrhage
An adolescent with acute hemophilia episode what does RICE promote?
Controlling bleeding and retaining joint function
Which medication is most beneficial to the client with sickle cell anemia on a blood transfusion regimen who has cardiac dysrhythmias due to iron overdose toxicity?
Deferoxamine
Sirs - Sepsis
Fever High BP
Common interventions for management of sickle cell crisis?
HYDRATION Electrolyte replacement Pain control Blood replacement Infection treatment
Sepsis tell tale sign?
High glucose in non-diabetic
The nurse receives a physicians order to transfuse fresh frozen plasma to a patient suffering from an acute blood loss. Which of the following procedures is most appropriate for infusing this blood product?
Infuse the FFP as rapidly as the patient will tolerate
hydroxurea for sickle cell
Makes RBC/s bigger Creates production of hemoglobin F
Multiple myeloma cancer of?
Mature plasma cell
Leukemis s/s young child?
Pallor Fatigue Multiple bruises
A client is receiving a unit of packed RBC's. Which findings lead the nurse to suspect a transfusion reaction caused by incompatible blood?
Respiratory distress Backache Chills
A client is receiving a unit of packed red blood cells. Which findings led the nurse to suspect a transfusion caused by incompatible blood?
Respiratory distress Backache Chills
Imatinib side effects
Signs of infection Bleeding tendencies
Imatinib side effects for cml
Signs of infection Bleeding tendencies
Which intervention is most appropriate to help control VL's pain? Obtain an order for a heating pad for her abdomen Teach her guided imagery and relaxation techniques Position her in a fowlers position with the knee elevated Divert het attention by asking what she would like to watch on tv
Teach her guided imagery and relaxation techniques
Multiple myeloma s/s
Typically discover by accident
Non-Hodgkin's Lymphoma
a malignant cancer that starts in the lymphocytes; includes any type of lymphoma except Hodgkin's lymphoma
Hodgkin's lymphoma
distinguished from other lymphomas by the presence of large, cancerous lymphocytes known as Reed-Sternberg cells
Hodgkin lymphoma diagnosed
during adolescence and young adulthood
What does albumin do?
maintains osmotic pressure
