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Questions and Answers
How can the nurse best gauge the course of the client's disease in polycythemia vera?
How can the nurse best gauge the course of the client's disease in polycythemia vera?
Follow the trends of the client's hematocrit.
Which method is least effective for gauging the course of polycythemia vera?
Which method is least effective for gauging the course of polycythemia vera?
Which intervention by the nurse would decrease the risk for narcotic substance abuse in a client with sickle cell disease taking narcotic analgesics for pain control?
Which intervention by the nurse would decrease the risk for narcotic substance abuse in a client with sickle cell disease taking narcotic analgesics for pain control?
A client newly diagnosed with thrombocytopenia asks the nurse for an explanation of the condition. What should the nurse explain is the cause?
A client newly diagnosed with thrombocytopenia asks the nurse for an explanation of the condition. What should the nurse explain is the cause?
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What treatment option may be considered for a client with immune hemolytic anemia who is not responding to conservative treatments?
What treatment option may be considered for a client with immune hemolytic anemia who is not responding to conservative treatments?
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What should the nurse include in health education for a client with iron deficiency anemia who has been prescribed iron supplements?
What should the nurse include in health education for a client with iron deficiency anemia who has been prescribed iron supplements?
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What form of hematologic disorder is indicated by a client showing acute fatigue and a sore, smooth, beefy red tongue?
What form of hematologic disorder is indicated by a client showing acute fatigue and a sore, smooth, beefy red tongue?
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A client with acute kidney injury has decreased erythropoietin production. What will the nurse expect to find upon analysis of the client's complete blood count?
A client with acute kidney injury has decreased erythropoietin production. What will the nurse expect to find upon analysis of the client's complete blood count?
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With a low serum iron level and low ferritin level, what is the likely diagnosis for a client with symptoms of pica?
With a low serum iron level and low ferritin level, what is the likely diagnosis for a client with symptoms of pica?
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Which condition should a nurse suspect in a client with increased bilirubin concentration and reticulocyte count?
Which condition should a nurse suspect in a client with increased bilirubin concentration and reticulocyte count?
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For a client with pernicious anemia, which medication should the nurse prepare to administer?
For a client with pernicious anemia, which medication should the nurse prepare to administer?
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What finding would be consistent with a client having a platelet level of 17,000/mm3?
What finding would be consistent with a client having a platelet level of 17,000/mm3?
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What medications should a nurse be alert for when admitting a client with immune thrombocytopenic purpura?
What medications should a nurse be alert for when admitting a client with immune thrombocytopenic purpura?
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A client admitted with excessive bleeding shows prolonged prothrombin time. What is a plausible cause of the client's symptoms?
A client admitted with excessive bleeding shows prolonged prothrombin time. What is a plausible cause of the client's symptoms?
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What is the expected prescription for a client with liver dysfunction due to bleeding esophageal varices?
What is the expected prescription for a client with liver dysfunction due to bleeding esophageal varices?
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What nursing diagnosis is likely for a pediatric client with hemophilia?
What nursing diagnosis is likely for a pediatric client with hemophilia?
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Which individual is most likely to have anemia?
Which individual is most likely to have anemia?
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What nursing diagnosis applies most likely to an adult client diagnosed with iron-deficiency anemia?
What nursing diagnosis applies most likely to an adult client diagnosed with iron-deficiency anemia?
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Which assessment finding would signal complications of anemia in a client experiencing declines in hemoglobin levels?
Which assessment finding would signal complications of anemia in a client experiencing declines in hemoglobin levels?
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What foods should a woman in her third trimester of pregnancy consume to increase her iron stores?
What foods should a woman in her third trimester of pregnancy consume to increase her iron stores?
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Which nursing diagnosis should the nurse prioritize in the client's plan of care?
Which nursing diagnosis should the nurse prioritize in the client's plan of care?
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A client is being treated on the medical unit for a sickle cell crisis. Which action by the nurse would be the most appropriate?
A client is being treated on the medical unit for a sickle cell crisis. Which action by the nurse would be the most appropriate?
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When teaching a client with sickle cell disease about strategies to prevent crises, what measures should the nurse recommend?
When teaching a client with sickle cell disease about strategies to prevent crises, what measures should the nurse recommend?
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Which assessment question relates most directly to a client with glucose-6-phosphate dehydrogenase deficiency?
Which assessment question relates most directly to a client with glucose-6-phosphate dehydrogenase deficiency?
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The nurse should assess for which factor in a client with a history of secondary polycythemia?
The nurse should assess for which factor in a client with a history of secondary polycythemia?
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What action should the nurse prioritize when caring for a client with an absolute neutrophil count (ANC) of 440/mm3 but no signs of infection?
What action should the nurse prioritize when caring for a client with an absolute neutrophil count (ANC) of 440/mm3 but no signs of infection?
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Which topic should the nurse prioritize when teaching a client diagnosed with a bleeding disorder?
Which topic should the nurse prioritize when teaching a client diagnosed with a bleeding disorder?
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When planning care for a new resident with a bleeding disorder, which action should the nurse include?
When planning care for a new resident with a bleeding disorder, which action should the nurse include?
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A client with a recent diagnosis of ITP asks why platelets are not administered. How should the nurse respond?
A client with a recent diagnosis of ITP asks why platelets are not administered. How should the nurse respond?
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Which component of a client's previous medication regimen may have contributed to the development of a qualitative platelet defect?
Which component of a client's previous medication regimen may have contributed to the development of a qualitative platelet defect?
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What should the nurse's next action be for a client with hemophilia A who is bleeding?
What should the nurse's next action be for a client with hemophilia A who is bleeding?
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When addressing the nursing diagnosis of Acute Pain Related to Joint Hemorrhage for a client with hemophilia A, what principle should guide the nurse's interventions?
When addressing the nursing diagnosis of Acute Pain Related to Joint Hemorrhage for a client with hemophilia A, what principle should guide the nurse's interventions?
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When reviewing a client's medication administration record (MAR), what is the nurse's best action regarding a PRN antiemetic with both oral and subcutaneous options?
When reviewing a client's medication administration record (MAR), what is the nurse's best action regarding a PRN antiemetic with both oral and subcutaneous options?
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What intervention should be performed in anticipation of a screening colonoscopy for a client with von Willebrand disease?
What intervention should be performed in anticipation of a screening colonoscopy for a client with von Willebrand disease?
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In the case of a client who has overdosed on warfarin, which antidote should the nurse recognize as necessary?
In the case of a client who has overdosed on warfarin, which antidote should the nurse recognize as necessary?
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Which ICU client most likely faces the highest risk of disseminated intravascular coagulation (DIC)?
Which ICU client most likely faces the highest risk of disseminated intravascular coagulation (DIC)?
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Which practice should the nurse recommend to a client treated for polycythemia vera to prevent complications?
Which practice should the nurse recommend to a client treated for polycythemia vera to prevent complications?
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Study Notes
Pain Management in Sickle Cell Disease
- Encourage reliance on a single primary provider for consistent pain management and care coordination.
- Avoid exclusive reliance on complementary therapies, as they may not sufficiently address pain.
Thrombocytopenia Insights
- Characterization of thrombocytopenia primarily involves decreased production of platelets.
- Possible causes include increased destruction or consumption of platelets, not typically immune issues.
Treatment of Immune Hemolytic Anemia
- A splenectomy may be necessary if conservative treatments fail for immune hemolytic anemia.
- Vitamin K is not effective for treating anemia; it targets vitamin K deficiency only.
Education on Iron Deficiency Anemia
- Inform clients that iron supplements can cause darkening of stools.
- Advise taking iron on an empty stomach and increasing vitamin C intake to enhance absorption.
Indicators of Megaloblastic Anemia
- A smooth, beefy red tongue coupled with fatigue indicates potential megaloblastic anemia.
Acute Kidney Injury and Erythropoiesis
- Anticipate decreased hemoglobin and hematocrit levels due to diminished erythropoietin production.
Diagnosis Related to Pica
- Symptoms of pica and low serum ferritin suggest diagnosis of iron deficiency anemia.
Identifying Hemolytic Anemia
- Increased bilirubin levels and elevated reticulocyte counts are indicators of hemolytic anemia.
Pernicious Anemia Management
- Vitamin B12 administration is critical for treating pernicious anemia.
Symptoms Associated with Low Platelet Count
- Petechiae may appear when platelet counts fall below 20,000/mm3.
Medications Affecting Platelet Function
- Monitor for the use of NSAIDs, aspirin, and sulfa-containing medications during assessments for immune thrombocytopenic purpura.
Causes of Excessive Bleeding with Prolonged PT
- Prolonged prothrombin time without vitamin K deficiency points to possible hepatic dysfunction.
Treatment for Liver Dysfunction Complications
- Packed red blood cells (PRBCs) are necessary for managing significant bleeding in clients with liver disease.
Coping with Hemophilia
- Children with hemophilia may struggle with ineffective coping due to the chronic nature and inherited implications of the disorder.
High-Risk Groups for Anemia
- Older adults, especially those with chronic heart conditions, face elevated risks for anemia.
Nursing Diagnosis for Anemia
- Fatigue is the most common symptom associated with anemia, typically linked to decreased oxygen-carrying capacity.
Complications Linked to Long-Term Anemia
- Monitor for shortness of breath and peripheral edema as potential complications indicative of heart failure.
Nutrition for Iron-Deficient Pregnant Women
- Recommend iron-rich foods like beef liver paired with orange juice for improved iron absorption.
Prioritizing Nursing Diagnoses in Sickle Cell Crisis
- Focus on ineffective tissue perfusion related to thrombosis during acute vaso-occlusive crises.
Infection Monitoring in Sickle Cell Patients
- Early signs such as fever and lung auscultation findings necessitate immediate communication with the healthcare provider to investigate potential infections.### General Guidelines for Management
- Avoiding Cold Temperatures: Helps to reduce the occurrence and severity of certain medical crises.
- Hydration: Essential for managing health and preventing complications.
Glucose-6-Phosphate Dehydrogenase Deficiency
- Primary Trigger: Recent medications can precipitate exacerbations of the deficiency.
- Common Symptoms: Pallor, jaundice, and malaise.
Secondary Polycythemia
- Key Assessment: Evidence of lung disease may indicate causes of secondary polycythemia due to reduced oxygenation.
- Blood Donation: Not a contributing factor to secondary polycythemia.
Neutropenia Care
- Hand Hygiene: Critical for preventing infections in clients with low absolute neutrophil counts.
- Antibiotics and Nutrition: Less relevant for immediate care compared to strict hygiene practices.
Bleeding Disorders Education
- Activity Limitations: Clients should avoid high-risk activities that could cause injury.
- Focus on Immunization: Ensures safety but must consider bleeding risks associated with injections.
Safety in Long-Term Care Settings
- Fall Prevention Plans: Important for residents with bleeding disorders to mitigate injury risk.
Immune Thrombocytopenic Purpura (ITP) Testing
- Viral Causes: Hepatitis and HIV screening recommended due to their potential role in ITP.
Platelet Transfusion in ITP
- Ineffectiveness: Platelet transfusions are typically avoided because the body rapidly destroys the transfused platelets.
Qualitative Platelet Defects
- Aspirin Use: Known to induce platelet dysfunction, increasing bleeding risk.
Management of Hemophilia A
- Factor VIII Administration: Prompt administration is crucial after injuries to manage bleeding effectively.
Pain Management in Hemophilia
- NSAIDs: Contraindicated due to the risk of exacerbating bleeding; opioids are a safer option.
Medication Administration Considerations
- Avoid Subcutaneous Injections: Necessary in clients with hemophilia to prevent bleeding complications.
von Willebrand Disease (vWD) Intervention
- Clotting Factors: Essential to administer prior to invasive procedures to avoid bleeding.
Warfarin Overdose
- Antidote: Vitamin K is the specific antidote for managing warfarin toxicity.
Disseminated Intravascular Coagulation (DIC) Risk
- Septic Shock: Recognized as a high-risk condition for developing DIC, necessitating vigilant monitoring.
Polycythemia Vera Management
- Avoid Tight Clothing: Reduces the risk of deep vein thrombosis due to increased blood viscosity.
Monitoring Course of Polycythemia Vera
- Hematocrit Trends: Best measures disease progression; should remain below 45% to manage condition effectively.
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Description
This quiz focuses on the best methods for nurses to gauge the course of a client's disease in polycythemia vera. It also examines which assessment method is the least effective for monitoring this condition. Test your understanding of nursing practices related to this hematologic disorder.
