2. Sickle Cell Anemia & Pernicious Anemia.pdf

Sickle Cell Anemia & Pernicious Anemia Pediatrics: Hematological Sickle Cell Anemia Normal Cell Sickle Cell The RBCs have a distorted shape, transforming fr...

Sickle Cell Anemia & Pernicious Anemia Pediatrics: Hematological Sickle Cell Anemia Normal Cell Sickle Cell The RBCs have a distorted shape, transforming from a nice round plumb O2 shape to a skinny sucked in sickle shape. These misshaped RBCs die O2 O2 O2 O2 quicker than normal RBCs, carry less oxygen to the body & get clogged O2 O2 O2 O2 O2 O2 in tiny blood vessels - blocking or occluding the blood supply causing O2 O2 O2 O2 O2 O2 ischemia (low oxygen) to the organs. A vaso-occlusive crisis or O2 “sickle cell crisis” can occur, causing extreme pain from the lack of oxygen! Signs & Symptoms Complication Splenomegaly Splenic sequestration crisis One sided arm weakness Kaplan Question Rapidly enlarging spleen Swelling of the feet and Client experiencing a vaso-occlusive crisis. The nurse Low blood pressure hands (Dactylitis) determines care is appropriate if which observation is made? NCLEX TIP The client receives regular neurological assessments Treatment ATI Question New-onset paralysis of Hydration: IV fluids A pediatric nurse is giving instructions to a 12-year-old extremities client with sickle cell disease Bed rest and his parents. To prevent a crisis, the nurse explains that the Pain Control NCLEX TIP Sudden inability to be child should do which of the PCA - patient control following? Select all that apply. aroused analgesia pump Call the HCP for Stay away from sick children Increase fluids Be aware that high altitudes Higher doses may lead to a crisis Pernicious Anemia The body can not absorb B12, which is a vital building block to create RBC’s. HESI Question Clients lack intrinsic factor in the GI tract, which helps the body take in B12. Which factor results from pernicious anemia? B12 The absence of intrinsic B12 B12 B12 B12 factor secreted by the gastric mucosa B12 Signs & Symptoms Treatment Kaplan Question Kaplan Question Clinical manifestations B12 - Injection: IM or IV Client diagnosed with pernicious anemia asks why vitamin B12 cannot of pernicious anemia? be given in pill form. Which response NOT orally (PO) by the nurse is best? Glossitis: A smooth, Glossitis: EXAM TIP red tongue “Stomach doesn’t secrete the necessary substance for B12 Inflamed red smooth tongue to be absorbed orally.” Extreme weakness HESI Question HESI Question A client asks the nurse how long A nurse is caring for a patient injections of vitamin B12 will be Jaundice: “pale yellow skin” The nurse is caring for a patient with pernicious anemia needed. Which response by the who reports extreme weakness secondary to total gastrectomy. nurse is best? and glossitis, and the nurse identifies pale yellow skin. Which The nurse would question which You may need lifelong injections type of anemia does the nurse provider's order? anticipate in the patient? Vitamin B12 supplement, PO Pernicious anemia B12 B12 B12 B12 B12 B12 B12 B12 B12 B12 B12 B12 B12 B12 B12 B12