It is a serious condition in which the bone marrow does not produce enough new blood cells. It may be passed down from the parents or develop sometime during childhood:
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Solution
Answer: C. Aplastic anemia
Option C: Aplastic anemia is characterized by pancytopenia (anemia, granulocytopenia, and thrombocytopenia) and bone marrow hypoplasia.
Option A: Iron deficiency anemia is caused by an inadequate supply of iron for normal red blood cell (RBC) formation.
Option B: Sickle cell disease is a group of chronic, severe, genetic, hemolytic diseases associated with hemoglobin (Hb) S, which transform red blood cells (RBCs) into a sickle (crescent) shape when blood oxygenation is decreased.
Option D: Thalassemia is a group of inherited blood disorders characterized by a deficient synthesis of specific globulin chains of hemoglobin molecule.
Option E: Hemophilia is a group of hereditary bleeding disorders characterized by a deficiency in a blood-clotting factor.
Option F: Idiopathic thrombocytopenic purpura (ITP) is an acquired hemorrhagic disorder in which the number of circulating platelets is reduced.
Archie is a child with iron deficiency anemia. He is required to receive elemental iron therapy at 6 mg/kg/day in three divided doses. He weighs 44 lbs. How many milligrams of iron should he receive per dose?
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Solution
40 mg/dose
Option B: The child weighs 44 lbs, which is equal to 20 kg (1 kg=2.2 lb;44/2.2=20kg). Elemental iron therapy is ordered at 6 mg/kg/day in three doses. Therefore, the child receives 120 mg/day (6 mg/20 kg/day=120), divided into three doses (120/3), which is equal to 40 mg/dose.
Mr. and Mrs. Robertson’s son was diagnosed with idiopathic thrombocytopenic purpura. They should be aware that the drug to be avoided is:
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Solution
Aspirin
Option B: Aspirin exerts an antiplatelet action and therefore may increase platelet destruction in ITP.
Options A, C, and D: Acetaminophen, codeine, and morphine have no effect on platelets and, therefore, are not contraindicated.
Nurse Hannah is administering a steroid to a child diagnosed with idiopathic thrombocytopenic purpura (ITP); which of the following should the nurse monitor?
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Solution
Infection
Option A: Steroids may promote immunosuppression, making the child more susceptible to infections.
Option B: Anemia is not connected to the disorder or medication.
Options C and D: Bleeding and bruising are recognized as a result of the disorder, not the steroid therapy.
The long-term complications seen in thalassemia major are associated to which of the following?
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Solution
Hemochromatosis
Option C: Long-term complications arise from hemochromatosis, excessive iron deposits precipitating in the tissues and causing destruction.
Option A: Anemia is a sign of this disorder.
Options B and D: Cellular damage from hemochromatosis may lead to splenomegaly, growth retardation, skeletal complications, cardiac problems, gallbladder disease, hepatomegaly, and skin changes.
A child with thalassemia was given deferoxamine (Desferal); which of the following should alert the nurse to notify the physician?
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Solution
Decreased hearing
Option A: Desferoxamine is ototoxic. Thus, any hearing problem should be immediately addressed to the physician.
Option B: Hypotension, not hypertension, is a possible adverse effect.
Option C: Red urine is an expected occurrence with deferoxamine.
Option D: Vomiting is not an emergency with this drug.
Nurse Olenna is performing community assessment; which of the following age-groups would be inappropriate for her to monitor iron deficiency anemia?
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Solution
School-age children
Option B: Periods of rapid growth predispose a person to iron deficiency anemia. Iron deficiency anemia is not prevalent in school-age children because this stage is not a period of rapid growth.
Options A, C, and D: Toddlerhood, adolescence, and pregnancy are periods of rapid growth. Thus, individuals in these groups are more likely to experience iron deficiency anemia. The “picky appetites” of toddlers and adolescents may also predispose them to this condition.
Mrs. Baker was instructed by the nurse on foods to encourage her child’s diet concerning the latter’s iron deficiency anemia; which of the following if stated by the mother would indicate the need for further instruction?
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Solution
Yellow vegetables
Option D: If a parent states that she should stress the intake of yellow vegetables, she needs additional teaching because yellow vegetables are not good source of iron.
Options A, B, and C: Fish, lean meats, and whole-grain breads are good food sources of iron and should be supported and encouraged.
Which of the following tests is most effective in diagnosing hemophilia?
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Solution
Partial thromboplastin time (PTT)
Option C: PTT is abnormal in hemophilia. Therefore, this test will be the most helpful in diagnosing the disorder.
Options A and D: Bleeding time and platelet count are normal in hemophilia.
Option B: The CBC is not affected in hemophilia.
Mr. and Mrs. Smith’s child has hemophilia; which of the following actions would you instruct them to avoid?
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Solution
Lowering the injured area
Option B: With hemophilia, the injured area must be elevated, not lowered.
Options A, C, and D: Immobilizing the joint and applying cold or pressure to the area are appropriate measures to control bleeding.