NUR 254 Exam 4 with questions and
answers for revision
Iron deficiency Anemia:Etiology/Diagnostics - CORRECT ANSWERS-inadequate amount of iron, children
12-36 months at risk
Iron deficiency Anemia: S/S - CORRECT ANSWERS--tachy
-can be underweight or overweight
Iron deficiency Anemia: treatment - CORRECT ANSWERS--Iron rich foods (green leafy), supplements,
dietary supplements, organ meats, rice cereal at 6 months,
Iron deficiency Anemia: Teaching - CORRECT ANSWERS-- No cow's milk until the baby is 1 years old
-NO iron supplements with milk, give on empty stomach acid makes it absorb beer*
o Liquid supplement can stain teach, use straw or regular iron supplement capsule/pill
o Black tarry green stools
o Keep away from children, never keep more than a month supply at home
o Infants 30 mins before on empty, older child with something citric for the acid*
o Dietary counseling
Sickle Cell Anemia: Important* - CORRECT ANSWERS-Prevent Dehydration
Sickle Cell Anemia: Etiology/Diagnostics - CORRECT ANSWERS--Hereditary, Autosomal recessive trait.
-Cells are sickle shaped. -Repetitive decrease in 02 cell walls become rigid.
-Cells are getting jammed, causing an obstruction of RBC's, resulting in PAIN.
-The normal HGB is replaced with abnormal HGB.
-Effects the spleen.
o Organ that's mostly effected is the spleen*
,o Newborn Screening in the US
Sickle Cell Anemia: S/S - CORRECT ANSWERS-o Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis
o Stroke -> Severe unrelieved headache**
o Painful Swelling: hands, feet, joint pain
o Headache. Doesn't go away with meds? Possible CVA. EMERGENCY*
o One CVA? R/F another** (stroke)
o Visual disturbances
o Obstructive jaundice
o Fever 101.3 or higher
o Severe hypoxia
Sickle Cell Anemia: VASOCCLUSIVE Crisis - CORRECT ANSWERS--: Acute chest syndrome
-mimics pneumonia "painful episode"
Sickle Cell Anemia: Splenic Sequestration - CORRECT ANSWERS--Pooling of blood in the spleen
-Causes infection, stress, dehydration, *USE IV FLUIDS***
-trauma
Sickle Cell Anemia: treatment - CORRECT ANSWERS-o DON'T over oxygenate o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection* ( Vaccines, Anbiocs (PCN))
o If they've had a stroke, every 3-4 weeks for transfusions* to prevent CVA
o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization
,o Splenectomy (severe)
o Stem cell Transplant: considered curative (severe)
o Rest
o Control Pain: Morphine
o Electrolyte replacement
Sickle Cell Anemia: Teaching - CORRECT ANSWERS-o Prevent hydration
o Rest
o Improve oxygen but don't over oxygenate
o Educate importance of vaccines
o Know s/s of a stroke
o Child is normal just gets sicker easier
Hemophilia: term - CORRECT ANSWERS-MIssing clotting factors
Hemophilia:Etiology/Diagnostics - CORRECT ANSWERS-Deficiency of factor VIII, produced by the liver,
bleeding disorder
Hemophilia: education - CORRECT ANSWERS-Parents -> genetic counseling
Hemophilia: S/S - CORRECT ANSWERS-o PROLONGED bleeding, kid will bleed longer than other kids,
gums, cuts, injections
o Hemorrhage: At higher risk
o Bruising
o Hemarthrosis: blood in joints (knees, elbows, ankles)
o Spontaneous Hematuria: dark urine, blood
, o Hematomas -> pain, swelling, limited motion
o Headache
o Slurred Speech
o Loss of Consciousness
o Black Tarry Stools= Bleed
o Vomiting coffee ground emesis
o Bleeding gyms with teeth brushing
Hemophilia: Treatment - CORRECT ANSWERS--NO cure; lifelong
o Replace VIII factor:
o Prevent bleeding: No IM vaccines, try subQ or less invasive first
o Medications
Steroids
NSAIDS
DDAVP
o Wear helmets
o Safety, protective equipment
o Regular Exercise and Physical Therapy
o Go to doctor for sprains
o Control Bleeding
R: Rest
I: ICE
answers for revision
Iron deficiency Anemia:Etiology/Diagnostics - CORRECT ANSWERS-inadequate amount of iron, children
12-36 months at risk
Iron deficiency Anemia: S/S - CORRECT ANSWERS--tachy
-can be underweight or overweight
Iron deficiency Anemia: treatment - CORRECT ANSWERS--Iron rich foods (green leafy), supplements,
dietary supplements, organ meats, rice cereal at 6 months,
Iron deficiency Anemia: Teaching - CORRECT ANSWERS-- No cow's milk until the baby is 1 years old
-NO iron supplements with milk, give on empty stomach acid makes it absorb beer*
o Liquid supplement can stain teach, use straw or regular iron supplement capsule/pill
o Black tarry green stools
o Keep away from children, never keep more than a month supply at home
o Infants 30 mins before on empty, older child with something citric for the acid*
o Dietary counseling
Sickle Cell Anemia: Important* - CORRECT ANSWERS-Prevent Dehydration
Sickle Cell Anemia: Etiology/Diagnostics - CORRECT ANSWERS--Hereditary, Autosomal recessive trait.
-Cells are sickle shaped. -Repetitive decrease in 02 cell walls become rigid.
-Cells are getting jammed, causing an obstruction of RBC's, resulting in PAIN.
-The normal HGB is replaced with abnormal HGB.
-Effects the spleen.
o Organ that's mostly effected is the spleen*
,o Newborn Screening in the US
Sickle Cell Anemia: S/S - CORRECT ANSWERS-o Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis
o Stroke -> Severe unrelieved headache**
o Painful Swelling: hands, feet, joint pain
o Headache. Doesn't go away with meds? Possible CVA. EMERGENCY*
o One CVA? R/F another** (stroke)
o Visual disturbances
o Obstructive jaundice
o Fever 101.3 or higher
o Severe hypoxia
Sickle Cell Anemia: VASOCCLUSIVE Crisis - CORRECT ANSWERS--: Acute chest syndrome
-mimics pneumonia "painful episode"
Sickle Cell Anemia: Splenic Sequestration - CORRECT ANSWERS--Pooling of blood in the spleen
-Causes infection, stress, dehydration, *USE IV FLUIDS***
-trauma
Sickle Cell Anemia: treatment - CORRECT ANSWERS-o DON'T over oxygenate o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection* ( Vaccines, Anbiocs (PCN))
o If they've had a stroke, every 3-4 weeks for transfusions* to prevent CVA
o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization
,o Splenectomy (severe)
o Stem cell Transplant: considered curative (severe)
o Rest
o Control Pain: Morphine
o Electrolyte replacement
Sickle Cell Anemia: Teaching - CORRECT ANSWERS-o Prevent hydration
o Rest
o Improve oxygen but don't over oxygenate
o Educate importance of vaccines
o Know s/s of a stroke
o Child is normal just gets sicker easier
Hemophilia: term - CORRECT ANSWERS-MIssing clotting factors
Hemophilia:Etiology/Diagnostics - CORRECT ANSWERS-Deficiency of factor VIII, produced by the liver,
bleeding disorder
Hemophilia: education - CORRECT ANSWERS-Parents -> genetic counseling
Hemophilia: S/S - CORRECT ANSWERS-o PROLONGED bleeding, kid will bleed longer than other kids,
gums, cuts, injections
o Hemorrhage: At higher risk
o Bruising
o Hemarthrosis: blood in joints (knees, elbows, ankles)
o Spontaneous Hematuria: dark urine, blood
, o Hematomas -> pain, swelling, limited motion
o Headache
o Slurred Speech
o Loss of Consciousness
o Black Tarry Stools= Bleed
o Vomiting coffee ground emesis
o Bleeding gyms with teeth brushing
Hemophilia: Treatment - CORRECT ANSWERS--NO cure; lifelong
o Replace VIII factor:
o Prevent bleeding: No IM vaccines, try subQ or less invasive first
o Medications
Steroids
NSAIDS
DDAVP
o Wear helmets
o Safety, protective equipment
o Regular Exercise and Physical Therapy
o Go to doctor for sprains
o Control Bleeding
R: Rest
I: ICE
