NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
What is the MCV for a microcytic anemia? - ANSWER- Less than 80
What is the MCV for a macrocytic anemia? - ANSWER- Over 100
What is the MCHC for a normochromic anemia? - ANSWER- 32-36%
What is the MCHC for a hypochromic anema? - ANSWER- Less than 32%
What is the MCHC for a hyperchromic anemia? - ANSWER- More than 36%
What type of anemia is iron deficiency anemia? - ANSWER- Microcytic hypochromic
Which is the most common anemia in childhood and why? - ANSWER- Iron Deficiency
Anemia due to increased intake of cow's milk (1-3 years).... cow's milk BLOCKS
absorption of iron
When should you begin screening for iron deficiency anemia? - ANSWER- 9-12 months
What are the main causes of iron deficiency anemia? - ANSWER- Inadequate dietary
intake of iron
Increased ingestion of cow's milk
Blood loss without replacememnt
Impaired absorption/ IBD
Increased need for growth
Menstruation (heavy flow)
What are the clinical manifestations of iron deficiency anemia? - ANSWER- Symptoms
begin when the Hg is below 9
- Pallor
- Blue tinged sclera
- Fatigue
- Tachycardia
- Systolic flow murmur
,NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
- Poor weight gain
What would the lab values look like for iron deficiency anemia? - ANSWER- LOW MCH
LOW MCHC
Low Hgb/Hct
INCREASED RDW
INCREASED TIBC
LOW FERRITIN
LOW SERUM IRON
What is the treatment plan for iron deficiency anemia? - ANSWER- Formula or breast
milk ONLY for the first year of life
Allow maximum of 16-24 oz a day of cow's milk after 1 year old
Increase intake of high iron foods such as dark green veggies
For severe cases:
- Ferrous sulfate 3 mg/kg/day
- Follow up in 1 month
- Treat until H/H normalize and for 1 month after
- Refer if the patient has not improved by 1-2 months of treatment OR if the Hgb is less
than 5
What should be given with iron to HELP absorption? - ANSWER- Vitamin C
What are some of the side effects of iron supplements? - ANSWER- Constipation
Teeth staining
GI bleed
Which type of anemia is autosomal recessive that occurs when both alpha and beta
protein chains are affected? - ANSWER- Thalassemia
How do symptomatic cases of Thalassemia present? - ANSWER- Pronounced anemia
with failure to thrive
,NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
Developmental disturbances
Splenomegaly
Bony changes (Frontal bossing)
What are the diagnostic tests to diagnose Thalassemia? - ANSWER- Can be detected
on new born screen
CBC w/ Diff will show
- Low MCV
- Low MCHC
What is the treatment plan for Thalassemia? - ANSWER- PRBC transfusion every 2-4
weeks
Iron chelation therapy
Folic acid supplementation to build healthy RBCs
Bone Marrow/stem cell transplant
Counseling/education
Refer to hematologist and genetic counseling
At what serum level is lead considered toxic? - ANSWER- Over 5 mcg/dL
What are the risk factors for lead poisoning? - ANSWER- Lead based paint in a house
built prior to 1978
Contaminated soil
Food/drinking water
Lead containing toys
Houses undergoing renovations
Construction workers
Gasoline emissions
Family member hobbies such as ceramics and stained glass
, NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
What are the clinical manifestations of lead poisoning? - ANSWER- Vague GI
symptoms
Headache
Poor attention span
Cognitive impairment
Irritability
Decreased growth
More severe symptoms include:
- Lethargy
- Neuropathies
- Encephalopathy
- Renal disorder
- Coma
- Death
What are the diagnostic tests done to screen for lead poisoning? - ANSWER- Screening
per CDC at every well check
What is the treatment plan for a patient with lead poisoning? - ANSWER- Reduce
exposure
Follow up lead levels
Refer to hematology for lead level over 10
Hospitalization and chelation therapy for anything over 70
What are the prevention education tips that should be provided to parents when it
comes to lead poisoning? - ANSWER- Screen/test if exposure is suspected
Caution in older homes built before 1978
Avoid older lead-based paint
Protect from lead dust
Wash work clothes separate from family clothes
253 Approved Verified Solutions.
NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
What is the MCV for a microcytic anemia? - ANSWER- Less than 80
What is the MCV for a macrocytic anemia? - ANSWER- Over 100
What is the MCHC for a normochromic anemia? - ANSWER- 32-36%
What is the MCHC for a hypochromic anema? - ANSWER- Less than 32%
What is the MCHC for a hyperchromic anemia? - ANSWER- More than 36%
What type of anemia is iron deficiency anemia? - ANSWER- Microcytic hypochromic
Which is the most common anemia in childhood and why? - ANSWER- Iron Deficiency
Anemia due to increased intake of cow's milk (1-3 years).... cow's milk BLOCKS
absorption of iron
When should you begin screening for iron deficiency anemia? - ANSWER- 9-12 months
What are the main causes of iron deficiency anemia? - ANSWER- Inadequate dietary
intake of iron
Increased ingestion of cow's milk
Blood loss without replacememnt
Impaired absorption/ IBD
Increased need for growth
Menstruation (heavy flow)
What are the clinical manifestations of iron deficiency anemia? - ANSWER- Symptoms
begin when the Hg is below 9
- Pallor
- Blue tinged sclera
- Fatigue
- Tachycardia
- Systolic flow murmur
,NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
- Poor weight gain
What would the lab values look like for iron deficiency anemia? - ANSWER- LOW MCH
LOW MCHC
Low Hgb/Hct
INCREASED RDW
INCREASED TIBC
LOW FERRITIN
LOW SERUM IRON
What is the treatment plan for iron deficiency anemia? - ANSWER- Formula or breast
milk ONLY for the first year of life
Allow maximum of 16-24 oz a day of cow's milk after 1 year old
Increase intake of high iron foods such as dark green veggies
For severe cases:
- Ferrous sulfate 3 mg/kg/day
- Follow up in 1 month
- Treat until H/H normalize and for 1 month after
- Refer if the patient has not improved by 1-2 months of treatment OR if the Hgb is less
than 5
What should be given with iron to HELP absorption? - ANSWER- Vitamin C
What are some of the side effects of iron supplements? - ANSWER- Constipation
Teeth staining
GI bleed
Which type of anemia is autosomal recessive that occurs when both alpha and beta
protein chains are affected? - ANSWER- Thalassemia
How do symptomatic cases of Thalassemia present? - ANSWER- Pronounced anemia
with failure to thrive
,NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
Developmental disturbances
Splenomegaly
Bony changes (Frontal bossing)
What are the diagnostic tests to diagnose Thalassemia? - ANSWER- Can be detected
on new born screen
CBC w/ Diff will show
- Low MCV
- Low MCHC
What is the treatment plan for Thalassemia? - ANSWER- PRBC transfusion every 2-4
weeks
Iron chelation therapy
Folic acid supplementation to build healthy RBCs
Bone Marrow/stem cell transplant
Counseling/education
Refer to hematologist and genetic counseling
At what serum level is lead considered toxic? - ANSWER- Over 5 mcg/dL
What are the risk factors for lead poisoning? - ANSWER- Lead based paint in a house
built prior to 1978
Contaminated soil
Food/drinking water
Lead containing toys
Houses undergoing renovations
Construction workers
Gasoline emissions
Family member hobbies such as ceramics and stained glass
, NUR 623 Exam 4 Maryville University
253 Approved Verified Solutions.
What are the clinical manifestations of lead poisoning? - ANSWER- Vague GI
symptoms
Headache
Poor attention span
Cognitive impairment
Irritability
Decreased growth
More severe symptoms include:
- Lethargy
- Neuropathies
- Encephalopathy
- Renal disorder
- Coma
- Death
What are the diagnostic tests done to screen for lead poisoning? - ANSWER- Screening
per CDC at every well check
What is the treatment plan for a patient with lead poisoning? - ANSWER- Reduce
exposure
Follow up lead levels
Refer to hematology for lead level over 10
Hospitalization and chelation therapy for anything over 70
What are the prevention education tips that should be provided to parents when it
comes to lead poisoning? - ANSWER- Screen/test if exposure is suspected
Caution in older homes built before 1978
Avoid older lead-based paint
Protect from lead dust
Wash work clothes separate from family clothes
