Week 2 Hematologic Problems Questions With Complete
Solutions
Anemias:
Question 1 of 3
Symptoms of anemia are primarily caused by which
pathological effect?
Increased oxygen demand
Stimulation of bone marrow
Decreased tissue oxygenation
Activation of the renin-aldosterone response Correct Answer
Decreased tissue oxygenation
Tissue hypoxia, or decreased tissue oxygenation, occurs due to
lack of hemoglobin from the decreased amount of red blood
cells. This leads to clinical manifestations such as fatigue and
activity intolerance.
Blood Cancers:
The three main cancers of the blood are Hodgkin's lymphoma,
leukemia, and multiple myeloma. Correct Answer
Blood Therapy= Method Purpose
-Platelets=Given to correct thrombocytopenia, supplements
blood cells.
-Cryoprecipitate=Replaces factor VIII and fibrinogen.
-Fresh Frozen Plasma (FFP)=Replaces all clotting factors except
platelets and provides source of antithrombin. Correct Answer
Chronic Venous Insufficiency and Leg Ulcers:
Question 1 of 3
,Which patient is at the highest risk for developing varicose
veins?
Male patient with arthritis.
Male patient who is a professional cyclist.
Female patient who works as a salon stylist.
Female patient who was successful in a weight-loss program.
Correct Answer Female patient who works as a salon stylist.
This patient is at highest risk for developing varicose veins. This
patient's risk factors include her gender and prolonged standing.
Disseminated Intravascular Coagulation
-Disseminated intravascular coagulation (DIC) is always caused
by an underlying disease that must be treated for DIC to be
resolved.
-DIC is a serious bleeding and thrombotic disorder that results
from abnormally initiated and accelerated clotting.
-This condition is characterized by profuse bleeding that results
from depletion of platelets and clotting factors.
-Bleeding in a person with no previous history or obvious cause
should be questioned, because it may be one of the first
manifestations of acute DIC Correct Answer
Health promotion and teaching are important parts of the nurse's
care of the patient. Additional teaching points include:
-Discourage excessive use of over-the-counter (OTC)
medications known to be possible causes of acquired
thrombocytopenia.
-Instruct the patient not to take medications that contain aspirin,
which reduces platelet adhesiveness and contributes to bleeding.
,-Encourage the patient to have a complete medical evaluation if
manifestations of bleeding tendencies (e.g., prolonged epistaxis,
petechiae) develop.
-Instruct the patient receiving cancer chemotherapy drugs to be
observant for early signs of thrombocytopenia. Correct Answer
Iron Deficiency Anemia Overview
The main goal is to treat the underlying cause of reduced iron
intake (e.g., malnutrition, alcoholism) or absorption of iron.
Efforts are directed toward replacing iron.
Iron Replacement:
-Teach the patient which foods are good sources of iron, such as
spinach, broccoli and lentils.
-If nutrition is adequate, increasing iron intake by dietary means
may not be practical. Consequently, oral or occasionally
parenteral iron supplements are used.
-Drug therapy with iron supplements requires special
considerations related to administration and side effects.
**If the iron deficiency is from acute blood loss, transfusion of
packed RBCs may be required. Correct Answer 1. Enteric-
coated or sustained-release capsules are counterproductive and
expensive. Iron is absorbed best from the duodenum and
proximal jejunum. Enteric-coated and sustained-release capsules
release farther down in the gastrointestinal (GI) tract.
2. The daily dose should provide 150-200 mg of elemental iron.
Iron is best absorbed as ferrous sulfate (e.g., a 300-mg tablet of
ferrous sulfate contains 60 mg of elemental iron).
3. Iron is best absorbed in an acidic environment. The patient
should take iron at least an hour before meals to avoid binding
iron with food. Taking iron with vitamin C (ascorbic acid) or
orange juice, which contains ascorbic acid, enhances iron
, absorption. Gastric side effects, however, may necessitate taking
with meals.
4. Undiluted liquid iron may stain the patient's teeth. Therefore
it should be diluted and ingested through a straw.
5. GI side effects may occur, including heartburn, constipation,
and diarrhea. If side effects develop, the dose and type of iron
supplement may be adjusted. Constipation is common, and the
patient should be started on stool softeners and laxatives, if
needed.
Parenteral Iron Replacement
-In some situations it may be necessary to administer iron
parenterally.
-Parenteral use is indicated for malabsorption, intolerance of
oral iron, a need for iron beyond oral limits, or poor patient
adherence in taking the oral preparations.
-Parenteral iron can be given intramuscularly (IM) or
intravenously (IV).
-Some preparations of IV iron have a risk of an allergic reaction,
and the patient should be monitored accordingly.
-IM solutions may stain the skin; separate needles should be
used for withdrawing the solution and for injecting the
medication. Use a Z-track injection technique. Correct Answer
Folic Acid Deficiency Anemia
Encourage the patient to eat foods containing large amounts of
folic acid. Examples of foods containing high levels of folic acid
are: certain breakfast cereals, whole wheat breads, pasta, rice,
beans, and citrus fruits. The picture above shows foods that
contain high levels of folic acid. Although it is best to obtain
folic acid from natural sources, certain whole grain products
Solutions
Anemias:
Question 1 of 3
Symptoms of anemia are primarily caused by which
pathological effect?
Increased oxygen demand
Stimulation of bone marrow
Decreased tissue oxygenation
Activation of the renin-aldosterone response Correct Answer
Decreased tissue oxygenation
Tissue hypoxia, or decreased tissue oxygenation, occurs due to
lack of hemoglobin from the decreased amount of red blood
cells. This leads to clinical manifestations such as fatigue and
activity intolerance.
Blood Cancers:
The three main cancers of the blood are Hodgkin's lymphoma,
leukemia, and multiple myeloma. Correct Answer
Blood Therapy= Method Purpose
-Platelets=Given to correct thrombocytopenia, supplements
blood cells.
-Cryoprecipitate=Replaces factor VIII and fibrinogen.
-Fresh Frozen Plasma (FFP)=Replaces all clotting factors except
platelets and provides source of antithrombin. Correct Answer
Chronic Venous Insufficiency and Leg Ulcers:
Question 1 of 3
,Which patient is at the highest risk for developing varicose
veins?
Male patient with arthritis.
Male patient who is a professional cyclist.
Female patient who works as a salon stylist.
Female patient who was successful in a weight-loss program.
Correct Answer Female patient who works as a salon stylist.
This patient is at highest risk for developing varicose veins. This
patient's risk factors include her gender and prolonged standing.
Disseminated Intravascular Coagulation
-Disseminated intravascular coagulation (DIC) is always caused
by an underlying disease that must be treated for DIC to be
resolved.
-DIC is a serious bleeding and thrombotic disorder that results
from abnormally initiated and accelerated clotting.
-This condition is characterized by profuse bleeding that results
from depletion of platelets and clotting factors.
-Bleeding in a person with no previous history or obvious cause
should be questioned, because it may be one of the first
manifestations of acute DIC Correct Answer
Health promotion and teaching are important parts of the nurse's
care of the patient. Additional teaching points include:
-Discourage excessive use of over-the-counter (OTC)
medications known to be possible causes of acquired
thrombocytopenia.
-Instruct the patient not to take medications that contain aspirin,
which reduces platelet adhesiveness and contributes to bleeding.
,-Encourage the patient to have a complete medical evaluation if
manifestations of bleeding tendencies (e.g., prolonged epistaxis,
petechiae) develop.
-Instruct the patient receiving cancer chemotherapy drugs to be
observant for early signs of thrombocytopenia. Correct Answer
Iron Deficiency Anemia Overview
The main goal is to treat the underlying cause of reduced iron
intake (e.g., malnutrition, alcoholism) or absorption of iron.
Efforts are directed toward replacing iron.
Iron Replacement:
-Teach the patient which foods are good sources of iron, such as
spinach, broccoli and lentils.
-If nutrition is adequate, increasing iron intake by dietary means
may not be practical. Consequently, oral or occasionally
parenteral iron supplements are used.
-Drug therapy with iron supplements requires special
considerations related to administration and side effects.
**If the iron deficiency is from acute blood loss, transfusion of
packed RBCs may be required. Correct Answer 1. Enteric-
coated or sustained-release capsules are counterproductive and
expensive. Iron is absorbed best from the duodenum and
proximal jejunum. Enteric-coated and sustained-release capsules
release farther down in the gastrointestinal (GI) tract.
2. The daily dose should provide 150-200 mg of elemental iron.
Iron is best absorbed as ferrous sulfate (e.g., a 300-mg tablet of
ferrous sulfate contains 60 mg of elemental iron).
3. Iron is best absorbed in an acidic environment. The patient
should take iron at least an hour before meals to avoid binding
iron with food. Taking iron with vitamin C (ascorbic acid) or
orange juice, which contains ascorbic acid, enhances iron
, absorption. Gastric side effects, however, may necessitate taking
with meals.
4. Undiluted liquid iron may stain the patient's teeth. Therefore
it should be diluted and ingested through a straw.
5. GI side effects may occur, including heartburn, constipation,
and diarrhea. If side effects develop, the dose and type of iron
supplement may be adjusted. Constipation is common, and the
patient should be started on stool softeners and laxatives, if
needed.
Parenteral Iron Replacement
-In some situations it may be necessary to administer iron
parenterally.
-Parenteral use is indicated for malabsorption, intolerance of
oral iron, a need for iron beyond oral limits, or poor patient
adherence in taking the oral preparations.
-Parenteral iron can be given intramuscularly (IM) or
intravenously (IV).
-Some preparations of IV iron have a risk of an allergic reaction,
and the patient should be monitored accordingly.
-IM solutions may stain the skin; separate needles should be
used for withdrawing the solution and for injecting the
medication. Use a Z-track injection technique. Correct Answer
Folic Acid Deficiency Anemia
Encourage the patient to eat foods containing large amounts of
folic acid. Examples of foods containing high levels of folic acid
are: certain breakfast cereals, whole wheat breads, pasta, rice,
beans, and citrus fruits. The picture above shows foods that
contain high levels of folic acid. Although it is best to obtain
folic acid from natural sources, certain whole grain products
