NUR 2356 FINAL EXAM 2 LATEST
VERSIONS 2023 MULTIDIMENSIONAL
CARE 1 FINAL/ MDC 1 FINAL EXAM
200+QUESTIONS AND CORRECT
ANSWERS|RASMUSSEN COLLEGE
Red blood cell production is stimulated by:
1. Tachycardia
2. Tachypnea
3. Renin angiotensin
4. Hypoxia - Answer - Hypoxia
4 Main components of blood composition - Answer - RBC, WBC, platelets, plasma
What is the composition of plasma - Answer - 90% H2O
10% solutes - glucose, protein, albumin, hormones, etc
Where is bone marrow aspiration in infants? - Answer - Tibia
Where is bone marrow aspiration in toddlers and preschoolers? - Answer - femur and
tibia
Where is bone marrow aspiration in children over 5? - Answer - pelvis (iliac crest)
Where is bone marrow production in young adults/adults? - Answer - ribs, sternum,
vertebra, pelvis, skull, clavicle, scapula
what is anemia - Answer - a condition in which levels of red blood cells and hemoglobin
are lower than normal
4 types of anemia - Answer - Iron deficiency
lead poisoning
sickle cell
B-thalassemia
,Define iron deficiency anemia - Answer - reduction in the iron stores of the body causing
an inadequate production of hemoglobin
What is iron needed for? - Answer - to make hgb
signs and symptoms of iron deficiency anemia - Answer - pallor
tachycardia
tachypnea
lethargy
fatigue
irritability
Why are neonates at risk for iron deficiency anemia? - Answer - -lack the maternal iron
stores
-Full term infants have maternal iron stores until approximately 6 months of age
-Havent had the time in utero to store up the needed iron supply (preterm)
How can you treat a neonate with iron deficiency anemia? - Answer - Iron fortified
formula
What are risk factors for iron deficiency anemia in infants and children? - Answer -
1.inadequate iron intake
2.Malabsorption of iron in GI tract
3.Chronic blood loss
Food with good sources of iron - Answer - red meat, egg yolk, leafy greens, dried fruits,
fortified cereals/formulas, beef, chicken, fish, beans, nuts, seeds, peanut butter, eggs,
prunes, whole grain bread
How is iron deficiency anemia diagnosed? - Answer - Serum lab evaluation:
-Red blood cell count = microcytic (small) and hypo chronic (pale in color)
-low hemoglobin
-low hematocrit
-low reticulocyte count
-low serum iron concentration
-high total iron binding capacity
What is the goal of treatment for iron deficiency anemia - Answer - treat medical
problem causing malabsorption or blood loss/ identify cause
,What is the treatment method for iron deficiency anemia? - Answer - Increase iron take
~ Dietary sources
~Medication supplement (ferrosol or ferrous sulfate)
What should nurses and parents know about administering iron to children? - Answer - -
Administer to back of mouth because it stains teeth, can cause constipation, and
black/green stool
-Give with orange juice or citric acid to help with absorption
-Do not give with milk or antacids
-Give on empty stomach unless GI distress
Lead Poisoning Risks - Answer - -Children under the age of 6
-Children living at or below the poverty line who live in older (prior to 1978) housing
-Children adopted from other countries where there are less strict environmental
regulations
Environmental causes of lead poisoning - Answer - -Lead based paint
-Plumbing from lead pipes
-soil
Dietary factors of lead poisoning - Answer - -iron deficiency
-calcium deficiency
Patient-child interactions - Answer - -Job or hobby exposure
-home remedies or cultural practices
How does lead poisoning cause anemia - Answer - lead can replace iron on Hgb
causing O2 to not be delivered causing anemia
Clinical manifestation of lead poisoning - Answer - -Asymptomatic
-Signs of anemia
-Growth and developmental lags
-Behavioral changes
-Neurologic changes
-Gastrointestinal changes
can someone be asymptomatic if they have lead poisoning - Answer - yes
signs of anemia (lead poisoning) - Answer - pallor, fatigue, weakness, shortness of
breath, headache, tachycardia - because lead replaces iron in Hgb causing anemia
, Growth and developmental lags in lead poisoning - Answer - learning difficulties
Neurologic signs and symptoms of lead poisoning - Answer - -Headache, irritability,
difficulty concentrating, loss of motor skills, paralysis, tremors
High levels: encephalopathy, seizures, and brain damage
Gastrointestinal signs and symptoms of lead poisoning - Answer - abdominal pain,
failure to gain weight, weight loss, vomiting, constipation
Lead poisoning diagnostics - Answer - Blood lead level (BBL) test
-5mcg/dL = lead exposure
-45 mcg/dL = medical treatment required with chelation therapy
->70= mcg/dL = severe lead toxicity
Therapeutic management of lead poisoning - Answer - -Decontamination
-Chelation
-Supportive therapy
-Deterrence and prevention
How do you decontaminate a person with lead poisoning? - Answer - Xray of GI tract to
see of lead is there. if it is, they flush it out to stop absorption
when to use Chelation therapy for lead poisoning - Answer - -45-69 mcg/dL outpatient
therapy with oral succorer and parenteral disodium calcium edetate
->70 Hospitalization with dimercaprol and disodium calcium EDTA
-Monitor urinary output (possibly on 24 hour urine collection)
What do patients who have lead poisoning need in their diet? - Answer - Adequate
calcium, iron, and vitamin C
Chelation drugs - Answer - 1.Edetate calcium disodium (CaNA2EDTA)
2.Succimer (Chemet)
3.Dimercaprol (BAL in Oil)
Information on Chelation drug Edetate calcium disodium (CaNA2EDTA) - Answer - -
Given IM or IV for 5 days
- Increase lead concentrations in CNS resulting in encephalopathy in its with BLL >70
mcg/dL, used in combination with dimercaprol
VERSIONS 2023 MULTIDIMENSIONAL
CARE 1 FINAL/ MDC 1 FINAL EXAM
200+QUESTIONS AND CORRECT
ANSWERS|RASMUSSEN COLLEGE
Red blood cell production is stimulated by:
1. Tachycardia
2. Tachypnea
3. Renin angiotensin
4. Hypoxia - Answer - Hypoxia
4 Main components of blood composition - Answer - RBC, WBC, platelets, plasma
What is the composition of plasma - Answer - 90% H2O
10% solutes - glucose, protein, albumin, hormones, etc
Where is bone marrow aspiration in infants? - Answer - Tibia
Where is bone marrow aspiration in toddlers and preschoolers? - Answer - femur and
tibia
Where is bone marrow aspiration in children over 5? - Answer - pelvis (iliac crest)
Where is bone marrow production in young adults/adults? - Answer - ribs, sternum,
vertebra, pelvis, skull, clavicle, scapula
what is anemia - Answer - a condition in which levels of red blood cells and hemoglobin
are lower than normal
4 types of anemia - Answer - Iron deficiency
lead poisoning
sickle cell
B-thalassemia
,Define iron deficiency anemia - Answer - reduction in the iron stores of the body causing
an inadequate production of hemoglobin
What is iron needed for? - Answer - to make hgb
signs and symptoms of iron deficiency anemia - Answer - pallor
tachycardia
tachypnea
lethargy
fatigue
irritability
Why are neonates at risk for iron deficiency anemia? - Answer - -lack the maternal iron
stores
-Full term infants have maternal iron stores until approximately 6 months of age
-Havent had the time in utero to store up the needed iron supply (preterm)
How can you treat a neonate with iron deficiency anemia? - Answer - Iron fortified
formula
What are risk factors for iron deficiency anemia in infants and children? - Answer -
1.inadequate iron intake
2.Malabsorption of iron in GI tract
3.Chronic blood loss
Food with good sources of iron - Answer - red meat, egg yolk, leafy greens, dried fruits,
fortified cereals/formulas, beef, chicken, fish, beans, nuts, seeds, peanut butter, eggs,
prunes, whole grain bread
How is iron deficiency anemia diagnosed? - Answer - Serum lab evaluation:
-Red blood cell count = microcytic (small) and hypo chronic (pale in color)
-low hemoglobin
-low hematocrit
-low reticulocyte count
-low serum iron concentration
-high total iron binding capacity
What is the goal of treatment for iron deficiency anemia - Answer - treat medical
problem causing malabsorption or blood loss/ identify cause
,What is the treatment method for iron deficiency anemia? - Answer - Increase iron take
~ Dietary sources
~Medication supplement (ferrosol or ferrous sulfate)
What should nurses and parents know about administering iron to children? - Answer - -
Administer to back of mouth because it stains teeth, can cause constipation, and
black/green stool
-Give with orange juice or citric acid to help with absorption
-Do not give with milk or antacids
-Give on empty stomach unless GI distress
Lead Poisoning Risks - Answer - -Children under the age of 6
-Children living at or below the poverty line who live in older (prior to 1978) housing
-Children adopted from other countries where there are less strict environmental
regulations
Environmental causes of lead poisoning - Answer - -Lead based paint
-Plumbing from lead pipes
-soil
Dietary factors of lead poisoning - Answer - -iron deficiency
-calcium deficiency
Patient-child interactions - Answer - -Job or hobby exposure
-home remedies or cultural practices
How does lead poisoning cause anemia - Answer - lead can replace iron on Hgb
causing O2 to not be delivered causing anemia
Clinical manifestation of lead poisoning - Answer - -Asymptomatic
-Signs of anemia
-Growth and developmental lags
-Behavioral changes
-Neurologic changes
-Gastrointestinal changes
can someone be asymptomatic if they have lead poisoning - Answer - yes
signs of anemia (lead poisoning) - Answer - pallor, fatigue, weakness, shortness of
breath, headache, tachycardia - because lead replaces iron in Hgb causing anemia
, Growth and developmental lags in lead poisoning - Answer - learning difficulties
Neurologic signs and symptoms of lead poisoning - Answer - -Headache, irritability,
difficulty concentrating, loss of motor skills, paralysis, tremors
High levels: encephalopathy, seizures, and brain damage
Gastrointestinal signs and symptoms of lead poisoning - Answer - abdominal pain,
failure to gain weight, weight loss, vomiting, constipation
Lead poisoning diagnostics - Answer - Blood lead level (BBL) test
-5mcg/dL = lead exposure
-45 mcg/dL = medical treatment required with chelation therapy
->70= mcg/dL = severe lead toxicity
Therapeutic management of lead poisoning - Answer - -Decontamination
-Chelation
-Supportive therapy
-Deterrence and prevention
How do you decontaminate a person with lead poisoning? - Answer - Xray of GI tract to
see of lead is there. if it is, they flush it out to stop absorption
when to use Chelation therapy for lead poisoning - Answer - -45-69 mcg/dL outpatient
therapy with oral succorer and parenteral disodium calcium edetate
->70 Hospitalization with dimercaprol and disodium calcium EDTA
-Monitor urinary output (possibly on 24 hour urine collection)
What do patients who have lead poisoning need in their diet? - Answer - Adequate
calcium, iron, and vitamin C
Chelation drugs - Answer - 1.Edetate calcium disodium (CaNA2EDTA)
2.Succimer (Chemet)
3.Dimercaprol (BAL in Oil)
Information on Chelation drug Edetate calcium disodium (CaNA2EDTA) - Answer - -
Given IM or IV for 5 days
- Increase lead concentrations in CNS resulting in encephalopathy in its with BLL >70
mcg/dL, used in combination with dimercaprol
