NRSG 3420 Exam 1 With Correct Answers A+

NRSG 3420 Exam 1 With Correct
Answers A+Graded.




medical management of sickle cell anemia - CORRECT ANSWER✔✔hematopoietic stem cell transplant
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(HSCT) - may cure SCD but is not readily available due to lack of compatible donors or due to severe organ
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damage that may be already present in patient
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pharmacologic therapy: j




- hydroxyurea (increases levels of fetal hemoglobin decreasing formation of sickled cells)
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- folic acid supplements (maintain the amount needed for increased erythropoiesis to counteract the effects
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of hemolysis)
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- infections are common and can lead to crisis: immunization
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- transfusion therapy (caution with repeat blood transfusions - pt can develop antibodies to donor blood,
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hemolytic transfusion reactions may mimic the s/sx of sickle cell crisis
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- supportive therapy (pain management, aspirin, NSAIDS, PCA, hydration, oxygen therapy)
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,cancer & thrombocytopenia - CORRECT ANSWER✔✔many chemotherapy agents cause some degree of
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myelosuppression (depression of bone marrow function), resulting in:
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- leukopenia
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- neutropenia
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- anemia
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- thrombocytopenia
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- increased r/o infection and bleeding
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is predictable:
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- pts usually reach point at which blood counts are lowest 7 to 14 days after chemo
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- during 2 weeks, nurses anticipate associated toxicities, especially a fever associated with neutrophil count
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less than 1500 cells/mm3
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- frequent monitoring of CBC is essential
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- pts are educated on strategies to protect against infection, injury, and blood loss
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- erythropoetin (EPO) stimulated RBC production, decreasing the symptoms of treatment-induced chronic
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anemia and reducing the need for blood transfusions
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- interleukin 11 (IL-11) (oprelvekin) stimulates the production of megakaryocytes (precursors to platelets)
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and can be used to prevent and treat severe thrombocytopenia but has had limited use because of toxicities
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thrombocytopenia - CORRECT ANSWER✔✔abnormally low platelet levels j j j j j j j




<20,000 - petechiae, gingival bleeding, excessive menstrual bleeding, excessive bleeding after
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surgery/dental extractions
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<5,000 - fatal CNS, or GI hemorrhage
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, management of thrombocytopenia - CORRECT ANSWER✔✔treat underlying condition j j j j j j j




monitor for factors increasing risk of bleeding (elevated INR/PT/aPTT, decreased fibrinogen, use of
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medications)
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assess for and instruct patient/family on s/sx of bleeding (petechiae, bleeding, decrease HgB/HcT, frank or
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occult blood in body fluids, altered mental status, tachycardia)
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minimize risk of bleeding: j j j




- use soft toothbrush, electric razor for shaving, keep lips moisturized, maintain fluid intake of at least 3 L q24
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hrs
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- avoid rectal temp, avoid IM injections (use smallest needle possible)
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- apply direst pressure to venipuncture site for at least 5 min
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- avoid aspirin
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- caution against forceful nose blowing
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preventing hemorrhage post-op - CORRECT ANSWER✔✔hemorrhage is an uncommon yet serious
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complication of surgery that can result in hypovolemic shock and death.
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patient presents with hypotension; rapid, thready pulse; disorientation; restlessness, oliguria; and cold, pale
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skin; concentrated urine; air hunger (looking to catch breath)
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assessment and identification of at-risk individuals, monitoring
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nursing management of transfusion reactions - CORRECT ANSWER✔✔- stop the transfusion, maintain the IV
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line with NS through new IV tubing (given at slow rate)
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