,Nursing interventions for a patient a, c
with severe anemia related to peptic
ulcer disease include (select all that
apply) Rationale: Stool occult blood test is performed to
determine the cause of iron-deficiency anemia that
a. instructions for high-iron diet. is related to gastrointestinal bleeding. Iron is
b. taking vital signs every 8 hours. increased in the diet. Teach the patient which foods
c. monitoring stools for occult are good sources of iron. If nutrition is already
blood. adequate, increasing iron intake by dietary means
d. teaching self-injection of may not be practical. The patient with iron
erythropoietin. deficiency related to acute blood loss may require
e. administration of cobalamin a transfusion of packed red blood cells (RBCs).
(vitamin B12) injections.
The nursing management of a patient a, b, c, d
in sickle cell crisis includes (select all
that apply)
Rationale: Complete blood count (CBC) is
a. monitoring CBC. monitored. Infections are common with elevated
b. optimal pain management and O2 WBC counts, and anemia may occur with low
therapy. hemoglobin levels and low RBC counts. O2 may be
c. blood transfusions if required and administered to treat hypoxia and control sickling.
iron chelation. Rest may be instituted to reduce metabolic
d. rest as needed and deep vein requirements, and prophylaxis for deep vein
thrombosis prophylaxis. thrombosis (with anticoagulants) is prescribed.
e. administration of IV iron and diet Transfusion therapy is indicated when an aplastic
high in iron content. crisis occurs. Patients may require iron chelation
therapy to reduce transfusion-produced iron
overload. Pain occurring during an acute crisis is
usually undertreated; patients should have optimal
pain control with opioid analgesics, nonsteroidal
antiinflammatory agents, antineuropathic pain
medications, local anesthetics, or nerve blocks.
,A complication of the hyperviscosity a
of polycythemia is
a. thrombosis. Rationale: The patient with polycythemia may
b. cardiomyopathy. experience angina, heart failure, intermittent
c. pulmonary edema. claudication, and thrombophlebitis, which may be
d. disseminated intravascular complicated by embolization. These manifestations
coagulation (DIC). are caused by blood vessel distention, impaired
blood flow, circulatory stasis, thrombosis, and
tissue hypoxia, which is caused by the
hypervolemia and hyperviscosity. The most
common serious acute complication is stroke,
caused by thrombosis.
When caring for a patient with a
thrombocytopenia, the nurse
instructs the patient to
Rationale: Patients with thrombocytopenia should
a. dab his or her nose instead of avoid aspirin because it reduces platelet
blowing. adhesiveness, which contributes to bleeding.
b. be careful when shaving with a Patients should not perform vigorous exercise or
safety razor. lift weights. If a patient is weak and at risk for
c. continue with physical activities to falling, supervise the patient when he or she is out
stimulate thrombopoiesis. of bed. Blowing the nose forcefully should be
d. avoid aspirin because it may mask avoided. The patient should gently pat the nose
the fever that occurs with with a tissue if needed. Instruct patients not to
thrombocytopenia. shave with a blade; an electric razor should be
used.
, The nurse would anticipate that a d
patient with von Willebrand disease
undergoing surgery would be
treated with administration of vWF Rationale: von Willebrand disease involves
and deficiency of the von Willebrand coagulation
protein, variable factor VIII deficiencies, and
a. thrombin. platelet dysfunction. Treatment includes
b. factor VI. administration of von Willebrand factor and factor
c. factor VII. VIII.
d. factor VIII.
DIC is a disorder in which c
a. the coagulation pathway is
genetically altered, leading to Rationale: In disseminated intravascular
thrombus formation in all major coagulation (DIC), the coagulation process is
blood vessels. stimulated, with resultant thrombosis and depletion
b. an underlying disease depletes of clotting factors, which leads to diffuse clotting
hemolytic factors in the blood, and hemorrhage. The paradox of this condition is
leading to diffuse thrombotic characterized by the profuse bleeding that results
episodes and infarcts. from the depletion of platelets and clotting factors.
c. a disease process stimulates
coagulation processes with resultant
thrombosis, as well as depletion of
clotting factors, leading to diffuse
clotting and hemorrhage.
d. an inherited predisposition causes
a deficiency of clotting factors that
leads to overstimulation of
coagulation processes in the
vasculature.
with severe anemia related to peptic
ulcer disease include (select all that
apply) Rationale: Stool occult blood test is performed to
determine the cause of iron-deficiency anemia that
a. instructions for high-iron diet. is related to gastrointestinal bleeding. Iron is
b. taking vital signs every 8 hours. increased in the diet. Teach the patient which foods
c. monitoring stools for occult are good sources of iron. If nutrition is already
blood. adequate, increasing iron intake by dietary means
d. teaching self-injection of may not be practical. The patient with iron
erythropoietin. deficiency related to acute blood loss may require
e. administration of cobalamin a transfusion of packed red blood cells (RBCs).
(vitamin B12) injections.
The nursing management of a patient a, b, c, d
in sickle cell crisis includes (select all
that apply)
Rationale: Complete blood count (CBC) is
a. monitoring CBC. monitored. Infections are common with elevated
b. optimal pain management and O2 WBC counts, and anemia may occur with low
therapy. hemoglobin levels and low RBC counts. O2 may be
c. blood transfusions if required and administered to treat hypoxia and control sickling.
iron chelation. Rest may be instituted to reduce metabolic
d. rest as needed and deep vein requirements, and prophylaxis for deep vein
thrombosis prophylaxis. thrombosis (with anticoagulants) is prescribed.
e. administration of IV iron and diet Transfusion therapy is indicated when an aplastic
high in iron content. crisis occurs. Patients may require iron chelation
therapy to reduce transfusion-produced iron
overload. Pain occurring during an acute crisis is
usually undertreated; patients should have optimal
pain control with opioid analgesics, nonsteroidal
antiinflammatory agents, antineuropathic pain
medications, local anesthetics, or nerve blocks.
,A complication of the hyperviscosity a
of polycythemia is
a. thrombosis. Rationale: The patient with polycythemia may
b. cardiomyopathy. experience angina, heart failure, intermittent
c. pulmonary edema. claudication, and thrombophlebitis, which may be
d. disseminated intravascular complicated by embolization. These manifestations
coagulation (DIC). are caused by blood vessel distention, impaired
blood flow, circulatory stasis, thrombosis, and
tissue hypoxia, which is caused by the
hypervolemia and hyperviscosity. The most
common serious acute complication is stroke,
caused by thrombosis.
When caring for a patient with a
thrombocytopenia, the nurse
instructs the patient to
Rationale: Patients with thrombocytopenia should
a. dab his or her nose instead of avoid aspirin because it reduces platelet
blowing. adhesiveness, which contributes to bleeding.
b. be careful when shaving with a Patients should not perform vigorous exercise or
safety razor. lift weights. If a patient is weak and at risk for
c. continue with physical activities to falling, supervise the patient when he or she is out
stimulate thrombopoiesis. of bed. Blowing the nose forcefully should be
d. avoid aspirin because it may mask avoided. The patient should gently pat the nose
the fever that occurs with with a tissue if needed. Instruct patients not to
thrombocytopenia. shave with a blade; an electric razor should be
used.
, The nurse would anticipate that a d
patient with von Willebrand disease
undergoing surgery would be
treated with administration of vWF Rationale: von Willebrand disease involves
and deficiency of the von Willebrand coagulation
protein, variable factor VIII deficiencies, and
a. thrombin. platelet dysfunction. Treatment includes
b. factor VI. administration of von Willebrand factor and factor
c. factor VII. VIII.
d. factor VIII.
DIC is a disorder in which c
a. the coagulation pathway is
genetically altered, leading to Rationale: In disseminated intravascular
thrombus formation in all major coagulation (DIC), the coagulation process is
blood vessels. stimulated, with resultant thrombosis and depletion
b. an underlying disease depletes of clotting factors, which leads to diffuse clotting
hemolytic factors in the blood, and hemorrhage. The paradox of this condition is
leading to diffuse thrombotic characterized by the profuse bleeding that results
episodes and infarcts. from the depletion of platelets and clotting factors.
c. a disease process stimulates
coagulation processes with resultant
thrombosis, as well as depletion of
clotting factors, leading to diffuse
clotting and hemorrhage.
d. an inherited predisposition causes
a deficiency of clotting factors that
leads to overstimulation of
coagulation processes in the
vasculature.
