NUR 2356 STUDY GUIDE CORRECT QUESTIONS
AND ANSWERS SET A+
✔✔What are the benefits of hypertransfusion therapy for beta-thalassemia - ✔✔-
suppresses extra medullary erythropoiesis
-minimizes facial alterations
-decreses the risk of osteoporosis
-reduces the possibility of splenectomy
-lessens cardiac dilation
(basically the opposite of the clinical manifestations)
✔✔What are 4 other treatment measures (besides hyper transfusion) for beta-
thalassemia - ✔✔1. iron chelation therapy with Exjade (deferasirox) and/or Desferal
(deferoxamine)
2. Oral supplementation of vitamin C and avoidance of iron rich foods
3. Splenectomy
4. Bone marrow or stem cell transplants
✔✔Define hemophilia and what are the 2 types - ✔✔A group of hereditary bleeding
disorders that result from a deficiency in specific clotting factors
1. Hemophilia A or "Classic hemophilia" = missing Factor VIII (antihemophilic factor-
AHF)
2. Hemophilia B or "Christmas disease" = missing Factor IX (plasma thromboplastin
component - PTC)
✔✔How is hemophilia diagnosed? - ✔✔-History of bleeding
-X-linked inheritance
-Lab findings
,✔✔What lab tests would be ordered on a patient who is suspected to have hemophilia?
- ✔✔Clotting studies - PT, PTT, aPTT, INR
Coagulating factor concentrations
✔✔A patient with hemophilia is placed on what precautions and what are the goals
when they are hospitalized and at home? - ✔✔Bleeding precautions/ prevention of
bleeding
Hospitalized
-No rectal temps
-No continuous BP monitoring
-No IM if possible
-Stool softeners, if risk for constipation
Home
-Avoid injury
-Medication administration
-School education
✔✔What are the clinical manifestations of hemophilia - ✔✔-Prolonged bleeding,
bruising, and epistaxis
-Internal bleeding
-Hemarthrosis - bleeding into the joint cavity
~ early signs = feeling of stiffness, tingling, or ache followed by decrease in the ability
to move the joint
✔✔A nurse is suspecting their patient with hemophilia is bleeding internally based on
the assessment findings from GI, GU, and CNS. What assessment findings lead them
to this suspect and what nursing interventions might be performed? - ✔✔GI: abdominal
pain, frank blood in stool or dark black stool, vomiting blood
~ NSG: guaiac stool
GU: abdominal or lower back pain, blood in urine
~NSG: perform urine dipstick for hematuria and encourage PO fluids
CNS: headache, change in LOC, weakness, gait change
~NSG: neuro assessments
✔✔Therapeutic management of a bleeding episode in a patient with hemophilia - ✔✔-
Administer medications
~factor for moderate to severe hemophiliacs (prophylactic treatment to prevent
bleeding episodes with sever hemophilia)
~ Desmopressin Acetate (DDAVP) for mild to moderate Hemophilia A patients
, -Administration of blood products (packed RBC or FFP)
-Nursing considerations
~Double check the factor or blood product transfusion with another RN hemarthrosis
-For hemarthrosis (bleeding in joint): immobilize and elevate (RICE)
✔✔Define Immune thrombocytopenic purpura (ITP) - ✔✔A bleeding disorder
characterized by increased destruction of platelets in spleen
platelet destruction due to an antiplatelet antibody that destroys platelets making this an
autoimmune disorder
✔✔A patient presents to the hospital with excessive bruising, miniature petechiae, large
areas of asymmetrical ecchymosis, epistaxis, and marked thrombocytopenia but normal
WBC, Hgb, and Hct. What condition may this patient have? - ✔✔Immune
thrombocytopenic purpura (ITP)
✔✔True or false:
Children with Immune thrombocytopenic purpura (ITP) require immediate medical
treatment. - ✔✔FALSE!!!!
many children only require observation and reevaluation of labs. No medical
interventions are required
✔✔A nurse is assessing if the patient and family understood her instructions for their
child with Immune thrombocytopenic purpura (ITP). Which statement by the family
needs further teaching?
"We can give our child aspirin, NSAIDS, or antihistamines if he has any pain."
"We must prevent any serious traumas that may involve our child."
"We will watch for any signs of bleeding in our child." - ✔✔DO NOT GIVE THIS
PATIENT ASPIRIN, NSAIDS, OR ANTIHISTAMINES!
All other options are correct
✔✔A nurse is reviewing the orders in the chart for her patient with Immune
thrombocytopenic purpura (ITP). Would she follow the orders or question what was put
in?
-Steroid therapy for 2-4 weeks
-IVIGs given once a day foe 3-5 days
AND ANSWERS SET A+
✔✔What are the benefits of hypertransfusion therapy for beta-thalassemia - ✔✔-
suppresses extra medullary erythropoiesis
-minimizes facial alterations
-decreses the risk of osteoporosis
-reduces the possibility of splenectomy
-lessens cardiac dilation
(basically the opposite of the clinical manifestations)
✔✔What are 4 other treatment measures (besides hyper transfusion) for beta-
thalassemia - ✔✔1. iron chelation therapy with Exjade (deferasirox) and/or Desferal
(deferoxamine)
2. Oral supplementation of vitamin C and avoidance of iron rich foods
3. Splenectomy
4. Bone marrow or stem cell transplants
✔✔Define hemophilia and what are the 2 types - ✔✔A group of hereditary bleeding
disorders that result from a deficiency in specific clotting factors
1. Hemophilia A or "Classic hemophilia" = missing Factor VIII (antihemophilic factor-
AHF)
2. Hemophilia B or "Christmas disease" = missing Factor IX (plasma thromboplastin
component - PTC)
✔✔How is hemophilia diagnosed? - ✔✔-History of bleeding
-X-linked inheritance
-Lab findings
,✔✔What lab tests would be ordered on a patient who is suspected to have hemophilia?
- ✔✔Clotting studies - PT, PTT, aPTT, INR
Coagulating factor concentrations
✔✔A patient with hemophilia is placed on what precautions and what are the goals
when they are hospitalized and at home? - ✔✔Bleeding precautions/ prevention of
bleeding
Hospitalized
-No rectal temps
-No continuous BP monitoring
-No IM if possible
-Stool softeners, if risk for constipation
Home
-Avoid injury
-Medication administration
-School education
✔✔What are the clinical manifestations of hemophilia - ✔✔-Prolonged bleeding,
bruising, and epistaxis
-Internal bleeding
-Hemarthrosis - bleeding into the joint cavity
~ early signs = feeling of stiffness, tingling, or ache followed by decrease in the ability
to move the joint
✔✔A nurse is suspecting their patient with hemophilia is bleeding internally based on
the assessment findings from GI, GU, and CNS. What assessment findings lead them
to this suspect and what nursing interventions might be performed? - ✔✔GI: abdominal
pain, frank blood in stool or dark black stool, vomiting blood
~ NSG: guaiac stool
GU: abdominal or lower back pain, blood in urine
~NSG: perform urine dipstick for hematuria and encourage PO fluids
CNS: headache, change in LOC, weakness, gait change
~NSG: neuro assessments
✔✔Therapeutic management of a bleeding episode in a patient with hemophilia - ✔✔-
Administer medications
~factor for moderate to severe hemophiliacs (prophylactic treatment to prevent
bleeding episodes with sever hemophilia)
~ Desmopressin Acetate (DDAVP) for mild to moderate Hemophilia A patients
, -Administration of blood products (packed RBC or FFP)
-Nursing considerations
~Double check the factor or blood product transfusion with another RN hemarthrosis
-For hemarthrosis (bleeding in joint): immobilize and elevate (RICE)
✔✔Define Immune thrombocytopenic purpura (ITP) - ✔✔A bleeding disorder
characterized by increased destruction of platelets in spleen
platelet destruction due to an antiplatelet antibody that destroys platelets making this an
autoimmune disorder
✔✔A patient presents to the hospital with excessive bruising, miniature petechiae, large
areas of asymmetrical ecchymosis, epistaxis, and marked thrombocytopenia but normal
WBC, Hgb, and Hct. What condition may this patient have? - ✔✔Immune
thrombocytopenic purpura (ITP)
✔✔True or false:
Children with Immune thrombocytopenic purpura (ITP) require immediate medical
treatment. - ✔✔FALSE!!!!
many children only require observation and reevaluation of labs. No medical
interventions are required
✔✔A nurse is assessing if the patient and family understood her instructions for their
child with Immune thrombocytopenic purpura (ITP). Which statement by the family
needs further teaching?
"We can give our child aspirin, NSAIDS, or antihistamines if he has any pain."
"We must prevent any serious traumas that may involve our child."
"We will watch for any signs of bleeding in our child." - ✔✔DO NOT GIVE THIS
PATIENT ASPIRIN, NSAIDS, OR ANTIHISTAMINES!
All other options are correct
✔✔A nurse is reviewing the orders in the chart for her patient with Immune
thrombocytopenic purpura (ITP). Would she follow the orders or question what was put
in?
-Steroid therapy for 2-4 weeks
-IVIGs given once a day foe 3-5 days
