CPN Exam Moderate and
Low Priority
Anemia - ANSWERSdecrease in serum hemoglobin (11.5-14.5) that can be acute or chronic
Acute Anemia Manifestations - ANSWERSacute tissue hypoxia
muscle weakness, fatigue, pallor, lightheaded, increased HR
Chronic Anemia Manifestations - ANSWERScompensated anemia
growth retardation, delayed sexual maturation, increased HR, heart murmur
Iron Deficiency Anemia - ANSWERSmost prevalent nutritional disorder in the US
lack of iron leads to small RBC that break and do not carry oxygen well
Iron Deficiency Anemia at risk population - ANSWERSpremature infants and multiple birth
infants
fetal transfer of iron is highest in last trimester, full term infants have 6 month store of iron
Poor source of iron intake - ANSWERSwhole milk
identify excessive milk intake or early introduction of whole milk
Iron Supplementation Interventions - ANSWERStemporarily stain teeth- medicine dropper and
brush teeth after
absorption best between meals with citrus fruit or juice
stool should be tarry green or black when iron levels are adequate
,sickle cell disease - ANSWERSgenetic disorder causing abnormal HGB S
RBC get trapped in vasculature causing dehydration and hypoxia
RBC lifespan in chronic hemolytic anemia - ANSWERS20 days
Normal RBC lifespan - ANSWERS90-120 days
Vasoocclusive pain crisis - ANSWERSrbcs will un-sickle with adequate oxygen and hydration
to prevent, promote hydration, avoid extreme cold or heat
sickle cell disease fever/infection - ANSWERScaused by splenic failure (decreases ability to fight
infection)
first sign of bacteremia is fever
monitor for sepsis, start abx (penicillin)
pneumococcal vaccine helps prevent infections
Altered Clotting Function Disorder Names - ANSWERSImmune/ Idiopathic Thrombocytopenia
Purpura (ITP)
Hemophilia
Disseminated Intravascular Coagulation (DIC)
Immune/ Idiopathic Thrombocytopenic Purpura (ITP) - ANSWERSacquired hemorrhagic disorder
that results in the autoimmune distruction of platelets in spleen
most children are age 2-10 and completely recover within 2 months
,Idiopathic Thrombocytopenic Purpura Assessment - ANSWERSpetechiae, bruises, and bleeding
(urine and gums)
Idiopathic Thrombocytopenic Purpura treatment - ANSWERSIf platelets <20,000- IVIG (responds
in 10-12 hours)
Anti-D antibody (winrho) less expensive than IVIG (5-10 minutes IV, response in 48 hours)
Bleeding Precautions - ANSWERSavoid ibuprofen, injections, and trauma
hemophilia - ANSWERSgroup of bleeding disorders where there is a deficiency in one of the
factors necessary for coagulation of blood
severe can cause spontaneous bleeding- give factor VIII or IX
Immobilize and elevate affected area, ROM exercises, prevent injury
Disseminated Intravascular Coagulation (DIC) - ANSWERSCaused by trauma, transfusion
reaction, cancer
consumption of clotting factors and platelets leads to massive bleeding from multiple sites
resulting in hypovolemia
Disseminated Intravascular Coagulation Treatment - ANSWERStransfuse FFP and platelets
PRBC Administration - ANSWERSVS prior to start
IV NS to piggyback tubing
Administer 20% of transfusion slowly, then can speed up
Transfusion Reactions- types - ANSWERSSTOP INFUSION, START NS
hemolytic- flank pain, severe HA, dyspnea, shock, renal failure
allergic- hives and itching
, febrile- fever/ chills
Hypothyroidism - ANSWERSthyroid hormone regulates basal metabolic rate
can be either congenital or acquired
Hypothyroidism Assessment - ANSWERSimpaired growth/ development
constipation
sleepy
hypotonia, hypothermia
slow pulse
weight gain
Congenital Hypothyroidism Assessment - ANSWERSintellectual disability, enlarged tongue,
hoarse cry
Hypothyroidism Intervention - ANSWERSprompt treatment for infants to reduce neurologic
impairment
monitor progress of growth and development (should resolve with TH replacement)
routine monitoring of serum TH levels
Hyperthyroidism (Graves Disease) - ANSWERSTypically occurs in older school age children and is
caused by autoimmune response to TSH receptors
Hyperthyroidism (Graves Disease) Assessment - ANSWERSirritability/ emotional lability
hyperactivity, short attention span, tremors
insomnia
weight loss with increased appetite
Low Priority
Anemia - ANSWERSdecrease in serum hemoglobin (11.5-14.5) that can be acute or chronic
Acute Anemia Manifestations - ANSWERSacute tissue hypoxia
muscle weakness, fatigue, pallor, lightheaded, increased HR
Chronic Anemia Manifestations - ANSWERScompensated anemia
growth retardation, delayed sexual maturation, increased HR, heart murmur
Iron Deficiency Anemia - ANSWERSmost prevalent nutritional disorder in the US
lack of iron leads to small RBC that break and do not carry oxygen well
Iron Deficiency Anemia at risk population - ANSWERSpremature infants and multiple birth
infants
fetal transfer of iron is highest in last trimester, full term infants have 6 month store of iron
Poor source of iron intake - ANSWERSwhole milk
identify excessive milk intake or early introduction of whole milk
Iron Supplementation Interventions - ANSWERStemporarily stain teeth- medicine dropper and
brush teeth after
absorption best between meals with citrus fruit or juice
stool should be tarry green or black when iron levels are adequate
,sickle cell disease - ANSWERSgenetic disorder causing abnormal HGB S
RBC get trapped in vasculature causing dehydration and hypoxia
RBC lifespan in chronic hemolytic anemia - ANSWERS20 days
Normal RBC lifespan - ANSWERS90-120 days
Vasoocclusive pain crisis - ANSWERSrbcs will un-sickle with adequate oxygen and hydration
to prevent, promote hydration, avoid extreme cold or heat
sickle cell disease fever/infection - ANSWERScaused by splenic failure (decreases ability to fight
infection)
first sign of bacteremia is fever
monitor for sepsis, start abx (penicillin)
pneumococcal vaccine helps prevent infections
Altered Clotting Function Disorder Names - ANSWERSImmune/ Idiopathic Thrombocytopenia
Purpura (ITP)
Hemophilia
Disseminated Intravascular Coagulation (DIC)
Immune/ Idiopathic Thrombocytopenic Purpura (ITP) - ANSWERSacquired hemorrhagic disorder
that results in the autoimmune distruction of platelets in spleen
most children are age 2-10 and completely recover within 2 months
,Idiopathic Thrombocytopenic Purpura Assessment - ANSWERSpetechiae, bruises, and bleeding
(urine and gums)
Idiopathic Thrombocytopenic Purpura treatment - ANSWERSIf platelets <20,000- IVIG (responds
in 10-12 hours)
Anti-D antibody (winrho) less expensive than IVIG (5-10 minutes IV, response in 48 hours)
Bleeding Precautions - ANSWERSavoid ibuprofen, injections, and trauma
hemophilia - ANSWERSgroup of bleeding disorders where there is a deficiency in one of the
factors necessary for coagulation of blood
severe can cause spontaneous bleeding- give factor VIII or IX
Immobilize and elevate affected area, ROM exercises, prevent injury
Disseminated Intravascular Coagulation (DIC) - ANSWERSCaused by trauma, transfusion
reaction, cancer
consumption of clotting factors and platelets leads to massive bleeding from multiple sites
resulting in hypovolemia
Disseminated Intravascular Coagulation Treatment - ANSWERStransfuse FFP and platelets
PRBC Administration - ANSWERSVS prior to start
IV NS to piggyback tubing
Administer 20% of transfusion slowly, then can speed up
Transfusion Reactions- types - ANSWERSSTOP INFUSION, START NS
hemolytic- flank pain, severe HA, dyspnea, shock, renal failure
allergic- hives and itching
, febrile- fever/ chills
Hypothyroidism - ANSWERSthyroid hormone regulates basal metabolic rate
can be either congenital or acquired
Hypothyroidism Assessment - ANSWERSimpaired growth/ development
constipation
sleepy
hypotonia, hypothermia
slow pulse
weight gain
Congenital Hypothyroidism Assessment - ANSWERSintellectual disability, enlarged tongue,
hoarse cry
Hypothyroidism Intervention - ANSWERSprompt treatment for infants to reduce neurologic
impairment
monitor progress of growth and development (should resolve with TH replacement)
routine monitoring of serum TH levels
Hyperthyroidism (Graves Disease) - ANSWERSTypically occurs in older school age children and is
caused by autoimmune response to TSH receptors
Hyperthyroidism (Graves Disease) Assessment - ANSWERSirritability/ emotional lability
hyperactivity, short attention span, tremors
insomnia
weight loss with increased appetite
