NUR 254 EXAM 4 COMPREHENSIVE
QUESTIONS AND SOLUTIONS
◉ Iron deficiency Anemia: S/S
Answer: -tachy
-can be underweight or overweight
◉ Iron deficiency Anemia: treatment
Answer: -Iron rich foods (green leafy), supplements, dietary
supplements, organ meats, rice cereal at 6 months,
◉ Iron deficiency Anemia: Teaching
Answer: - No cow's milk until the baby is 1 years old
-NO iron supplements with milk, give on empty stomach acid
makes it absorb beer*
o Liquid supplement can stain teach, use straw or regular iron
supplement capsule/pill
o Black tarry green stools
o Keep away from children, never keep more than a month supply
at home
o Infants 30 mins before on empty, older child with something
citric for the acid*
o Dietary counseling
,◉ Sickle Cell Anemia: Important*
Answer: Prevent Dehydration
◉ Sickle Cell Anemia: Etiology/Diagnostics
Answer: -Hereditary, Autosomal recessive trait.
-Cells are sickle shaped. -Repetitive decrease in 02 cell walls
become rigid.
-Cells are getting jammed, causing an obstruction of RBC's,
resulting in PAIN.
-The normal HGB is replaced with abnormal HGB.
-Effects the spleen.
o Organ that's mostly effected is the spleen*
o Newborn Screening in the US
◉ Sickle Cell Anemia: S/S
Answer: o Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1
min-days -> crisis
o Stroke -> Severe unrelieved headache**
o Painful Swelling: hands, feet, joint pain
o Headache. Doesn't go away with meds? Possible CVA.
EMERGENCY*
o One CVA? R/F another** (stroke)
,o Visual disturbances
o Obstructive jaundice
o Fever 101.3 or higher
o Severe hypoxia
◉ Sickle Cell Anemia: VASOCCLUSIVE Crisis
Answer: -: Acute chest syndrome
-mimics pneumonia "painful episode"
◉ Sickle Cell Anemia: Splenic Sequestration
Answer: -Pooling of blood in the spleen
-Causes infection, stress, dehydration, *USE IV FLUIDS***
-trauma
◉ Sickle Cell Anemia: treatment
Answer: o DON'T over oxygenate o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection* (
Vaccines, Anbiocs (PCN))
o If they've had a stroke, every 3-4 weeks for transfusions* to
prevent CVA
o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization
o Splenectomy (severe)
o Stem cell Transplant: considered curative (severe)
, o Rest
o Control Pain: Morphine
o Electrolyte replacement
◉ Sickle Cell Anemia: Teaching
Answer: o Prevent hydration
o Rest
o Improve oxygen but don't over oxygenate
o Educate importance of vaccines
o Know s/s of a stroke
o Child is normal just gets sicker easier
◉ Hemophilia: term
Answer: MIssing clotting factors
◉ Hemophilia:Etiology/Diagnostics
Answer: Deficiency of factor VIII, produced by the liver, bleeding
disorder
◉ Hemophilia: education
Answer: Parents -> genetic counseling
◉ Hemophilia: S/S
QUESTIONS AND SOLUTIONS
◉ Iron deficiency Anemia: S/S
Answer: -tachy
-can be underweight or overweight
◉ Iron deficiency Anemia: treatment
Answer: -Iron rich foods (green leafy), supplements, dietary
supplements, organ meats, rice cereal at 6 months,
◉ Iron deficiency Anemia: Teaching
Answer: - No cow's milk until the baby is 1 years old
-NO iron supplements with milk, give on empty stomach acid
makes it absorb beer*
o Liquid supplement can stain teach, use straw or regular iron
supplement capsule/pill
o Black tarry green stools
o Keep away from children, never keep more than a month supply
at home
o Infants 30 mins before on empty, older child with something
citric for the acid*
o Dietary counseling
,◉ Sickle Cell Anemia: Important*
Answer: Prevent Dehydration
◉ Sickle Cell Anemia: Etiology/Diagnostics
Answer: -Hereditary, Autosomal recessive trait.
-Cells are sickle shaped. -Repetitive decrease in 02 cell walls
become rigid.
-Cells are getting jammed, causing an obstruction of RBC's,
resulting in PAIN.
-The normal HGB is replaced with abnormal HGB.
-Effects the spleen.
o Organ that's mostly effected is the spleen*
o Newborn Screening in the US
◉ Sickle Cell Anemia: S/S
Answer: o Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1
min-days -> crisis
o Stroke -> Severe unrelieved headache**
o Painful Swelling: hands, feet, joint pain
o Headache. Doesn't go away with meds? Possible CVA.
EMERGENCY*
o One CVA? R/F another** (stroke)
,o Visual disturbances
o Obstructive jaundice
o Fever 101.3 or higher
o Severe hypoxia
◉ Sickle Cell Anemia: VASOCCLUSIVE Crisis
Answer: -: Acute chest syndrome
-mimics pneumonia "painful episode"
◉ Sickle Cell Anemia: Splenic Sequestration
Answer: -Pooling of blood in the spleen
-Causes infection, stress, dehydration, *USE IV FLUIDS***
-trauma
◉ Sickle Cell Anemia: treatment
Answer: o DON'T over oxygenate o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection* (
Vaccines, Anbiocs (PCN))
o If they've had a stroke, every 3-4 weeks for transfusions* to
prevent CVA
o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization
o Splenectomy (severe)
o Stem cell Transplant: considered curative (severe)
, o Rest
o Control Pain: Morphine
o Electrolyte replacement
◉ Sickle Cell Anemia: Teaching
Answer: o Prevent hydration
o Rest
o Improve oxygen but don't over oxygenate
o Educate importance of vaccines
o Know s/s of a stroke
o Child is normal just gets sicker easier
◉ Hemophilia: term
Answer: MIssing clotting factors
◉ Hemophilia:Etiology/Diagnostics
Answer: Deficiency of factor VIII, produced by the liver, bleeding
disorder
◉ Hemophilia: education
Answer: Parents -> genetic counseling
◉ Hemophilia: S/S
