NURS6202 (Capella)Advanced Pathophysiology Final Exam Guide Q & A latest update
anemia - correct answer A condition in which the blood is deficient in red blood cells, in
hemoglobin, or in total volume. (Hgb and HCT)
can be blood loss, destruction (hemolysis, sickle cell disease, some meds, blood mismatch,
trauma) ,or decreased production of RBCs (iron deficiency, kidney disease)
normocytic normochromic anemia - correct answer Characterized by red cells that are
relatively normal in size and hemoglobin content but insufficient in number
- caused by acute blood loss, CKD, hemolysis, sickle cell
MCH is size (mean corpuscular hemoglobin) MCV is color (mean corpuscular volume)
microcytic hypochromic anemia - correct answer anemia characterized by small, pale red blood
cells that lack adequate hemoglobin to carry oxygen; can be caused by deficiency of iron or
vitamin B6
low MCH and MCV
macrocytic normochromic anemia - correct answer - large cells (megaloblastic), normal color
- usually folic acid or vitamin B12 deficiency anemia, liver disease
- pernicious anemia
- MCH and MCV high
anemia manifestations - correct answer weakness, fatigue, pallor, syncope, dyspnea,
tachycardia and murmurs from low blood viscosity, integumentary changes- pruritus pallor and
jaundice
Anemia manifestations - correct answer Mild: Hemoglobin 10-12 (tired, pale nails and MM)
Moderate/Severe: Hemoglobin BELOW 6g/dl is severe, 7-10 is moderate (more stuggish, chest
pain, eyes look pale)
between 12-16 is normal
Anemia: Cardiopulmonary Manifestations - correct answer Result from additional attempts by
heart and lungs to provide adequate O2 to the tissues
Cardiac output maintained by increasing the heart rate and stroke volume
low blood viscosity leads to murmur
,Gerontologic Considerations - correct answer more common, s/s not recognized bc similar to
normal aging
decreased erythrocyte production - correct answer iron deficiency (tired and pale, ischemia)
megaloblastic (b12 deficiency, folic acid def.) - neuropathy, tingling around
mouth/hands/face/LE's, early graying of the hair w folic acid def.
iron deficiency - correct answer decreased Hbg and Hct, MCV low, iron low
normal b12 and folate
treat underlying cause- lots of GI bleeds
iron replacement- good nutrition, blood transfusion of packed RBCs, meds
iron supplements- best absorbed before meals on empty stomach, liquid iron stains teeth so
use straw and dilute, take w vitamin c, can cause constipation, heartburn or diarrhea
parental iron- IV or IM- im may stain skin, indicated for malabsorption or oral intolerance,
higher dose, poor pt compliance w oral
Cobalamin (B12) deficiency - correct answer -Found in strict vegetarians - gastric system
missing protein needed for absorption
-Pernicious anemia (weakness, sore tongue, apathy)- gastric mucosa not secreting intrinsic
factor in gut
can be GI alterations like surgery and chronic disease, chronic alcoholics, h12 blockers and ppi
long term use bc decreased acid and causes issues w absorption
s/s: beefy red tongue, n/v, abd pain, weakness, parethesia, confusion, decreased senses, ataxia
- treatment: cobalamin parental or intranasal, lifelong if no gi absorption, neuromuscular may
not improve, b12 supplement may help a little bit but maybe not if absorption problems, b12
injections
Folic acid deficiency - correct answer Macrocytic, megaloblastic anemia; no neurologic Sx (as
opposed to vitamin B12 deficiency). Most common vitamin deficiency in the USA. Seen in
alcoholism and pregnancy.
commonly caused by dietary deficiency and malabsorption, drugs, increased requirement,
alcohol abuse, anorexia, hemodialysis loss
treat w folic acid supplement and diet rich in folic acid
megaloblastic anemia nursing management - correct answer hx of pernicious anemia for early
detection, ensure safety w diminished sensations to heat and pain from neuro impairment,
protect from burns/falls/trauma, frequent medical screening for risk of dev gastric cancers
,Sickle Cell Disease (SCD) - correct answer a group of inherited, autosomal recessive disorders
characterized by the presence of an abnormal form of hemoglobin in the erythrocyte
Hbg S destruction, severe pain often undertreated and can be fatal bc it sickles and cuts off
oxygen and cause damage to joints and organs
goal is to prevent
a/s: asymptomatic except during sickling, pain, pallor, jaundice d/t blood cell destruction and
liver breaking them down and bilirubin spills in bloodstream bc liver can't keep up,
complications when organs affected by hypoxia and infection, make sure patient is oxygenated
and given IV fluids and need pain meds
Sickling episodes are triggered by - correct answer low O2 in the blood
can lead to crisis, and necrosis and go into shock bc low fluid volume and oxygenation
sickle cell crisis - correct answer condition in sickle cell anemia in which the sickled cells
interfere with oxygen transport, obstruct capillary blood flow, and cause fever and severe pain
in the joints and abdomen
need pain treatment, oxygen, watch for respiratory failure, rest, dvt prophylaxis, f/e,
transfusions
sickle cell management - correct answer pain management - often tolerant to pain meds,
requires continuous and breakthrough analgesia
preventative meds- folic acid and hydrea an anti sickling agent
hematopoietic stem cell transplant
prevent infection and get vaccinated, avoid high altitudes, stay hydrated, prompt med attention
and treat infections early, counseling and support groups, med alert bracelet
Thrombocytopenia - correct answer low platelet count <150,000, abnormal hemostasis,
prolonged or spontaneous bleeding, primarily an acquired disorder
mucosal bleeding or cutaneous bleeding, petichae, prolonged bleeding w routine procedures
when less than 50,000
hemorrhage risk when less than 20,000
Immune Thrombocytopenic Purpura (ITP) - correct answer Autoimmune platelet destruction is
a common cause of thrombocytopenia and should be supsected in patients with echymoses,
petechiae, mucosal bleeding, and no other obvious causes of thrombocytopenia (ex-
medications, bone marrow failure) abnormal destruction of platelets
, avoid aspirin, need corticosteroids, splenectomy if not responding to treatments, platelet
transfusion if less than 10,000 or if actively bleeding or prophylactically for planned procedure
thrombocytopenia nursing management - correct answer - treat bleeding and evaluate and
avoid anything that causes bleeding, like sq/im injections avoided, monitor labs-
platelets/pt/aptt time/coag studies,hbg/hct
teach self care to reduce bleeding risk, prompt treatment for s/s of bleeding, awareness of
cancer drugs causing this, heparin, and otc meds
leukemia - correct answer cancer of white blood cells, affects bone marrow, lymph, and spleen
acute: immature hematopoietic cells proliferate, abrupt onset
chronic: more mature form of WBCs, gradual onset
acute myelogenous (usually presents as bleeding or infection, hyperplasia of bone marrow and
spleen, 80%, 1 in 4 survive), acute lymphocytic, chronic myelogenous, chronic lymphocytic (CLL
complications may develop w time, lymph nodes enlarge and cause pain and paralysis from
pressure)
acutes in kids and chronics in elderly usually
acute: myeloblasts and lymphocytes: rapid onset, fatal in days to months, need bone marrow
biopsy to dx
chronic: granulocytes and b lymphocytes
Leukemia Clinical Manifestations - correct answer - Anemia
- Bruising , thrombocyopenia
- Bleeding (epistaxis)
- Fatigue
- Bone pain
- Headache
- Visual disturbances
- Nausea/vomiting
- Weight loss
- Fever
- Lymph node and organ enlargement
decreased # and function of WBCs
anemia - correct answer A condition in which the blood is deficient in red blood cells, in
hemoglobin, or in total volume. (Hgb and HCT)
can be blood loss, destruction (hemolysis, sickle cell disease, some meds, blood mismatch,
trauma) ,or decreased production of RBCs (iron deficiency, kidney disease)
normocytic normochromic anemia - correct answer Characterized by red cells that are
relatively normal in size and hemoglobin content but insufficient in number
- caused by acute blood loss, CKD, hemolysis, sickle cell
MCH is size (mean corpuscular hemoglobin) MCV is color (mean corpuscular volume)
microcytic hypochromic anemia - correct answer anemia characterized by small, pale red blood
cells that lack adequate hemoglobin to carry oxygen; can be caused by deficiency of iron or
vitamin B6
low MCH and MCV
macrocytic normochromic anemia - correct answer - large cells (megaloblastic), normal color
- usually folic acid or vitamin B12 deficiency anemia, liver disease
- pernicious anemia
- MCH and MCV high
anemia manifestations - correct answer weakness, fatigue, pallor, syncope, dyspnea,
tachycardia and murmurs from low blood viscosity, integumentary changes- pruritus pallor and
jaundice
Anemia manifestations - correct answer Mild: Hemoglobin 10-12 (tired, pale nails and MM)
Moderate/Severe: Hemoglobin BELOW 6g/dl is severe, 7-10 is moderate (more stuggish, chest
pain, eyes look pale)
between 12-16 is normal
Anemia: Cardiopulmonary Manifestations - correct answer Result from additional attempts by
heart and lungs to provide adequate O2 to the tissues
Cardiac output maintained by increasing the heart rate and stroke volume
low blood viscosity leads to murmur
,Gerontologic Considerations - correct answer more common, s/s not recognized bc similar to
normal aging
decreased erythrocyte production - correct answer iron deficiency (tired and pale, ischemia)
megaloblastic (b12 deficiency, folic acid def.) - neuropathy, tingling around
mouth/hands/face/LE's, early graying of the hair w folic acid def.
iron deficiency - correct answer decreased Hbg and Hct, MCV low, iron low
normal b12 and folate
treat underlying cause- lots of GI bleeds
iron replacement- good nutrition, blood transfusion of packed RBCs, meds
iron supplements- best absorbed before meals on empty stomach, liquid iron stains teeth so
use straw and dilute, take w vitamin c, can cause constipation, heartburn or diarrhea
parental iron- IV or IM- im may stain skin, indicated for malabsorption or oral intolerance,
higher dose, poor pt compliance w oral
Cobalamin (B12) deficiency - correct answer -Found in strict vegetarians - gastric system
missing protein needed for absorption
-Pernicious anemia (weakness, sore tongue, apathy)- gastric mucosa not secreting intrinsic
factor in gut
can be GI alterations like surgery and chronic disease, chronic alcoholics, h12 blockers and ppi
long term use bc decreased acid and causes issues w absorption
s/s: beefy red tongue, n/v, abd pain, weakness, parethesia, confusion, decreased senses, ataxia
- treatment: cobalamin parental or intranasal, lifelong if no gi absorption, neuromuscular may
not improve, b12 supplement may help a little bit but maybe not if absorption problems, b12
injections
Folic acid deficiency - correct answer Macrocytic, megaloblastic anemia; no neurologic Sx (as
opposed to vitamin B12 deficiency). Most common vitamin deficiency in the USA. Seen in
alcoholism and pregnancy.
commonly caused by dietary deficiency and malabsorption, drugs, increased requirement,
alcohol abuse, anorexia, hemodialysis loss
treat w folic acid supplement and diet rich in folic acid
megaloblastic anemia nursing management - correct answer hx of pernicious anemia for early
detection, ensure safety w diminished sensations to heat and pain from neuro impairment,
protect from burns/falls/trauma, frequent medical screening for risk of dev gastric cancers
,Sickle Cell Disease (SCD) - correct answer a group of inherited, autosomal recessive disorders
characterized by the presence of an abnormal form of hemoglobin in the erythrocyte
Hbg S destruction, severe pain often undertreated and can be fatal bc it sickles and cuts off
oxygen and cause damage to joints and organs
goal is to prevent
a/s: asymptomatic except during sickling, pain, pallor, jaundice d/t blood cell destruction and
liver breaking them down and bilirubin spills in bloodstream bc liver can't keep up,
complications when organs affected by hypoxia and infection, make sure patient is oxygenated
and given IV fluids and need pain meds
Sickling episodes are triggered by - correct answer low O2 in the blood
can lead to crisis, and necrosis and go into shock bc low fluid volume and oxygenation
sickle cell crisis - correct answer condition in sickle cell anemia in which the sickled cells
interfere with oxygen transport, obstruct capillary blood flow, and cause fever and severe pain
in the joints and abdomen
need pain treatment, oxygen, watch for respiratory failure, rest, dvt prophylaxis, f/e,
transfusions
sickle cell management - correct answer pain management - often tolerant to pain meds,
requires continuous and breakthrough analgesia
preventative meds- folic acid and hydrea an anti sickling agent
hematopoietic stem cell transplant
prevent infection and get vaccinated, avoid high altitudes, stay hydrated, prompt med attention
and treat infections early, counseling and support groups, med alert bracelet
Thrombocytopenia - correct answer low platelet count <150,000, abnormal hemostasis,
prolonged or spontaneous bleeding, primarily an acquired disorder
mucosal bleeding or cutaneous bleeding, petichae, prolonged bleeding w routine procedures
when less than 50,000
hemorrhage risk when less than 20,000
Immune Thrombocytopenic Purpura (ITP) - correct answer Autoimmune platelet destruction is
a common cause of thrombocytopenia and should be supsected in patients with echymoses,
petechiae, mucosal bleeding, and no other obvious causes of thrombocytopenia (ex-
medications, bone marrow failure) abnormal destruction of platelets
, avoid aspirin, need corticosteroids, splenectomy if not responding to treatments, platelet
transfusion if less than 10,000 or if actively bleeding or prophylactically for planned procedure
thrombocytopenia nursing management - correct answer - treat bleeding and evaluate and
avoid anything that causes bleeding, like sq/im injections avoided, monitor labs-
platelets/pt/aptt time/coag studies,hbg/hct
teach self care to reduce bleeding risk, prompt treatment for s/s of bleeding, awareness of
cancer drugs causing this, heparin, and otc meds
leukemia - correct answer cancer of white blood cells, affects bone marrow, lymph, and spleen
acute: immature hematopoietic cells proliferate, abrupt onset
chronic: more mature form of WBCs, gradual onset
acute myelogenous (usually presents as bleeding or infection, hyperplasia of bone marrow and
spleen, 80%, 1 in 4 survive), acute lymphocytic, chronic myelogenous, chronic lymphocytic (CLL
complications may develop w time, lymph nodes enlarge and cause pain and paralysis from
pressure)
acutes in kids and chronics in elderly usually
acute: myeloblasts and lymphocytes: rapid onset, fatal in days to months, need bone marrow
biopsy to dx
chronic: granulocytes and b lymphocytes
Leukemia Clinical Manifestations - correct answer - Anemia
- Bruising , thrombocyopenia
- Bleeding (epistaxis)
- Fatigue
- Bone pain
- Headache
- Visual disturbances
- Nausea/vomiting
- Weight loss
- Fever
- Lymph node and organ enlargement
decreased # and function of WBCs
