Nokea
A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention should occur next?
- A. Reduce environmental stimulation to prevent seizures.
- B. Have the laboratory repeat the analysis with a new specimen.
- C. Minimize energy expenditure to decrease cardiac workload.
- D. Administer intravenous fluids to correct the dehydration.
Correct Answer: C
Rationale: A hemoglobin of 6.4 g/dl (normal 11.5-15.5 g/dl) indicates severe anemia, increasing cardiac workload to compensate for reduced oxygen delivery. Minimizing energy expenditure reduces cardiac strain. Seizures aren?t a risk, repeat testing is unnecessary, and dehydration isn?t evident.
You may also like to solve these questions
What explanation provides the rationale for why iron-deficiency anemia is common during infancy?
- A. Cows milk is a poor source of iron.
- B. Iron cannot be stored during fetal development.
- C. Fetal iron stores are depleted by 1 month of age.
- D. Dietary iron cannot be started until 12 months of age.
Correct Answer: A
Rationale: Cows milk, common in diets of 12-36-month-olds, is low in iron, increasing anemia risk. Fetal iron stores, dependent on maternal stores, last 5-6 months, and iron-fortified foods can be introduced before 12 months via breastfeeding or formula.
What statement best describes b-thalassemia major (Cooley anemia)?
- A. It is an acquired hemolytic anemia.
- B. Inadequate numbers of red blood cells (RBCs) are present.
- C. Increased incidence occurs in families of Mediterranean extraction.
- D. It commonly occurs in individuals from West Africa.
Correct Answer: C
Rationale: B-thalassemia major has a higher incidence in Mediterranean populations and is inherited, not acquired. It involves overproduction of unstable RBCs, not inadequate numbers, and is distinct from sickle cell anemia, which is common in West African populations.
What condition occurs when the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?
- A. Aplastic anemia
- B. Sickle cell anemia
- C. Thalassemia major
- D. Iron deficiency anemia
Correct Answer: B
Rationale: Sickle cell anemia involves replacement of normal hemoglobin with abnormal sickled hemoglobin, a hemoglobinopathy. Aplastic anemia is bone marrow failure, thalassemia major involves reduced hemoglobin chain production, and iron deficiency affects RBC size, not hemoglobin type.
For children who do not have a matched sibling bone marrow donor, the therapeutic management of aplastic anemia includes what intervention?
- A. Antibiotics
- B. Antiretroviral drugs
- C. Iron supplementation
- D. Immunosuppressive therapy
Correct Answer: D
Rationale: Immunosuppressive therapy (e.g., antilymphocyte globulin, cyclosporine) treats aplastic anemia, likely an autoimmune condition, improving prognosis. Antibiotics treat infections, not the condition; antiretrovirals and iron are irrelevant to aplastic anemia management.
In which condition are all the formed elements of the blood simultaneously depressed?
- A. Aplastic anemia
- B. Sickle cell anemia
- C. Thalassemia major
- D. Iron deficiency anemia
Correct Answer: A
Rationale: Aplastic anemia involves bone marrow failure, depressing all blood elements (RBCs, WBCs, platelets). Sickle cell anemia affects hemoglobin, thalassemia major impacts hemoglobin chain production, and iron deficiency reduces RBC size and hemoglobin, not all elements.