Nokea
In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan?
- A. Encourage drinking.
- B. Keep accurate records of output.
- C. Check for moist mucous membranes.
- D. Monitor the concentration of the childs urine.
Correct Answer: C
Rationale: Checking for moist mucous membranes assesses hydration in SCA, where impaired kidney function prevents urine concentration. General encouragement to drink is vague, output records don?t reflect fluid needs, and urine concentration is unreliable due to kidney dysfunction.
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What physiologic defect is responsible for causing anemia?
- A. Increased blood viscosity
- B. Depressed hematopoietic system
- C. Presence of abnormal hemoglobin
- D. Decreased oxygen-carrying capacity of blood
Correct Answer: D
Rationale: Anemia is defined by reduced RBCs or hemoglobin, leading to decreased oxygen-carrying capacity. Increased viscosity occurs with too many cells, a depressed hematopoietic system or abnormal hemoglobin may contribute, but the core defect is reduced oxygen delivery.
The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration?
- A. Decreased blood viscosity
- B. Deficiency in coagulation
- C. Increased red blood cell (RBC) destruction
- D. Greater affinity for oxygen
Correct Answer: C
Rationale: SCA causes increased RBC destruction due to sickled cells, leading to vasoocclusion and hemolysis. Sickled cells increase viscosity, not decrease it; coagulation is unaffected; and sickled hemoglobin has reduced oxygen affinity, transforming under low oxygen tension.
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.
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 information should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?
- A. Give with meals.
- B. Stop immediately if nausea and vomiting occur.
- C. Adequate dosage will turn the stools a tarry green color.
- D. Allow preparation to mix with saliva and bathe the teeth before swallowing.
Correct Answer: C
Rationale: Adequate iron dosage turns stools tarry green, indicating sufficient absorption. Iron is best given between meals for acidic absorption, nausea may require dose adjustment, not cessation, and liquid iron should be given through a straw to avoid tooth staining.