Nokea
Intravenous immune globulin (IVIG) therapy is prescribed for a child diagnosed with idiopathic thrombocytopenic purpura (ITP). What are the expected results of this medication?
- A. Urine positive for glucose and negative for protein
- B. Urine specific gravity of 1.020 and negative for red blood cells
- C. White blood cell count 18,000 mm^3 (18 × 10^9/L) and platelets 355,000 mm^3 (355 × 10^9/L)
- D. Blood urea nitrogen (BUN) 22 mg/dL (7.92 mmol/L) and creatinine levels of 2.1 mg/dL (185 mcmol/L)
Correct Answer: C
Rationale: IVIG is usually effective to rapidly increase the platelet count. It is thought to act by interfering with the attachment of antibody-coded platelets to receptors on the macrophage cells of the reticuloendothelial system. Corticosteroids may be prescribed to enhance vascular stability and decrease the production of antiplatelet antibodies. Based on this information, the remaining options are unrelated to the administration of this medication.
You may also like to solve these questions
A home care nurse is assessing a client who is prescribed prazosin. Which statement by the client would support the need for further teaching regarding medication compliance?
- A. If I feel dizzy, I'll skip my dose for a few days.
- B. I can't see the numbers on the label to know how much salt is in the food.
- C. I understand why I have to keep taking the pills even when my blood pressure is normal.
- D. If I have a cold, I shouldn't take any over-the-counter remedies without consulting my doctor.
Correct Answer: A
Rationale: Prazosin is used to treat hypertension. The side effects of prazosin are dizziness and impotence. The client needs to be instructed to call the primary health care provider if these side effects occur. Holding (skipping) medication will cause an abrupt rise in blood pressure. Option 2 indicates difficulty taking care of oneself. The remaining options indicate client understanding regarding the medication.
The nurse caring for a child diagnosed with kidney disease is analyzing the child's laboratory results and notes a sodium level of 148 mEq/L (148 mmol/L). On the basis of this finding, which clinical manifestation should the nurse expect to note in the child?
- A. Lethargy
- B. Diaphoresis
- C. Cold, wet skin
- D. Dry, sticky mucous membranes
Correct Answer: D
Rationale: Hypernatremia occurs when the sodium level is more than 145 mEq/L (145 mmol/L). Clinical manifestations include intense thirst, oliguria, agitation, restlessness, flushed skin, peripheral and pulmonary edema, dry and sticky mucous membranes, nausea, and vomiting. None of the remaining options are associated with the clinical manifestations of hypernatremia.
The nurse is assigned to care for a child diagnosed with juvenile idiopathic arthritis (JIA). What is the child's priority problem?
- A. Acute pain
- B. Potential difficulty with everyday tasks
- C. Impaired mobility causing potential injury
- D. Negative view of body because of activity intolerance
Correct Answer: A
Rationale: All of the problems identified in the options are appropriate for the child with JIA; however, acute pain must be managed before other problems can be addressed.
A child was diagnosed with acute poststreptococcal glomerulonephritis and renal insufficiency. Which laboratory result should the nurse expect to note in the child?
- A. Urine positive for glucose and negative for protein
- B. Urine specific gravity of 1.020 and negative for red blood cells
- C. White blood cell count 18,000 mm^3 (18 × 10^9/L) and platelets 355,000 mm^3 (355 × 10^9/L)
- D. Blood urea nitrogen (BUN) 22 mg/dL (7.92 mmol/L) and creatinine levels of 2.1 mg/dL (185 mcmol/L)
Correct Answer: D
Rationale: With poststreptococcal glomerulonephritis, a urinalysis will reveal hematuria with red cell casts. Proteinuria is also present. If renal insufficiency is severe, the BUN and creatinine levels will be elevated. The WBC is usually within normal limits, and mild anemia is common. Platelets would be lower, whereas glucose is not related.
The nurse is caring for an infant admitted to the hospital with a diagnosis of hemolytic disease. Which finding should the nurse expect to note in this infant when reviewing the laboratory results?
- A. Decreased bilirubin count
- B. Elevated blood glucose level
- C. Decreased red blood cell count
- D. Decreased white blood cell count
Correct Answer: C
Rationale: The two primary pathophysiological alterations associated with hemolytic disease are anemia and hyperbilirubinemia. The red blood cell count is decreased because red blood cell production cannot keep pace with red blood cell destruction. Hyperbilirubinemia results from the red blood cell destruction that accompanies this disorder and from the normally decreased ability of the neonate's liver to conjugate and excrete bilirubin efficiently from the body. Hypoglycemia is associated with hypertrophy of the pancreatic islet cells and increased levels of insulin. The white blood cell count is not related to this disorder.