Nokea
Iron overload is a side effect of chronic transfusion therapy. What treatment assists in minimizing this complication?
- A. Magnetic therapy
- B. Infusion of deferoxamine
- C. Hemoglobin electrophoresis
- D. Washing red blood cells (RBCs) to reduce iron
Correct Answer: B
Rationale: Deferoxamine infusions chelate and excrete excess iron, minimizing overload from chronic transfusions. Magnetic therapy is ineffective, hemoglobin electrophoresis is diagnostic, and washing RBCs removes other components, not iron.
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A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The childs care should include which therapeutic interventions?
- A. Hydration and pain management
- B. Oxygenation and factor VIII replacement
- C. Electrolyte replacement and administration of heparin
- D. Correction of alkalosis and reduction of energy expenditure
Correct Answer: A
Rationale: Vasoocclusive sickle cell crisis requires hydration to reduce blood viscosity and pain management to alleviate discomfort. Oxygen may prevent further sickling but doesn?t reverse it, factor VIII and heparin are irrelevant, and acidosis, not alkalosis, needs correction.
A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse?
- A. Administer 100% oxygen to relieve hypoxia.
- B. Notify the practitioner because chest syndrome is suspected.
- C. Infuse intravenous antibiotics as soon as cultures are obtained.
- D. Give ordered pain medication to relieve symptoms of pain episode.
Correct Answer: B
Rationale: Symptoms suggest acute chest syndrome, a medical emergency in SCA, requiring immediate practitioner notification. Oxygen may be needed but doesn?t reverse sickling, antibiotics follow evaluation, and pain management is secondary to addressing the emergency.
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.
What statement best describes iron deficiency anemia in infants?
- A. It is caused by depression of the hematopoietic system.
- B. Diagnosis is easily made because of the infants emaciated appearance.
- C. It results from a decreased intake of milk and the premature addition of solid foods.
- D. Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.
Correct Answer: D
Rationale: Iron deficiency anemia reduces oxygen availability to tissues, causing symptoms like pallor and fatigue. The hematopoietic system produces smaller, less hemoglobin-rich RBCs, infants are often overweight from milk, and diagnosis requires lab confirmation, not appearance.
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.