Nokea
What are the nursing interventions for a client with thalassemia?
- A. Maintain the client on bed rest and protect him or her from infections
- B. Ambulate the client frequently
- C. Advise drinking 3 quarts (L) of fluid per day
- D. Instruct the client to elevate the lower extremities as much as possible
Correct Answer: A
Rationale: Thalassemia is a genetic blood disorder that results in the reduced production of hemoglobin and red blood cells. Nursing interventions for a client with thalassemia aim to manage symptoms and prevent complications. Maintaining the client on bed rest helps conserve energy and prevent fatigue, which is commonly experienced due to anemia. Protecting the client from infections is crucial because individuals with thalassemia are at a higher risk of infections due to their weakened immune system. By minimizing the risk of infections, nurses can help prevent further complications in clients with thalassemia.
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Thirty minutes after the nurse removes a nasogastric tube that has been In place for seven days, the patient experiences epistaxis (nosebleed). Which of the following nursing actions is most appropriate to control the bleeding? a.Apply pressure by pinching the anterior portion of the for five to ten minutes
- A. Place the patient in a sitting position with the neck hyperextended
- B. Pack the nostrils with gauze and keep the gauze in piace for four to five days
- C. Apply ice compresses to the patient's forehead and back of the neck
Correct Answer: A
Rationale: The most appropriate nursing action to control the bleeding in this situation is to apply pressure by pinching the anterior portion of the nose for five to ten minutes. This is a common first aid technique used to stop nosebleeds, known as epistaxis. Applying pressure helps promote clotting and stops the bleeding. Placing the patient in a sitting position with the neck hyperextended or packing the nostrils with gauze for several days are not recommended first-line actions for controlling a nosebleed. The use of ice compresses to the forehead and neck may constrict blood vessels but is not as effective as direct pressure to the nose in this case.
Older school-age children who begin to participate in competitive sports should have a careful evaluation of the
- A. vision
- B. hearing
- C. sexual maturity
- D. cardiovascular system
Correct Answer: D
Rationale: Cardiovascular evaluation is important for children participating in competitive sports.
A patient admitted with gastrointestinal tract bleeding has a hemoglobin level of 6 g/dL. She asks the nurse why she feels SOB. Which response is best?
- A. "Anemia prevents your lungs from absorbing oxygen effectively."
- B. "You do not have enough hemoglobin to carry oxygen to your tissues."
- C. ""You don't have enough blood to feed your cells."
- D. "You have lost a lot of blood, and that has damaged your lungs."
Correct Answer: B
Rationale: The best response is option B, "You do not have enough hemoglobin to carry oxygen to your tissues." Hemoglobin is the protein in red blood cells that carries oxygen from the lungs to the tissues throughout the body. With a low hemoglobin level of 6 g/dL due to gastrointestinal tract bleeding, there is a reduced capacity to carry oxygen to the body's tissues. This decreased oxygen-carrying capacity leads to symptoms of shortness of breath (SOB) because the body's cells are not receiving an adequate supply of oxygen. It is important to provide a clear and accurate explanation to the patient about the relationship between hemoglobin, oxygen transport, and symptoms of anemia like shortness of breath.
A nurse explains to a child's parents that the role of methotrexate (Rheumatrex®) in treating children with juvenile arthritis is to:
- A. decrease the inflammatory response.
- B. improve functional ability.
- C. control the febrile response.
- D. minimize the effects of uveitis.
Correct Answer: A
Rationale: Methotrexate, which is a disease-modifying antirheumatic drug (DMARD), is commonly used to treat juvenile arthritis by decreasing the inflammatory response in the joints. By suppressing the overactive immune response that causes inflammation in the joints, methotrexate helps reduce pain, swelling, and stiffness in children with juvenile arthritis. This ultimately helps to improve joint function and prevent joint damage. While methotrexate may indirectly contribute to improving functional ability and controlling febrile responses in some cases, its primary mechanism of action is to target and reduce inflammation in juvenile arthritis. The medication may also help in managing associated conditions like uveitis, but its main role lies in decreasing the inflammatory response in arthritis.
Jose is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?
- A. Directed at his parents because he is too young to understand
- B. Detailed in regard to the actual procedures so he will know what to expect
- C. Done several days before the procedure so that he will be prepared
- D. Adapted to his level of development so that he can understand
Correct Answer: D
Rationale: Preoperative teaching for Jose, a 4-year-old child, scheduled for a cardiac catheterization should be adapted to his level of development so that he can understand. Children at this age have limited cognitive and emotional understanding, so using simple language, visuals, and play-based strategies is essential. It is important to provide age-appropriate information to reduce anxiety and improve cooperation during the procedure. Preoperative teaching should focus on preparing Jose for what he will see, hear, and experience in a way that is tailored to his developmental stage. Involving play tools such as medical play dolls or child-friendly illustrations can help Jose grasp the concept of the procedure and alleviate fears. It is important to involve both Jose and his parents in the teaching process to ensure they understand how to support and prepare him for the procedure.