NUR 258 EXAM 4 FINAL QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE GRADED
A+ 100% GUARANTEED PASS
anemia: three types Hypo-proliferative: Defective RBC production,
bone marrow sup. or chemo
Hemolytic: RBC destruction, sickle cell disease
Bleeding/blood loss: GI, hemorrhage, heavy
menstruation
anemia: manifestations - fatigue
- dizzy
- syncope with standing/exertion
- pallor
- sensitivity to cold
- brittle/ridged/concave nails
- angular cheilosis of lips
- pica
, - tongue changes
- vitals: ↑ HR, ↑ RR, ↓ SpO2, dyspnea, hy
potension (bleeding)
- jaundice if from hemolysis(sickle cell anemia)
Complete Blood Count (CBC) Hemoglobin (Hgb): Transports O₂ to all tissues
Labs Hematocrit (HCT): % of RBC in relation to blood
volume
diagnostics for hematologic Ferritin: iron stores
disorders Sickle-cell test: sickling RBC
Bone marrow aspiration/biopsy: aplastic
anemia and leukemia, performed on iliac crest,
post-op precautions for bleeding and
infection
iron deficiency anemia Risks, Risks: inadequate intake of iron, vegan,
Causes, Diagnostics: vegetarian
Check ferritin level
Causes: blood loss, menorrhagia, pregnancy,
alcohol abuse, IBD, NSAID & aspirin
Diagnostics: colonoscopies, history of heavy
periods, dietary intake
,iron deficiency anemia: Replace what is
management missing Iron
supplements:
- Vit C helps absorption
- food decreases absorption
- take between meals
- liquid supplement: stains teeth, brush teeth
after, drink through straw
Diet: meat, seafood, legume, leafy vegetables,
raisins
aplastic anemia & SSx damage to the bone marrow stem cells
Pancytopenia: anemia, leukopenia,
thrombocytopenia
S/S: infections, purpura, petechiae, retinal
hemorrhage, splenomegaly
aplastic anemia Tx Tx:
- Hematopoietic stem cell transplantation
(HSCT)
- Immunosuppressive therapy
- transfusions (prevent infection & bleeding)
megaloblastic/pernicious large RBC
, anemia & SSx/Labs Deficient in: Vit B12 (no intrinsic factor) and folic
acid
S/S: think neuro
- sore red tongue
- pallor
- paresthesia in legs and feet
- loss of balance
- loss of proprioception
- confusion (late sign)
Labs: folic acid, Vit B12, MCV
megaloblastic anemia: Lifelong
management Vitamin B9: broccoli, eggs, legumes, avocados,
oral supplement
- educate: large doses will turn urine dark yellow
and can mask B12 deficiency
Vitamin B12: milk, almonds, fish, cheese, eggs,
red meats
- IM or Sub Q for life
sickle cell anemia & blood is thick and sickling
SSx/Causes/Findings Hypoxemia: occlusive/ischemia of organs
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE GRADED
A+ 100% GUARANTEED PASS
anemia: three types Hypo-proliferative: Defective RBC production,
bone marrow sup. or chemo
Hemolytic: RBC destruction, sickle cell disease
Bleeding/blood loss: GI, hemorrhage, heavy
menstruation
anemia: manifestations - fatigue
- dizzy
- syncope with standing/exertion
- pallor
- sensitivity to cold
- brittle/ridged/concave nails
- angular cheilosis of lips
- pica
, - tongue changes
- vitals: ↑ HR, ↑ RR, ↓ SpO2, dyspnea, hy
potension (bleeding)
- jaundice if from hemolysis(sickle cell anemia)
Complete Blood Count (CBC) Hemoglobin (Hgb): Transports O₂ to all tissues
Labs Hematocrit (HCT): % of RBC in relation to blood
volume
diagnostics for hematologic Ferritin: iron stores
disorders Sickle-cell test: sickling RBC
Bone marrow aspiration/biopsy: aplastic
anemia and leukemia, performed on iliac crest,
post-op precautions for bleeding and
infection
iron deficiency anemia Risks, Risks: inadequate intake of iron, vegan,
Causes, Diagnostics: vegetarian
Check ferritin level
Causes: blood loss, menorrhagia, pregnancy,
alcohol abuse, IBD, NSAID & aspirin
Diagnostics: colonoscopies, history of heavy
periods, dietary intake
,iron deficiency anemia: Replace what is
management missing Iron
supplements:
- Vit C helps absorption
- food decreases absorption
- take between meals
- liquid supplement: stains teeth, brush teeth
after, drink through straw
Diet: meat, seafood, legume, leafy vegetables,
raisins
aplastic anemia & SSx damage to the bone marrow stem cells
Pancytopenia: anemia, leukopenia,
thrombocytopenia
S/S: infections, purpura, petechiae, retinal
hemorrhage, splenomegaly
aplastic anemia Tx Tx:
- Hematopoietic stem cell transplantation
(HSCT)
- Immunosuppressive therapy
- transfusions (prevent infection & bleeding)
megaloblastic/pernicious large RBC
, anemia & SSx/Labs Deficient in: Vit B12 (no intrinsic factor) and folic
acid
S/S: think neuro
- sore red tongue
- pallor
- paresthesia in legs and feet
- loss of balance
- loss of proprioception
- confusion (late sign)
Labs: folic acid, Vit B12, MCV
megaloblastic anemia: Lifelong
management Vitamin B9: broccoli, eggs, legumes, avocados,
oral supplement
- educate: large doses will turn urine dark yellow
and can mask B12 deficiency
Vitamin B12: milk, almonds, fish, cheese, eggs,
red meats
- IM or Sub Q for life
sickle cell anemia & blood is thick and sickling
SSx/Causes/Findings Hypoxemia: occlusive/ischemia of organs
