NUR 2356 FINAL EXAM 2 LATEST VERSIONS 2023
MULTIDIMENSIONAL CARE 1 FINAL/ MDC 1 FINAL EXAM
200+QUESTIONS AND CORRECT ANSWERS|RASMUSSEN
COLLEGE
Red blood cell production is stimulated by:
1. Tachycardia
2. Tachypnea
3. Renin angiotensin
4. Hypoxia - ANSWER: Hypoxia
4 Main components of blood composition - ANSWER: RBC, WBC, platelets, plasma
What is the composition of plasma - ANSWER: 90% H2O
10% solutes - glucose, protein, albumin, hormones, etc
Where is bone marrow aspiration in infants? - ANSWER: Tibia
Where is bone marrow aspiration in toddlers and preschoolers? - ANSWER: femur
and tibia
Where is bone marrow aspiration in children over 5? - ANSWER: pelvis (iliac crest)
Where is bone marrow production in young adults/adults? - ANSWER: ribs, sternum,
vertebra, pelvis, skull, clavicle, scapula
what is anemia - ANSWER: a condition in which levels of red blood cells and
hemoglobin are lower than normal
4 types of anemia - ANSWER: Iron deficiency
lead poisoning
sickle cell
B-thalassemia
Define iron deficiency anemia - ANSWER: reduction in the iron stores of the body
causing an inadequate production of hemoglobin
What is iron needed for? - ANSWER: to make hgb
signs and symptoms of iron deficiency anemia - ANSWER: pallor
tachycardia
tachypnea
lethargy
fatigue
,irritability
Why are neonates at risk for iron deficiency anemia? - ANSWER: -lack the maternal
iron stores
-Full term infants have maternal iron stores until approximately 6 months of age
-Havent had the time in utero to store up the needed iron supply (preterm)
How can you treat a neonate with iron deficiency anemia? - ANSWER: Iron fortified
formula
What are risk factors for iron deficiency anemia in infants and children? - ANSWER:
1.inadequate iron intake
2.Malabsorption of iron in GI tract
3.Chronic blood loss
Food with good sources of iron - ANSWER: red meat, egg yolk, leafy greens, dried
fruits, fortified cereals/formulas, beef, chicken, fish, beans, nuts, seeds, peanut
butter, eggs, prunes, whole grain bread
How is iron deficiency anemia diagnosed? - ANSWER: Serum lab evaluation:
-Red blood cell count = microcytic (small) and hypo chronic (pale in color)
-low hemoglobin
-low hematocrit
-low reticulocyte count
-low serum iron concentration
-high total iron binding capacity
What is the goal of treatment for iron deficiency anemia - ANSWER: treat medical
problem causing malabsorption or blood loss/ identify cause
What is the treatment method for iron deficiency anemia? - ANSWER: Increase iron
take
~ Dietary sources
~Medication supplement (ferrosol or ferrous sulfate)
What should nurses and parents know about administering iron to children? -
ANSWER: -Administer to back of mouth because it stains teeth, can cause
constipation, and black/green stool
-Give with orange juice or citric acid to help with absorption
-Do not give with milk or antacids
-Give on empty stomach unless GI distress
Lead Poisoning Risks - ANSWER: -Children under the age of 6
-Children living at or below the poverty line who live in older (prior to 1978) housing
-Children adopted from other countries where there are less strict environmental
regulations
,Environmental causes of lead poisoning - ANSWER: -Lead based paint
-Plumbing from lead pipes
-soil
Dietary factors of lead poisoning - ANSWER: -iron deficiency
-calcium deficiency
Patient-child interactions - ANSWER: -Job or hobby exposure
-home remedies or cultural practices
How does lead poisoning cause anemia - ANSWER: lead can replace iron on Hgb
causing O2 to not be delivered causing anemia
Clinical manifestation of lead poisoning - ANSWER: -Asymptomatic
-Signs of anemia
-Growth and developmental lags
-Behavioral changes
-Neurologic changes
-Gastrointestinal changes
can someone be asymptomatic if they have lead poisoning - ANSWER: yes
signs of anemia (lead poisoning) - ANSWER: pallor, fatigue, weakness, shortness of
breath, headache, tachycardia - because lead replaces iron in Hgb causing anemia
Growth and developmental lags in lead poisoning - ANSWER: learning difficulties
Neurologic signs and symptoms of lead poisoning - ANSWER: -Headache, irritability,
difficulty concentrating, loss of motor skills, paralysis, tremors
High levels: encephalopathy, seizures, and brain damage
Gastrointestinal signs and symptoms of lead poisoning - ANSWER: abdominal pain,
failure to gain weight, weight loss, vomiting, constipation
Lead poisoning diagnostics - ANSWER: Blood lead level (BBL) test
-5mcg/dL = lead exposure
-45 mcg/dL = medical treatment required with chelation therapy
->70= mcg/dL = severe lead toxicity
Therapeutic management of lead poisoning - ANSWER: -Decontamination
-Chelation
-Supportive therapy
-Deterrence and prevention
How do you decontaminate a person with lead poisoning? - ANSWER: Xray of GI
tract to see of lead is there. if it is, they flush it out to stop absorption
, when to use Chelation therapy for lead poisoning - ANSWER: -45-69 mcg/dL
outpatient therapy with oral succorer and parenteral disodium calcium edetate
->70 Hospitalization with dimercaprol and disodium calcium EDTA
-Monitor urinary output (possibly on 24 hour urine collection)
What do patients who have lead poisoning need in their diet? - ANSWER: Adequate
calcium, iron, and vitamin C
Chelation drugs - ANSWER: 1.Edetate calcium disodium (CaNA2EDTA)
2.Succimer (Chemet)
3.Dimercaprol (BAL in Oil)
Information on Chelation drug Edetate calcium disodium (CaNA2EDTA) - ANSWER: -
Given IM or IV for 5 days
- Increase lead concentrations in CNS resulting in encephalopathy in its with BLL >70
mcg/dL, used in combination with dimercaprol
Information on chelation drug Succimer (Chemet) - ANSWER: -Given po every 8hrs x
5 days, then every 12 hours x 2 wks
-Capsules contain small beads that can be mixed with food. Cannot be given through
a syringe
Information on chelation drug Dimercaprol (BAL in Oil) - ANSWER: -Drug of choice in
severe lead toxicity cases (BLL >70)
-IM every 4 hours with CaNA2EDTA started with dose 2
-Do not give with peanut allergy because it is made with peanut oil
-No iron supplements if receiving Dimercaprol because it can form toxic complex if
mixed with iron
Nursing interventions with lead poisoning - ANSWER: Monitoring parameters
-Blood lead levels
-Monitor fluid intake and urine output
-Seizure precautions
Dietary Considerations
-High iron
-Limit milk intake to 24 hours
-Adequate calcium and vitamin c
Prevention - screening
-Nutrition education: iron rich foods, calcium rich foods, vitamin c rich foods
Define sickle cell disease - ANSWER: Sickle cell disease is a group of disorders that
affects hemoglobin. People with this disorder have atypical hemoglobin molecules
called hemoglobin S, which can distort red blood cells into a sickle or crescent shape
What is normal adult hemoglobin? - ANSWER: Hemoglobin A
MULTIDIMENSIONAL CARE 1 FINAL/ MDC 1 FINAL EXAM
200+QUESTIONS AND CORRECT ANSWERS|RASMUSSEN
COLLEGE
Red blood cell production is stimulated by:
1. Tachycardia
2. Tachypnea
3. Renin angiotensin
4. Hypoxia - ANSWER: Hypoxia
4 Main components of blood composition - ANSWER: RBC, WBC, platelets, plasma
What is the composition of plasma - ANSWER: 90% H2O
10% solutes - glucose, protein, albumin, hormones, etc
Where is bone marrow aspiration in infants? - ANSWER: Tibia
Where is bone marrow aspiration in toddlers and preschoolers? - ANSWER: femur
and tibia
Where is bone marrow aspiration in children over 5? - ANSWER: pelvis (iliac crest)
Where is bone marrow production in young adults/adults? - ANSWER: ribs, sternum,
vertebra, pelvis, skull, clavicle, scapula
what is anemia - ANSWER: a condition in which levels of red blood cells and
hemoglobin are lower than normal
4 types of anemia - ANSWER: Iron deficiency
lead poisoning
sickle cell
B-thalassemia
Define iron deficiency anemia - ANSWER: reduction in the iron stores of the body
causing an inadequate production of hemoglobin
What is iron needed for? - ANSWER: to make hgb
signs and symptoms of iron deficiency anemia - ANSWER: pallor
tachycardia
tachypnea
lethargy
fatigue
,irritability
Why are neonates at risk for iron deficiency anemia? - ANSWER: -lack the maternal
iron stores
-Full term infants have maternal iron stores until approximately 6 months of age
-Havent had the time in utero to store up the needed iron supply (preterm)
How can you treat a neonate with iron deficiency anemia? - ANSWER: Iron fortified
formula
What are risk factors for iron deficiency anemia in infants and children? - ANSWER:
1.inadequate iron intake
2.Malabsorption of iron in GI tract
3.Chronic blood loss
Food with good sources of iron - ANSWER: red meat, egg yolk, leafy greens, dried
fruits, fortified cereals/formulas, beef, chicken, fish, beans, nuts, seeds, peanut
butter, eggs, prunes, whole grain bread
How is iron deficiency anemia diagnosed? - ANSWER: Serum lab evaluation:
-Red blood cell count = microcytic (small) and hypo chronic (pale in color)
-low hemoglobin
-low hematocrit
-low reticulocyte count
-low serum iron concentration
-high total iron binding capacity
What is the goal of treatment for iron deficiency anemia - ANSWER: treat medical
problem causing malabsorption or blood loss/ identify cause
What is the treatment method for iron deficiency anemia? - ANSWER: Increase iron
take
~ Dietary sources
~Medication supplement (ferrosol or ferrous sulfate)
What should nurses and parents know about administering iron to children? -
ANSWER: -Administer to back of mouth because it stains teeth, can cause
constipation, and black/green stool
-Give with orange juice or citric acid to help with absorption
-Do not give with milk or antacids
-Give on empty stomach unless GI distress
Lead Poisoning Risks - ANSWER: -Children under the age of 6
-Children living at or below the poverty line who live in older (prior to 1978) housing
-Children adopted from other countries where there are less strict environmental
regulations
,Environmental causes of lead poisoning - ANSWER: -Lead based paint
-Plumbing from lead pipes
-soil
Dietary factors of lead poisoning - ANSWER: -iron deficiency
-calcium deficiency
Patient-child interactions - ANSWER: -Job or hobby exposure
-home remedies or cultural practices
How does lead poisoning cause anemia - ANSWER: lead can replace iron on Hgb
causing O2 to not be delivered causing anemia
Clinical manifestation of lead poisoning - ANSWER: -Asymptomatic
-Signs of anemia
-Growth and developmental lags
-Behavioral changes
-Neurologic changes
-Gastrointestinal changes
can someone be asymptomatic if they have lead poisoning - ANSWER: yes
signs of anemia (lead poisoning) - ANSWER: pallor, fatigue, weakness, shortness of
breath, headache, tachycardia - because lead replaces iron in Hgb causing anemia
Growth and developmental lags in lead poisoning - ANSWER: learning difficulties
Neurologic signs and symptoms of lead poisoning - ANSWER: -Headache, irritability,
difficulty concentrating, loss of motor skills, paralysis, tremors
High levels: encephalopathy, seizures, and brain damage
Gastrointestinal signs and symptoms of lead poisoning - ANSWER: abdominal pain,
failure to gain weight, weight loss, vomiting, constipation
Lead poisoning diagnostics - ANSWER: Blood lead level (BBL) test
-5mcg/dL = lead exposure
-45 mcg/dL = medical treatment required with chelation therapy
->70= mcg/dL = severe lead toxicity
Therapeutic management of lead poisoning - ANSWER: -Decontamination
-Chelation
-Supportive therapy
-Deterrence and prevention
How do you decontaminate a person with lead poisoning? - ANSWER: Xray of GI
tract to see of lead is there. if it is, they flush it out to stop absorption
, when to use Chelation therapy for lead poisoning - ANSWER: -45-69 mcg/dL
outpatient therapy with oral succorer and parenteral disodium calcium edetate
->70 Hospitalization with dimercaprol and disodium calcium EDTA
-Monitor urinary output (possibly on 24 hour urine collection)
What do patients who have lead poisoning need in their diet? - ANSWER: Adequate
calcium, iron, and vitamin C
Chelation drugs - ANSWER: 1.Edetate calcium disodium (CaNA2EDTA)
2.Succimer (Chemet)
3.Dimercaprol (BAL in Oil)
Information on Chelation drug Edetate calcium disodium (CaNA2EDTA) - ANSWER: -
Given IM or IV for 5 days
- Increase lead concentrations in CNS resulting in encephalopathy in its with BLL >70
mcg/dL, used in combination with dimercaprol
Information on chelation drug Succimer (Chemet) - ANSWER: -Given po every 8hrs x
5 days, then every 12 hours x 2 wks
-Capsules contain small beads that can be mixed with food. Cannot be given through
a syringe
Information on chelation drug Dimercaprol (BAL in Oil) - ANSWER: -Drug of choice in
severe lead toxicity cases (BLL >70)
-IM every 4 hours with CaNA2EDTA started with dose 2
-Do not give with peanut allergy because it is made with peanut oil
-No iron supplements if receiving Dimercaprol because it can form toxic complex if
mixed with iron
Nursing interventions with lead poisoning - ANSWER: Monitoring parameters
-Blood lead levels
-Monitor fluid intake and urine output
-Seizure precautions
Dietary Considerations
-High iron
-Limit milk intake to 24 hours
-Adequate calcium and vitamin c
Prevention - screening
-Nutrition education: iron rich foods, calcium rich foods, vitamin c rich foods
Define sickle cell disease - ANSWER: Sickle cell disease is a group of disorders that
affects hemoglobin. People with this disorder have atypical hemoglobin molecules
called hemoglobin S, which can distort red blood cells into a sickle or crescent shape
What is normal adult hemoglobin? - ANSWER: Hemoglobin A
