NR 328 Exam 3 | Actual Questions and Answers Latest Updated 2024/2025
(Graded A+)
Iron Supplementation - ✔✔- limit milk intake (24 oz)
- stool might be black/green/tarry
- give with vitamin c
- use dropper or straw to avoid discoloring teeth
- do not give with dairy
- fatal in overdose
Chelating Agents - ✔✔removes iron if there's too much
Anemia: Diet (AVOID) - ✔✔avoid milk and vegan diets
Anemia: Assessment - ✔✔- pallor
- fatigue
- overweight "milk baby"
- pica habit
Anemia: Lab Values - ✔✔- decreased hemoglobin
- low serum iron
- elevated total iron binding capacity
Anemia: Diet (INCLUDE) - ✔✔- meat
- leafy greens
- fish
- liver
- whole grains
- legumes
,Anemia: Transfusions - ✔✔- consent
- must be checked with 2 RNs
- vitals Q15 after started and then Q1hr
- stay with patient for first 15 min
Blood Transfusion: S/S of Reaction - ✔✔- anxiety
- pain at infusion site
- crying
- flank pain
- temperature increased by more than 1 degree F
- stop immediately - flush IV and hang new bag of saline
- start within 30 minutes and finish in 4 hours
Sickle Cell: Care - ✔✔- minimize energy output
- hydration
- pain relief (no ice)
- prevent infection
- monitor I&O
- oxygen if hypoxic
Sickle Cell: Teaching - ✔✔- call HCP if temp is >101
- give fluids before bed (enuresis is normal)
- avoid contact sports
- do not refuse meds, they're in pain, not addicted
- NO meperidine (demerol) can cause seizures
Thalassemia: Treatment - ✔✔frequent transfusions can lead to iron overload-chelation therapy is used
(deferoxamine)
, Hemophilia: Labs - ✔✔- PTT is prolonged
- type A - factor 8 deficiency
- type B - factor 9 deficiency
Prevention of Bleeding in Hemophilia - ✔✔- soft tooth brush
- notify dentist
- electric razor
- pressure and ice for 15 min for superficial bleeding
- transfusions
- RICE
- active ROM after bleeding stops
RICE - ✔✔- rest
- ice
- compression
- elevate
Hemophilia and Joint Injuries - ✔✔- avoid obesity (joint injuries)
- bleeding into joint spaces - leads to impaired mobility
- bleeding into neck, chest, mouth = airway concern
Idiopathic Thrombocytopenia - ✔✔- acquired hemorrhagic disorder
- safe environment
- destruction of platelets
- URI
- restrict activity while platelets are low
- no contact sports
(Graded A+)
Iron Supplementation - ✔✔- limit milk intake (24 oz)
- stool might be black/green/tarry
- give with vitamin c
- use dropper or straw to avoid discoloring teeth
- do not give with dairy
- fatal in overdose
Chelating Agents - ✔✔removes iron if there's too much
Anemia: Diet (AVOID) - ✔✔avoid milk and vegan diets
Anemia: Assessment - ✔✔- pallor
- fatigue
- overweight "milk baby"
- pica habit
Anemia: Lab Values - ✔✔- decreased hemoglobin
- low serum iron
- elevated total iron binding capacity
Anemia: Diet (INCLUDE) - ✔✔- meat
- leafy greens
- fish
- liver
- whole grains
- legumes
,Anemia: Transfusions - ✔✔- consent
- must be checked with 2 RNs
- vitals Q15 after started and then Q1hr
- stay with patient for first 15 min
Blood Transfusion: S/S of Reaction - ✔✔- anxiety
- pain at infusion site
- crying
- flank pain
- temperature increased by more than 1 degree F
- stop immediately - flush IV and hang new bag of saline
- start within 30 minutes and finish in 4 hours
Sickle Cell: Care - ✔✔- minimize energy output
- hydration
- pain relief (no ice)
- prevent infection
- monitor I&O
- oxygen if hypoxic
Sickle Cell: Teaching - ✔✔- call HCP if temp is >101
- give fluids before bed (enuresis is normal)
- avoid contact sports
- do not refuse meds, they're in pain, not addicted
- NO meperidine (demerol) can cause seizures
Thalassemia: Treatment - ✔✔frequent transfusions can lead to iron overload-chelation therapy is used
(deferoxamine)
, Hemophilia: Labs - ✔✔- PTT is prolonged
- type A - factor 8 deficiency
- type B - factor 9 deficiency
Prevention of Bleeding in Hemophilia - ✔✔- soft tooth brush
- notify dentist
- electric razor
- pressure and ice for 15 min for superficial bleeding
- transfusions
- RICE
- active ROM after bleeding stops
RICE - ✔✔- rest
- ice
- compression
- elevate
Hemophilia and Joint Injuries - ✔✔- avoid obesity (joint injuries)
- bleeding into joint spaces - leads to impaired mobility
- bleeding into neck, chest, mouth = airway concern
Idiopathic Thrombocytopenia - ✔✔- acquired hemorrhagic disorder
- safe environment
- destruction of platelets
- URI
- restrict activity while platelets are low
- no contact sports
