ority information? - ANSWER -Iron can stain the skin and if the IV is painful or swollen it
can indicate infiltration where the iron is leaking out of the vessel.
-Melena is the black tarry stools and is caused by excess iron.
-Oral iron is best taken on an empty stomach but nausea is a common side effect. To combat
this they can take it with Orange juice (which improves absorption) or take at bedtime.
-Angular chelitis is a common symptom of iron deficiency anemia, as the anemia is corrected
the S/S of anemia should go away.
What are the priority assessments of a client diagnosed with thrombocytopenia? - AN-
SWER Thrombocytopenia can cause serious bleeding anywhere. The most worrisome
bleeding is hidden because it is often not caught until it is severe. Altered LOC is a priority
assessment to ensure no hemorrhage has occurred in the brain.
A client in sickle cell crisis questions the need for a type and screen. What would be the ap-
propriate response from the nurse? - ANSWER Your blood cells are being destroyed. We
will check your blood type to make sure that if you need to replace those destroyed blood
cells we can give you the kind your body will accept.
What are signs of hemorrhage? - ANSWER Shortness of breath due to decreased ability
to meet metabolic demand for O2
Palpitations due to tachycardia to attempt to increase cardiac output
Pallor due to decreased fluid volume, shunting to the core (decreased CO, decreased arterial
blood flow)
What education would be priority for a client receiving a blood transfusion? - ANSWER
Do not ignore symptoms such as chills, back pain, shortness of breath, or achiness.
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, How are clients with pernicious anemia treated? - ANSWER Pernicious anemia is caused
by failure to absorb B12 in the ileum, either due to an ileostomy or the autoimmune de-
struction of the intrinsic factor secreting cells. Treatment includes injections or nasal sprays
for life.
Blood transfusions are reserved for clients with an Hgb of less than 7, it is not the usual
treatment of pernicious anemia.
A diet rich in meats and grains can help with B12 deficient anemia if the problem arises from
malnutrition and not an absorption problem.
A diet rich in leafy greens and fish is a treatment for folic acid deficient anemia and would
not address the decreased B12 levels.
When differentiating megaloblastic anemias, what symptomology would be most differen-
tial? - ANSWER B12 is a required element for neurologic function. Paresthesia's and con-
fusion are manifestations of Pernicious anemia but not folic acid deficiency anemia.
The sore beefy red tongue and Dyspepsia and Nausea are symptoms of both megaloblastic
anemias. Weakness and fatigue are common symptoms for all anemias.
A client with a critically slow clotting time is admitted. What would be priority concerns for
this client? - ANSWER Fall precautions
musculoskeletal traction - ANSWER -Positioning a client in the prone position several
times a day will help to reduce the incidence of contracture
-Skin traction with a hip fracture decreases incidence of muscle spasm in the affected leg
-
What education would the nurse provide for the client recently diagnosed with polycythe-
mia? - ANSWER •Notify the provider if you start to have unilateral swelling to your legs or
arms.
•The FAST acronym with signs and pamphlets for close family and friends.
. Donating blood regularly may help reduce your symptoms.
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