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NURS 3900 Exam 3 Guide With Complete Solution
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NURS 3900 Exam 3 Guide WithComplete Solution
Sickle Cell Disease: Definition - ANSWER A group of inherited
hemoglobinopathies in which the RBCs carry a less effective type of
hemoglobin
Sickle Cell Disease: genetics - ANSWER -Autosomal recessive inheritance
-Hgb SS: elongated, rigid RBC with a shortened lifespan
SCD: Sx (1) - ANSWER 1. General: possible growth or sexual maturation
delay, chronic anemia, susceptibility to sepsis
2. Cerebrum: stroke, visual disturbance, hemiparesis, seizure
3. Eyes: visual disturbance with possible progressive retinal detachment
4. Heart: cardiomegaly, systolic murmurs
5. Lungs: altered pulmonary function, increase risk to infection
SCD: Sx (2) - ANSWER 1. Abdomen: severe pain
2. Liver: obstructive jaundice, hepatomegaly, cirrhosis, hepatic coma
3. Spleen: splenomegaly, autosplenectomy
4. Kidney: hematuria, inability to concentrate urine
5. GU: priapism
6. Bones: avascular necrosis
,SCD: Acute chest syndrome - ANSWER What: sickling in small blood vessels
in lungs causing a crisis
Sx: chest pain, fever, cough, dyspnea, retractions, decreased O2
SCD: Stroke - ANSWER What: crisis within cerebrum
Sx: twitching, inability to move are or leg, staggering, slurred speech,
weakness in extremities, change in vision
SCD: vaso-occlusive crisis assessments - ANSWER Important for pain
assessment: pain scale upon admission, frequent evaluation of pain. Always
believe child's report of pain!
What are side effects of iron? - ANSWER Constipation
SCD: importance of fluid intake - ANSWER -Deficient fluid volume occurs as
result of decreased intake, increased fluid requirement during vaso-occlusive
episode, and kidney's ability to concentrate urine
-Increase fluid intake will dilute blood and decrease its viscosity
What can increase risk of iron deficient anemia? - ANSWER Cow's milk
overuse especially in infants. In infants less than 1 yo, use iron fortified
formula or breast milk
Anemia: what it is - ANSWER Condition in which level of RBCs is lower than
normal value. Develops as a result of decreased production of RBCs or loss
and destruction of RBCs.
Anemia: types - ANSWER 1. Iron-deficiency anemia: body doesn't have
enough iron to produce Hgb
2. Folic acid deficiency, pernicious anemia, lead poisoning
,3. Aplastic anemia: failure of bone marrow to produce cells
4. Sickle cell anemia
Iron-Deficiency anemia - ANSWER Risk factors: cow's milk consumption
before 1 yo, lack of iron supplementation, meds interfering with iron
absorption
-Assessment: fatigue, pallor, spooning of nails, tachycardia, low pulse ox,
splenomegaly
-Interventions: safety from injury d/t falls, increase dietary intake of iron
Lead poisoning - ANSWER -condition caused by toxic levels of the metal lead
in the blood
-assessment: behavioral problems, learning difficulties, encephalopathy,
seizure, brain damage
-intervention: Screen for lead exposure, chelation therapy
Aplastic anemia - ANSWER -Assessment: determine hx of exposure to
myelosuppressive meds or radiation therapy, hx of epistaxis, increased bleed
with menstruation, note ecchymoses, petechiae, purpura, tachycardia,
tachypnea
-Intervention: preventing injury
Hemophilia: what it is - ANSWER Group of x-linked recessive disorders that
result in deficiency in one of the coagulation factors in the blood.
Transmitted by carrier mothers to their sons
Hemophilia: types - ANSWER Hemophilia A: factor VIII deficiency
Hemophilia B: christmas disease, factor IX deficiency
, Hemophilia C: factor XI deficiency
Hemophilia: sx - ANSWER Any sx of bleeding: nosebleed, bruising, GI bleed,
chest pain, abdominal pain
Hypovolemia, shock
Hemophilia: interventions - ANSWER 1. Prevent bleed episodes: regular
physical activity to keep muscles and joints stronger and have fewer bleed
episodes
2. Manage bleed: Factor VIII replacement, apply pressure or cold compress
Hemophilia: activities that children can participate in - ANSWER Level 1:
bicycling, fishing, swimming, walking
Level 2: baseball, basketball, running, skateboarding, volleyball
Level 3 (dangerous): boxing, football, rock climbing, hockey
Does hypoxia control RBC production? - ANSWER Yes, it can increase RBC
production
Leukemia: What it is - ANSWER Bone marrow disorder causing distorted and
uncontrolled proliferation of immature WBCs which can accumulate and
crowd marrow space, blood, and other organs
Leukemia: ALL vs AML - ANSWER ALL: abnormal lymphoid cell differentiation
and division (affects lymphoblasts and B/T cells), most common childhood
cancer
AML: abnormal myeloid cell differentiation and division (affects RBCs,
granulocytes, monocytes, platelets), second most common type of leukemia
Leukemia: sx - ANSWER 1. Pain
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