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NUR200 Exam 3 – Questions & Accurate Solutions
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NUR200 Exam 3 – Questions & Accurate Solutions
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NUR200 Exam 3 – Questions & Accurate SolutionsVinca Alkaloids Right Ans - vincristine, vinblastine
Anemia causes Right Ans - -nutrient deficiency
-destruction of rbcs
-excessive blood loss
general anemia clinical manifestations Right Ans - -SOB, dyspnea
-fatigue
-pallor
-dizziness
-tachycardia
-palpitations
-systolic murmurs
-less commonly: bone pain, sternal tenderness
Hematocrit normal range Right Ans - female: 37-47%
male: 42-52%
Hemoglobin normal range Right Ans - 12-18 grams/dL
high hemoglobin may indicate: Right Ans - hemoconcentration caused by
polycythemia (inc. of rbc) or dehydration
low hemoglobin may indicate: Right Ans - anemia or recent hemorrhage
high hematocrit may indicate: Right Ans - hemoconcentration caused by
polycythemia (inc. of rbc) or dehydration
low hematocrit may indicate: Right Ans - anemia, blood loss, or fluid
volume excess
WBC normal range Right Ans - 4,500-11,000/mm3
Platelet count normal range Right Ans - 150,000-400,000/mm3
,RBC count normal range Right Ans - male: 4.6 - 6.2 million/mm3
female: 4.2 - 5.4 million/m3
Reticulocyte count normal range Right Ans - 0.5-1.5%
Reticulocytes are Right Ans - immature RBCs
reticulocyte may be increased with: Right Ans - blood loss or hypoxic
conditions
MCV (mean corpuscular volume) - size of the RBC Right Ans - 80-100 fL
MCH (mean corpuscular hemoglobin) - pigmentation of the RBC Right Ans -
25.4-34.6 pg/cell*
(commonly used: 27 - 31 pg/ cell)
MCHC (mean corpuscular hemoglobin concentration) - average concentration
of hemoglobin in the RBC Right Ans - 32 - 36 g/dL
nutritional anemia Right Ans - -iron
-vitamin B12 (pernicious)
-folic acid
iron anemia causes Right Ans - -diet low in iron (meat, fish, poultry)
-pregnancy
-gastric bypass
-infants of premature birth
-infants with excessive intake of milk
-premature infants exclusively fed breast milk (delayed introduction of solids)
iron anemia manifestations Right Ans - -SOB
-fatigue
-pallor
-tachycardia
-lightheadedness
-brittle hair, nail changes
-irritability/difficulty concentrating (common in children and elderly)
iron anemia labs Right Ans - Hgb <12
,Hct <37
RBC <4.2million
MCV <80 (microcytic)
MCH low (hypochromic)
low serum transferrin
low ferritin
low TBIC
Iron anemia treatment Right Ans - -inc dietary intake (meat, poultry, fish,
leafy greens, whole grains)
-dec excessive milk in infants
-ferrous sulfate PO
ferrous sulfate side effects Right Ans - Nausea, constipation, stool color
changes (not harmful), diarrhea, epigastric pain
ferrous sulfate patient teaching Right Ans - -take with meals to avoid GI
upset (loses absorption but increases compliance)
-stool softeners for constipation
-liquid form taken through straw to avoid staining teeth
-vitamin C help inc absorption
-avoid antacids
Iron dextran Right Ans - IM/IV administration: Iron-deficiency anemia
Only for patients with documented Fe deficiency who are
unable to tolerate or absorb oral preparations and for patients with extensive
chronic anemia who cannot be maintained with oral therapy alone
black box: anaphylaxis ; wait 1 hour after test dose before full dose
iron sucrose Right Ans - Anemia
Iron preparation - Parenteral
Should be reserved for patients with iron deficiency who are unable to
tolerate or absorb oral iron, and for patients with extensive chronic anemia
who cannot be maintained with oral iron alone.
Used to correct hypochromic microcytic anemia due to iron deficiency.
-less risk of anaphylaxis
, -s/e: hypotension
Vitamin B12 Anemia causes Right Ans - -decreased intestinal absorption
r/t lack of intrinsic factor
-total or partial gastrectomy
-vegetarians (less dietary intake --B12 comes from animal products)
-demyelination of spinal cord
vitamin b12 anemia manifestations Right Ans - -general anemia s/sx
-disturbances in gait, coordination, muscle weakness
-mood swings, memory changes, impaired judgement
-sore, smooth tongue (glossitis)
vitamin b12 deficiency anemia labs Right Ans - Hgb <12
RBC <4.2 million
MCV >80 (macrocytic)
gastric analysis - increased pH, no HCl
-Schilling Test - radioactive B12 administration
vitamin b12 deficiency anemia treatment Right Ans - -vitamin b12
supplements if able to absorb
-cyanocobalamin injections
Cyanocobalamin (Vitamin B12) teaching Right Ans - s/e flushing, optic
nerve atrophy, CHF, peripheral vascular thrombosis pulmonary edema,
folic acid deficiency anemia causes Right Ans - -chronic malnourishment
-alcoholism
-inc metabolic requirements (common in children and pregnant women)
folic acid deficiency anemia manifestations Right Ans - -general anemia
s/sx
-headache
-diarrhea
folic acid deficiency anemia labs Right Ans - Hgb <12
Hct <37
MCV >80 (macrocytic)
dec serum folate
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