Chapter 30. Hematologic Disorders
1. The nurse is assessing a client admitted with cyanotic heart disease. Which
hematology laboratory result does the nurse expect to assess?
a.
Anemia
b.
Polycythemia
c.
Normal
d.
Decreased hemoglobin
ANS: B
Polycythemia can occur as a result of hypoxia, such as that experienced at high altitude or
when oxygen is not sufficiently directed to the tissues, as in cyanotic heart disease. Anemia is
a decrease in the number of RBCs, a reduction in their hemoglobin content, or a reduced
volume of packed RBCs. Anemia results from one of two problems: either too rapid a loss of
RBCs (by covert or overt bleeding or destruction) or too slow a production of RBCs. Anemias
are categorized according to the size of the RBC (macrocytic, microcytic, normocytic) and the
content of hemoglobin in the RBC (hypochromic, normochromic). The hematology laboratory
result would not be normal because of the chronic hypoxia seen with cyanotic heart disease.
, 2. What is the best response to a parent who asks the nurse whether her 5-month-old infant
can have cows milk?
a.
You need to wait until she is 8 months old and eating solids
well. b.
Yes, if you think that she will eat enough meat to get the iron she
needs. c.
Infants younger than 12 months need iron-rich formula to get the iron they
need. d.
Try it and see how she tolerates it.
ANS: C
Infants younger than 12 months need iron-fortified formula or breast milk. Infants who drink
cows milk do not get adequate iron and are at risk for iron deficiency anemia. A 5-month-old
infant cannot get adequate iron without drinking an iron-fortified formula or taking an iron
supplement. The American Academy of Pediatrics recommends beginning solid foods at 4 to
6 months of age. Meats are typically introduced in late infancy. Counseling a parent to give a
5- month-old infant cows milk is inappropriate.
3. An assessment of a 7-month-old infant with a hemoglobin level of 6.5 mg/dL is likely
to reveal which of the following?
a.
An infant who is lethargic, pale, and
irritable b.
An infant who is thin, energetic, and sleeps
little c.
An infant who is anorexic, vomiting, and has watery
stools d.
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