peds chp 28
Select the rationale for the relationship between children having anemia and lead poisoning?
Children with anemia absorb lead more easily
A child with severe anemia requires a unit of red blood cells(RBC) the nurse explains to the child that the transfusion is necessary for which reason?
Increase her energy so she will not be so tired
What explanation provides the rationale for why iron deficiency anemia is common during infancy?
Cows milk is a poor source of iron
what statement best describes iron deficiency anemia in infants?
Clinical manifestations are related to a reduction in the amount of oxygen available to tissue
The nurse is preparing a community outreach program about the prevention of iron deficiency anemia infants what statement should the nurse include in the program?
Breastmilk or iron fortified formula should be used for the first 12 months
What rationale explains why prolonged use of oxygen should be discouraged in a child with anemia?
Prolonged use of oxygen can decrease erythopoiesis
An overweight toddler with iron deficiency anemia which is the most likely explanation for the anemia?
Excessive intake of milk
An 8 yo girl is recieving a blood transfusion when the nurse notes she has developed precordial pain dyspnea distended neck veins slight cyanosis and a dry cough these manifestations are most suggestive of what complications?
Circulatory overload
Iron overload is a side effect of chronic transfusion therapy what treatment assists in minimizing this complication
Infusion of deferoxamine
The nurse is preparing to administer a unit of packed red blood cells to a hospitalized child what is an appropriate action that applies to administering blood?
Administer the first 50 mL of blood slowly and stay with child
What are signs and symptoms of anemia? (SATA)
Pallor
fatigue
muscle weakness
The nurse is administering a unit of blood to a child what are the signs and symptoms of a transfusion reaction?(SATA)
Chills
shaking
sudden severe headache
The nurse is evaluating causes for iron deficiency due to impaired iron absorption what should the nurse recognize as causes for iron deficiency due to impaired iron absorption
Chronic diarrhea
lactose intolerance
inflammatory bowel disease
Child with sickle cell crisis which signs and symptoms shows a child is having minor cerebral attack
Headache weakness visual disturbances
The nurse is developing the plan of care for a hospitalized child with von williebrand disease what priority nursing intervention should be included in this child plan of care?
Guard against bleeding
what therapeutic intervention is most appropriate for a child with B thalassemia major?
Frequent blood transfusion
The nurse is teaching the family of a child age 8 years with moderate hemophilia about homecare what should the nurse tell the family to do to stop the bleeding?
Administer DDAVP
The nurse is planning teaching for the parents of a child newly diagnosed with hemophilia will include information about which long term complication?
Joint destruction
The nurse provides discharge teaching for the parents of a child newly diagnosed with hemophilia A which statement by the parents indicate that the teaching has been effective? (SATA)
Our child should wear a medical alert bracelet @ all times
We should avoid giving our child over the counter medications containing aspirin
We should encourage a non contact sport such as swimming
The clinic nurse supervises a student nurse who is preparing to administer routine vaccinations to a child diagnosed with hemophilia period which instructions should the nurse provide to the student?
Administer vaccines via subcutaneous route
Hold firm on the site for 5 mins
The nurse recieves 4 prescriptions for a child diagnosed with hemophilia A who was brought to the emergency department following an injury on the school playground the child has vomited once & has a headache which prescription should the nurse carry out first?
Administer IV factor VIII
The school is caring for a child with hemophilia who fell on his arm during recess what supportive measures would the nurse implement first?
Elevate arm above level of heart
The nurse is teaching the family of a child with a 8 yo with moderate hemophilia about home care what should the nurse tell the family to do to minimize joint injury?
Provide IV infusion factor VIII concentrates
The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alterations?
Increased red blood cells destruction
What pain medication is contraindicated in children with sickle cell disease?
Merperdine( Demerol)
Which drink on a hot day indicates to the nurse that a teenager with sickle cell anemia understands dietary considerations related to the disease?
Lemonade
The parents of a child with sickle cell anemia(SCA) are concerned about subsequent children having the disease what statement most accurately reflects inheritance of SCA?
Each sibling has a 25% chance of having SCA
The nurse is triaging a 7 yo with sickle cell crisis the client is short of breath & vomiting and has a severe generalized body & joint pain what assessment finding requires the most immediate intervention?
Enlarged spleen on palpation
A teenage client with sickle cell disease is admitted with a diagnosis of crisis the clients current prescription is morphine 2mg intravenous push every 4 hours prn the client appears comfortable while watching television & tells the nurse I have severe intolerable pain & rates it @ a 10 what action should the nurse take?
Call the HCP for pca @ high dose of the same drug
The nurse is preparing to administer a unit of packed red blood cells to a hospitalized child what are appropriate actions that applies to administering blood? (SATA)
Administer blood with normal saline in a piggyback set up
Administer the first 50mL of blood supply slowly & stay with child
Administer blood through appropriate filter
The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesic causing addiction the nurse would explain what concerning narcotic analgesics?
When they are medically indicated children rarely become addicted
What is priority nursing considerations when caring for a child with sickle cell anemia?
Teach the parents how to recognize the signs and symptoms
In a child with sickle cell anemia(SCA) adequate hydration is essential to minimize sickling & delay the vasoocculsion & hypoxia ischemia cycle what information should the nurse share with parents in a teaching plan? (SATA)
Monitor child for sign of dehydration
Check for moist mucous membranes