12-The nursing student is presenting a clinical conference and discusses the cause of B-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these? 1.A child of Mexican descent 2.A child of Mediterranean descent 3.A child whose intake of iron is extremely poor 4.A breast-fed child of a mother with chronic anemia 13- A child with B-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed? 1.Fragmin 2. Meropenem 3.Metoprolol 4.Deferoxamine
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- 14- The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction? 1.Stress 2.Trauma 3. Infection 4.Fluid overload 15-A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? 1.Injection of factor X 2.Intravenous infusion of iron 3. Intravenous infusion of factor VIII 4.Intramuscular injection of iron using the Z-track method10-A child with thalassemia was given desferoxamine (Desferal); which of the following should alert the nurse to notify the physician? A. Decreased hearing B. Hypertension C. Red urine D. Vomiting 11-The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? 1.Soccer 2.Basketball 3.Swimming 4.Field hockeyCase #2Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years, but quit 3 years ago. Mr. H suggests hypoxemia and respiratory alkalosis which might be an indication of serious illness such as pulmonary embolism. Part 1: His arterial-venous oxygen content (Ca-vO2) difference is 5.73 mL/dL Part 2: His extraction ratio (ER) 0.276 or 27.6% What is clinically happening to the patient? Please explain.
- 16-The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? 1. Administer the iron at mealtimes. 2.Administer the iron through a straw. 3. Mix the iron with cereal to administer. 4. Add the iron to formula for easy administration 17- Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? 1.Elevated hemoglobin level 2.Decreased reticulocyte count 3.Elevated red blood cell count 4. Red blood cells that are microcytic and hypochromicCase #2Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years, but quit 3 years ago. Part 1: What is his arterial-venous oxygen content (Ca-vO2) difference? Part 2: Calculate his extraction ratio please.Case #2Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough,hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years, but quit 3 years ago.Blood work values on room air:Blood Gas Blood Gas Arterial Venous pH 7.51 7.40 PaCO2 30 mmHg 45 mmHg PaO2 60 mmHg 30 mmHg HCO3 24 mEq/l 21 mEq/l BE - 1 - 4 SaO2 90% 60% Hb 15 g/dl 15 g/dl Part 1: Interpret the ABGPart 2: What is the arterial- venous oxygen content (Ca-vO2) difference for this patient?
- 8. A 54 y/o Female presented to the emergency room w/ CC of dyspnea. The patient has a significant PMH of T2DM, GAD, CVD, and MI. The patient reported weight loss of 15 pounds in 2 weeks. The patients weight is 185lb and her height is 175cm. She reports that dietary intake has been poor and she cannot make it to the store without having SOB. She states her usual weight is 200lb. Find her energy needs using the Mifflin-St. Jeor equation 10. A 26 y/o F was admitted for GI discomfort, poor appetite, N/V/D. Upon ultrasound a bezoar was discovered in the distal large intestine. She repots a 10 pound weight loss in 2 weeks. Her current weight is 165 pounds or 75kg and her height is 160cm. Find her energy needs Using the Harris-Benedict equationPatient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…19-The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that not apply. A. Easy bruising occurs. B. Gum bleeding occurs. C. It is a hereditary bleeding disorder. D. Treatment and care are similar to that for hemophilia. E. It is characterized by extremely high creatinine levels. F. The disorder causes platelets to adhere to damaged 73-When positioning the neonate with an unrepaired myelomeningocele, which of the following positions would be most appropriate ? a. supine the hip at 90 degree flexion b. right side-lying position with knees flexed c. prone with hips in abduction d. semi-fowler's position with chest and abdomen elevated
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 1. His wife tells you that he has started having hallucinations. Which medication might be causing this?Discuss why this happens.Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 5. List some general education points regarding sleep hygiene