Patho Chap 21 – Flashcards

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question
A 1-year-old female is diagnosed with anemia secondary to insufficient erythropoiesis. When the parents asked what caused this, how should the nurse respond? The most likely cause(s) is (are):
answer
An iron deficiency
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A 12-month-old toddler weighing 18 pounds is brought to the clinic because of weakness, slow physical growth, and developmental delays. His mother reports that the only food he will consume is cow's milk. Considering this information, the nurse decides that the child probably has _____ anemia.
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Iron deficiency
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A 16-month-old female presents with tachycardia, pallor, anorexia, and systolic murmur. The nurse is checking the lab results, and the hemoglobin determination indicates a level below _____ g/dL.
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5
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Which mother is at most risk for a maternal-fetal blood incompatibility?
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Mother is Rh-negative, and fetus is Rh-positive.
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A 22-year-old female gives birth at 20 weeks' gestation to a stillborn fetus. Physical exam of the fetus by the nurse reveals gross edema of the entire body and anemia. This condition is referred to as:
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Hydrops fetalis
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Sickle cell disease is characterized by the presence of Hb S. A nurse is trying to differentiate between Hb S and normal Hb. Which of the following amino acids is present in Hb S and not present in normal Hb?
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Valine
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A 10-year-old male is diagnosed with sickle cell anemia. When the parents ask who is responsible for this disease, what is the nurse's best response? He most likely inherited it from:
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Both his mother and father
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In the United States, which group of people should be assessed first for sickle cell disease?
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African-Americans
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A 25-year-old female has a child that is diagnosed with sickle cell anemia. She does not have the disease. Which of the following characterizes the genetic makeup of the parents with regard to this trait?
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Hb S and Hb A
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When should the nurse start closely monitoring the patient with sickle cell anemia? If:
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Oxygen tension is low
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A 12-year-old male is diagnosed with sickle cell anemia. A blood smear reveals severely sickled cells. A nurse recalls the sickled cells will be removed from circulation mostly by the:
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Spleen
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Which major symptom in a patient with sickle cell anemia indicates to the nurse, the patient is experiencing a vaso-occlusive crisis?
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Pain
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For which type of sickle cell crisis should the nurse assess for in young children?
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Sequestration crisis
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A 6-year-old male presents with fatigue, jaundice, and irritability. A blood smear shows the presence of sickled cells. Erythropoiesis is compromised in this child; which crisis should the nurse monitor the patient for?
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Aplastic crisis
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A 5-year-old female dies from sickle cell disease. The pediatrician will document the most likely cause of death is:
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Infection
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A geneticist is discussing thalassemias. Which information should be included? The alpha and beta thalassemias are inherited in an _____ fashion.
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Autosomal recessive
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A 2-year-old male presented with growth and maturation retardation and splenomegaly. He died shortly after arriving at the ER. Autopsy revealed thalassemia secondary to defective:
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Hemoglobin synthesis
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A 38-year-old female gives birth to a stillborn fetus. Autopsy reveals cardiomegaly, hepatomegaly, edema, and ascites. Which of the following does the nurse suspect caused the death?
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Alpha thalassemia major
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If an infant has hydrops fetalis, which type of thalassemia does the nurse suspect?
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Alpha major
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The mother of a 3-year-old child speaks to the pediatrician because the child took several hours to stop bleeding following a minor scrape. Testing reveals that the child has hemophilia A resulting from a deficiency in factor:
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VIII
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A nurse wants to chart the other name for hemophilia B. Which term should the nurse write?
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Christmas disease
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A 3-year-old child presents with bruising on the legs and trunk and a petechial rash. The mother also reports frequent nosebleeds. Lab tests reveal a decreased platelet count. Which is the most likely diagnosis the nurse will see documented on the chart?
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Idiopathic thrombocytopenic purpura (ITP)
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A 5-year-old male is diagnosed with idiopathic thrombocytic purpura (ITP). Which information should the nurse give the staff regarding the cause of this condition?
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Virally induced antibody destruction of platelets
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Which of the following clusters of symptoms would lead the nurse to suspect a child has idiopathic thrombocytopenic purpura (ITP)?
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Spontaneous nosebleeds, bruising, petechiae
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A 1-year-old is diagnosed with idiopathic thrombocytopenic purpura (ITP). The nurse assesses for the most serious concern, which is development of:
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Intracranial bleeding
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A nurse monitors for the most common childhood cancer, which is:
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Acute lymphoblastic leukemia (ALL)
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A 10-year-old male with Down syndrome undergoes chemotherapy for cancer. Following treatment, monitoring for which condition is priority?
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Acute myelogenous leukemia (AML)
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A 10-year-old female is diagnosed with a malignancy in the brain and lung. DNA analysis reveals translocation at chromosome 7 and 14. The most likely medical diagnosis the primary care provider will make is:
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Lymphoblastic non-Hodgkin lymphoma (NHL)
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Which condition makes the patient most prone for developing non-Hodgkin lymphoma (NHL)?
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AIDS
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What is a priority assessment for Hodgkin lymphoma in children?
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Painless adenopathy in cervical nodes
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Which laboratory test will assist the nurse in identifying infants who are prone to develop hemolytic disease of the newborn (HDN)?
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Coombs
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A nurse is planning care for a child with iron deficiency anemia. What are characteristics of iron deficiency?
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It is most common between the ages of 6 months and 2 years. It may be related to socioeconomic factors. It is difficult to diagnose in early stages.
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A 5-year-old male is diagnosed with leukemia. Which symptoms would the nurse expect?
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Fatigue Pallor Petechiae
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