Families Exam 5 - hematologic disorders

Question 1

What does iron deficiency anemia look like?

Answer 1

• decreased H&H
• brittle, spoon-shaped nails
• pallor, fatigue

Question 2

When can iron supplements NOT be given?

Answer 2

1 hr before or 2 hrs after milk/antacids

Question 3

When is it best to give iron supplements?

Answer 3

on an empty stomach

Question 4

What is it best to give iron supplements with?

Answer 4

vitamin C
- orange juice

Question 5

How can staining of teeth be prevented with oral iron supplements?

Answer 5

• use a straw
• brush teeth after

Question 6

How should iron supplement injections be given?

Answer 6

• z-track
• IM

Question 7

What normal finding happens with iron supplements?

Answer 7

tarry, green stools

Question 8

How much milk should a toddler taking iron supplements consume?

Answer 8

no more than 32 oz/day

Question 9

What type of anemia causes jaundice, SOB, cold hands/feet, dizziness, and HA?

Answer 9

sickle cell anemia

Question 10

A vaso-occlusive crisis can occur with sickle cell anemia. What happens with this?

Answer 10

• severe pain (bones, joints, abdomen)
• swollen joints/hands/feet

Question 11

Sequestration can occur with sickle cell anemia. What happens with this?

Answer 11

• splenomegaly
• possible hepatomegaly
• hypovolemia/hypovolemic shock

Question 12

Aplastic crisis can occur with sickle cell anemia. What does this cause?

Answer 12

• decreased RBC production
• extreme anemia

Question 13

What do tachycardia, hypotension, decreased urine output, and a pale/weak pulse indicate with sickle cell anemia?

Answer 13

shock

Question 14

What is important to maintain with sickle cell anemia?

Answer 14

HYDRATION!!!
- give fluids
- maintain F&E balance

Question 15

What pain medication is given for sickle cell anemia? What pain medication is contraindicated?

Answer 15

• YES: morphine
• NO: meperidine

Question 16

Why is meperidine contraindicated for sickle cell anemia?

Answer 16

it increases the risk for seizures

Question 17

What can increasing fluids cause with sickle cell anemia?

Answer 17

hypokalemia

Question 18

What complications can occur with sickle cell anemia?

Answer 18

• cerebrovascular accident
• acute chest syndrome

Question 19

What does a cerebrovascular accident look like with sickle cell anemia?

Answer 19

• seizures
• abnormal behavior
• weakness/inability to move extremity
• slurred speech
• visual changes
• HA
• vomiting

Question 20

What does acute chest syndrome look like with sickle cell anemia?

Answer 20

• chest/back/abdominal pain
• fever > 101.3
• cough
• dyspnea, tachypnea
• retractions
• decreased O2 sat

Question 21

What deficiency occurs with haemophilia A?

Answer 21

factor VIII

Question 22

What deficiency occurs with haemophilia B?

Answer 22

factor IX

Question 23

What does haemophilia look like?

Answer 23

• BLEEDING
• joint pain and stiffness
• prolonged aPTT

Question 24

What type of sports can children with haemophilia play?

Answer 24

low-impact
- wear protective equipment (helmet)

Question 25

How can you control bleeding with haemophilia?

Answer 25

• pad corners of furniture
• use a soft-bristled toothbrush
• use RICE (rest, ice, compression, elevation)

Question 26

What medication can be used for haemophilia? What medication should NOT be used?

Answer 26

• YES: acetaminophen
• NO: aspirin

Question 27

What are adverse effects of replacing factor VIII or IX?

Answer 27

• HA
• flushing
• decreased sodium
• alterations in HR and BP