Deck 44: Nursing Care of a Family When a Child Has a Hematologic Disorder

Question 1

The nurse has been asked to participate in a community health teaching session. Which interventions should the nurse include to help achieve the 2020 National Health Goals to reduce the incidence of anemias? (Select all that apply.)

A) Explain the importance of healthy eating for adolescent participants.
B) Instruct pregnant women to take iron supplementation as prescribed.
C) Emphasize ways to reduce unintentional injuries at home, work, and play.
D) Review foods that are rich in iron that should be a part of school-age children's diets.
E) Examine strategies for elderly community members to improve the quality of life.

Answer 1

Explain the importance of healthy eating for adolescent participants.
Instruct pregnant women to take iron supplementation as prescribed.
Review foods that are rich in iron that should be a part of school-age children's diets.

Question 2

The nurse is concerned that a school-age child has iron-deficiency anemia. What did the nurse assess in this patient?

A) Shyness
B) Thumb-sucking
C) Asks many questions
D) Craving for ice cubes

Answer 2

Craving for ice cubes

Question 3

The nurse is evaluating the effectiveness of teaching provided to the parents of a school-age child prescribed liquid ferrous sulfate (Feosol) for iron-deficiency anemia. Which observations indicate that teaching has been effective? (Select all that apply.)

A) Mother places medication in orange juice.
B) Mother provides medication with a glass of milk.
C) Child observed consuming fresh raw fruit and drinking water.
D) Mother provides liquid-prepared medication to the child with a straw.
E) Child goes to the bathroom to brush teeth immediately after taking the medication.

Answer 3

Mother places medication in orange juice.
Child observed consuming fresh raw fruit and drinking water.
Mother provides liquid-prepared medication to the child with a straw.
Child goes to the bathroom to brush teeth immediately after taking the medication.

Question 4

A school-age child weighing 55 lb is prescribed to receive 15 ml/kg of packed red blood cells. If the child is to receive 10 ml/kg/hr, how many hours will it take to infuse the prescribed amount of blood for this patient? (Calculate to the nearest 10th decimal point.)

Question 5

A school-age child is scheduled for a bone marrow aspiration to confirm the diagnosis of aplastic anemia. What should the nurse instruct the child about this procedure?

A) Leg pain will occur after the procedure.
B) It will be done under general anesthesia.
C) A narrow needle is used so there is no pain.
D) The patient will have to lie on the stomach for the procedure.

Question 6

It is determined that a preschool-age child developed anemia after exposure to an insecticide. What should the nurse teach the parents before the child is discharged from the hospital?

A) Schedule weekly chelating treatments.
B) Provide the child with a high-protein diet.
C) Schedule hospital visits to desensitize the child to the insecticide.
D) Ensure that the child has no further exposure exposed to the insecticide.

Question 7

A toddler weighing 22 lb with hemophilia A fell down several steps and sustained a knee injury. The parents have been instructed to provide the child with an infusion of factor VIII concentrate, one bag per 5 kg of body weight. How many bags of the concentrate will the parents infuse into the child? (Calculate to the nearest tenth decimal point.)

Question 8

The nurse is caring for a school-age child recovering from an allogeneic stem cell transplant. What should the nurse do to ensure the child does not develop an infection after the transplant? (Select all that apply.)

A) Restrict all visits from other children.
B) Provide sterilized age-appropriate play materials.
C) Send for total body irradiation immediately after the transplant.
D) Make arrangements for schoolwork to be delivered to the hospital.
E) Encourage eating raw vegetables for each meal after the procedure.

Question 9

A child with hypoplastic anemia develops hemosiderosis. What should the nurse prepare to instruct the parents about the treatment for this disorder?

A) Need to avoid all products containing aspirin
B) Need to infuse deferoxamine (Desferal) at home
C) Importance of daily doses of ferrous sulfate (Feosol)
D) Importance of adhering to a strict schedule of prednisone

Question 10

The nurse is assessing a school-age child with sickle-cell anemia. Which assessment finding is consistent with this patient's diagnosis?

A) Slightly yellow sclera
B) Enlarged mandibular growth
C) Increased growth of long bones
D) Depigmented areas on the abdomen

Question 11

An 18-month-old child is diagnosed with insufficient platelets. What should the nurse instruct the parents to reduce the risk of the child bleeding when at home? (Select all that apply.)

A) Check that all toys have soft corners.
B) Engage in limited amounts of rough play each day.
C) Ensure mouth care is performed with a soft toothbrush.
D) Do not apply Band-Aids or adhesive tape onto the skin.
E) Pad the side and crib rails on the bed at home to prevent bruising.

Question 12

The nurse is instructing the parents of a child with sickle-cell anemia on safety precautions. What should the nurse emphasize during this teaching?

A) Suggest the child participate in sports activities without restriction.
B) Treat upper respiratory infections with over-the-counter medication.
C) Ensure a consistent and daily intake of adequate fluids to prevent dehydration.
D) Remind to avoid immunizations to prevent the introduction of bacteria into the body.

Question 13

While receiving a transfusion of packed red blood cells, a school-age child begins to experience itchy skin, hives, and wheezes. What should the nurse do first for this child?

A) Stop the transfusion.
B) Obtain a blood culture.
C) Slow the transfusion rate.
D) Provide a diuretic as prescribed.

Question 14

Which nursing diagnosis should the nurse identify as being the most appropriate for a child with idiopathic thrombocytopenic purpura?

A) Risk for infection related to abnormal immune system
B) Risk for bleeding related to insufficient platelet formation
C) Risk for altered urinary elimination related to kidney impairment
D) Ineffective breathing pattern related to decreased white blood count

Question 15

The nurse is planning care for a school-age child recovering from being hit by a motor vehicle while riding a bicycle home from school. For what will the nurse assess to determine the onset of disseminated intravascular coagulation in this child?

A) Blurred vision
B) Nausea and vomiting
C) Sudden onset of knee pain
D) Bleeding from intravenous sites