A client reports glossitis + numbness/tingling. Hgb low, MCV high. This anemia is most likely.
What is vitamin B12 deficiency (pernicious) anemia?
A classic “first clue” symptom of iron deficiency anemia that NCLEX loves is craving this nonfood item.
What is ice (pagophagia) / pica?
Deep bleeding and hemarthrosis strongly point to this inherited disorder.
What is Hemophilia A?
In DIC, this lab is elevated due to increased clot breakdown.
What is D-dimer?
List 6 common triggers for a sickle cell crisis.
I am the transfusion reaction with sudden respiratory distress + pulmonary infiltrates that occurs within hours of transfusion and is NOT improved by diuretics.
What is TRALI (transfusion-related acute lung injury)?
List 3 priority nursing actions before initiating a blood transfusion?
What is verify informed consent and type & crossmatch/compatibility and obtain baseline VS?
Hemophilia bleeding is commonly deep tissue/joint bleeding. The correct non-pharmacological nursing care is:
What is RICE?
Rest, Ice, Compression, Elevation
Describe the pathophysiology behind DIC.
DIC is uncontrolled activation of coagulation that causes microvascular clotting → organ ischemia, then consumption of platelets/clotting factors → severe bleeding.
List 3 priority nursing actions for vaso-occlusive crisis.
Hydration, Oxygen, and Pain Control.
Crackles, HTN, SOB during transfusion in older adult/HF suggests:
What is TACO?
Hgb 7.1 with hypotension + dizziness: the nurse should first suspect and assess for:
What is active bleeding/hypovolemic shock?
In thrombocytopenia, one of the most life-threatening signs of a complication is sudden severe headache + confusion, because it suggests:
What is intracranial hemorrhage?
A nurse is caring for a client with platelets 12,000/mm³. List at least 6 thrombocytopenic (bleeding) precautions that should be implemented.
Avoid IM injections and minimize venipunctures
No rectal temps, enemas, suppositories
Use soft toothbrush / oral swabs (avoid flossing if bleeding risk)
Use electric razor (no blades)
Avoid aspirin/NSAIDs (increases bleeding risk)
Stool softeners to avoid straining/Valsalva
Fall precautions / avoid contact sports
Monitor for bleeding: petechiae, purpura, hematuria, melena, gum/nose bleeding
No invasive procedures unless essential
Sickle Cell Disease + fever + hypoxia + chest pain → suspect this life-threatening complication.
What is acute chest syndrome?
Child with Sickle Cell Disease becomes suddenly weak/lethargic, tachycardic, with enlarged spleen.
What is Splenic sequestration crisis?
This is how iron is absorbed best:
What to avoid when taking iron:
With Vitamin C (orange juice), 1 hour before meals or 2 hours after meals.
*Avoid taking with milk/dairy, calcium/antacids
*Education on black stools when taking iron
A septic patient begins oozing from IV sites and has hematuria. This points most strongly to:
What is DIC?
A chemotherapy client has an ANC of 420/mm³. List at least 6 neutropenic precautions the nurse should implement.
Strict hand hygiene
Private room
Screen visitors: no sick contacts, limit visitors
No fresh flowers/plants
Avoid raw/undercooked foods; follow neutropenic diet guidelines (no sushi, runny eggs, unwashed produce)
Daily temp monitoring; report fever ≥ 100.4°F immediately
Use aseptic technique for lines; monitor IV site closely
A provider orders hydroxyurea for sickle cell disease. Which lab is most important to monitor for adverse effects?
What is CBC with differential (neutropenia/myelosuppression risk)?
I cause both thrombosis and bleeding simultaneously. I am often triggered by conditions like sepsis or trauma.
What is Disseminated Intravascular Coagulation (DIC)?
This explains how chronic kidney disease causes anemia.
Chronic kidney disease (CKD) causes anemia primarily because the kidneys stop making enough erythropoietin (EPO) - the hormone that tells the bone marrow to produce red blood cells.
Platelets 9,000. Patient has oozing from gums. VS stable. What is the nurse’s FIRST action?
Initiate bleeding precautions immediately
Child with SCD develops sudden pallor, tachycardia, lethargy, and rapidly enlarging LUQ abdomen. Hgb drops sharply with reticulocytes ↑.
What is it + priority action?
Splenic sequestration crisis. The spleen rapidly enlarges because it’s filling with blood The circulating blood volume drops → hypovolemia / shock Hemoglobin drops fast, Bone marrow tries to compensate → reticulocyte count increases.
Treat it like shock: Oxygen, Large-bore IV access, Fluids and urgent blood transfusion per provider protocol, Rapid response/provider STAT, Continuous VS monitoring
Sickle Cell Disease patient has SpO₂ 88% with fever and chest pain. The nurse’s FIRST action is:
Apply oxygen