Snow Anemias and Thrombocytopenia

Iron Deficiency Anemia

100

This medication can cause dark colored stool.

What is ferrous gluconate?

200

This person takes vitals  two hours after the blood transfusion. 

Who is PCT?

300

Inadequate intake of essential nutrition. 

What is nursing diagnosis for a patient with anemia?

400

Bone marrow aspiration is a definitive method of this anemia. 

What is the method of establishing the diagnosis iron deficiency anemia?

500

smooth red tongue; brittle and ridged nails, and angular cheilosis. 

What are the clinical manifestations of iron deficiency anemia?

Sickle-Cell Anemia

100

Begin Oxygen at 4 liters when this happens. 

What is when patient's oxygen level drops below 89%?

200

Encourage this patient to take 200 mL/hr. of fluids. 

What is the nursing priority for a sickle cell patient?

300

This population is most at risk for sickle cell anemia.

Who are African-Americans?

400

Risk for infection; acute pain and fatigue related to tissue hypoxia. 

What are some major nursing diagnosis for sickle cell anemia patients?

500

A person who inherits just one gene mutation for sickle cell anemia.

Who is a carrier for sickle cell anemia?

Pernicious Anemia

100

Parietal cells secrete this. 

What is intrinsic factor?

200

Difficult breathing and loss of balance. 

What are signs of pernicious anemia?

300

Inability to absorb B12.

What is the cause for pernicious anemia?

400

This is the treatment for folate deficiency.

What is administer 1 mg of folic acid daily?

500

Inspect the patient's skin, mucous membranes, and tongue for this disorder. 

What are the nursing assessment of patient who are at risk for megaloblastic anemia?

Thrombocytopenia

100

This is the nursing priority when the patient's platelet count is 14,000/mm3.

What is assess the patient's level of consciousness.  

200

This patient's platelet count is 90,000/mm3.

What is an abnormal platelet count.

300

Petechiae is the clinical manifestation for this.

What is a clinical manifestation for a patient with thrombocytopenia?

400

Nasal and gingival bleeding; excessive bleeding after the surgery. 

What are two clinical manifestations for a patient with thrombocytopenia?

500

Which objective finding in a patient with chronic anemia best indicates a significant reduction in the heart's compensatory effort?

• A. Decrease in fatigue and weakness.
• B. Improvement in skin pallor.
• C. Drop in baseline resting Heart Rate (HR).
• D. Increase in appetite.

C. Drop in baseline resting Heart Rate (HR).

• Rationale: Tachycardia (high HR) is an Early Sign of anemia (a compensatory mechanism). A drop in the resting HR suggests the anemia is improving, and the heart no longer needs to work as hard to maintain tissue oxygenation.

Aplastic anemia and others

100

A patient with Aplastic Anemia has a platelet count of and a temperature of (). The nurse's priority action is to:

• A. Place the patient on neutropenic precautions and avoid intramuscular injections.
• B. Administer an ordered platelet transfusion immediately.
• C. Obtain a sputum culture to rule out pneumonia.
• D. Increase fluid intake to prevent fever.

A. Place the patient on neutropenic precautions and avoid intramuscular injections.

• Rationale: With low platelets, bleeding precautions (avoiding IM injections) are necessary. With pancytopenia and a low-grade fever, neutropenic precautions are essential to prevent life-threatening infection, making this option the best combination of care.

200

Educate the patient to report low grade fever and to restrict fruit and vegetables. 

What instructions should the nurse teach to a patient with pancytopenia?

300

Patient has shortness of breath and dizziness after the nurse started infusing a pack of red blood cells. 

What are signs to stop the transfusion immediately?

400

A nurse is providing education to a patient with Sickle Cell Anemia. Which statement by the patient indicates a need for further teaching regarding crisis prevention?

• A. "I will drink at least 8 glasses of water a day."
• B. "I will avoid very cold water or swimming in cold pools."
• C. "I will call the doctor if I get flu symptoms or a bad cough."
• D. "I can take over-the-counter NSAIDs for severe pain."

D. "I can take over-the-counter NSAIDs for severe pain."

• Rationale: Patients should not rely on over-the-counter NSAIDs for the severe pain of a crisis; they require prompt, stronger analgesics (opioids) often given in a healthcare setting. The other options are correct teaching points for prevention.

500

A young patient with -Thalassemia Major is receiving chronic blood transfusions. The nurse should prioritize monitoring for which long-term complication?

• A. Neutropenia.
• B. Iron Overload (Hemosiderosis).
• C. Severe dehydration.
• D. Hypokalemia.

: B. Iron Overload (Hemosiderosis).

• Rationale: Patients receiving chronic transfusions (as needed in Thalassemia Major) accumulate excess iron, a condition called Hemosiderosis, which damages vital organs (heart, liver).

Mysteremia

100

A patient is admitted to the ED with a suspected gastrointestinal (GI) bleed. The nurse assesses the following vital signs: Heart Rate (HR) 128 bpm, Blood Pressure (BP) 88/50 mmHg, Respiratory Rate (RR) 22, and O₂ Saturation 95%. Which finding is the most concerning and requires immediate nursing action?

• A. O₂ Saturation of 95%
• B. Respiratory Rate of 22
• C. Blood Pressure of 88/50 mmHg
• D. Heart Rate of 128 bpm

C. Blood Pressure of 88/50 mmHg

• Rationale: Hypotension is a Late/Severe Sign of hypovolemic shock (from your document's Hemorrhagic Anemia section). It indicates severe volume loss and inadequate tissue perfusion, which is an immediate A-B-C priority.

Hemorrhagic Anemia (Hypovolemia)

200

A patient with a history of Sickle Cell Anemia is admitted reporting a 10/10 severe, sharp pain in their legs and chest. Which nursing intervention should be the highest priority?

• A. Apply warm compresses to the painful areas.
• B. Administer prescribed intravenous opioid analgesics.
• C. Start an IV infusion of Normal Saline (NS).
• D. Educate the patient on avoiding future crisis triggers.

B. Administer prescribed intravenous opioid analgesics.

• Rationale: Pain relief is the top priority in a vaso-occlusive crisis. While hydration (C) is also critical, prompt administration and reassessment of pain medication (B) is the initial priority intervention for patient comfort.

300

A patient with Aplastic Anemia is receiving a blood transfusion. The nurse notes the patient suddenly has a temperature of (), chills, and shortness of breath. Which action is the nurse's first priority?

• A. Administer the prescribed antipyretic (e.g., acetaminophen).
• B. Notify the Hematologist immediately.
• C. Stop the blood transfusion immediately.
• D. Complete a full set of vital signs and a head-to-toe assessment.

C. Stop the blood transfusion immediately.

• Rationale: The signs (fever, chills, SOB) are classic indicators of a potential transfusion reaction. The first priority in any suspected transfusion reaction is to stop the infusion to prevent further harm.

400

The nurse is reviewing the lab results of a patient receiving oral iron supplements for Iron Deficiency Anemia. Which lab value indicates the therapy is being most effective?

• A. Decreased Total Iron-Binding Capacity (TIBC).
• B. Increased Reticulocyte Count.
• C. Increased Serum Ferritin level.
• D. Decreased Mean Corpuscular Volume (MCV).

B. Increased Reticulocyte Count.

• Rationale: An Increased Reticulocyte Count indicates that the bone marrow is actively producing new red blood cells, which is the immediate desired effect of iron supplementation and the best early indicator of marrow response.

500

A nurse is providing discharge teaching to a patient newly diagnosed with Pernicious Anemia. The nurse should emphasize the need for lifelong treatment to prevent which potentially irreversible complication?

• A. Iron overload (hemosiderosis).
• B. Gastric carcinoma.
• C. Progressive neurological deficits.
• D. Severe joint pain.

C. Progressive neurological deficits.

• Rationale: Pernicious Anemia (B12 deficiency) can lead to demyelination of the spinal cord and peripheral nerves. Lifelong B12 replacement is necessary to prevent severe and often irreversible neurological deficits.