Anemia
List the different types of Anemia:
Production
Destruction
Loss
Which clients are at the greatest risk for Sickle-Cell Disease?
SCD occurs among about 1 out of every 365 Black or African American births
and followed by Hispanic-Americans with 1 out of 16,300 cases of SCD occurring in this population.
Whiteout of the lungs - indicating pulmonary edema
Hallmark sign of Lupus?
Butterfly Rash
Schizotypal, Paranoid, and Schizoid personality disorders are what cluster of personality disorders?
Cluster A
A client undergoing chemotherapy may be at risk for what type of Anemia?
Aplastic Anemia
During shift report, the nurse is notified that the client received a transfusion of PRBCs 6 hours ago. When the nurse enters the room to check on the client, the client exhibits dyspnea with audible crackles, pallor, and a pulse ox of 88% even though they're on 100% O2. What happened?
Transfusion Related Acute Lung Injury - requires immediate intervention (get that rapid response team!)
Patient teaching for clients with Lupus taking Hydroxychloroquine (Plaquenil)?
Need for frequent eye exams d/t increased risk for retinal toxicity and EKGs to monitor for prolonged QT interval and possible arythmias.
The client is being prepared for discharge from the inpatient psych unit. The client who was warm and friendly with the nurse hours before is now angry and yelling at the nurse: "You never cared about me! I can't believe you would hurt me so much and just leave me like this! How could you?!" The nurse knows this behavior is related to which personality disorder?
Bordeline Personality D/O - intense fear of being alone, black and white thinking - nurse was seen as good and is now awful simply for assisting with the patient discharge.
Your vegan client has been complaining of numbness and tingling in their hands and feet. You note glossitis on assessment, you suspect?
Vitamin B12 Defeciency Anemia
The nurse teaches the SCD client that ____(multiple answers)____ can exacerbate sickling in SCD clients:
Hypoxia
Dehydration
Infection
Venous stasis
Pregnancy
Alcohol consumption
High altitudes
Low or high environmental or body temperatures
Sepsis is defined as:
SIRS + Microbial Source
SIRS can be any 2 of the following:
Temp >100.4 or <95.0
RR >20 or PaCO2 > 32 mmHg
HR > 90
WBC >12k or < 4k or Bands > 10%
Methotrexate, Azathioprine, and Belimumab all put the client at an increased risk for what?
Infections!
No live vaccines when taking these meds either
Antisocial Personality Disorder is seen more often in which gender?
Male - in the general population about 3% of men and 1% of women display ASPD
Anticipated lab findings in a client diagnosed with Lukemia?
Decreased hemoglobin (Hgb) and hematocrit (Hct)
Low platelet count
Reduced levels of fibrinogen and other clotting factors are common
Abnormal WBC count (20,000 to 100,000)
The SCD client reports sudden excruciating pain, tachycardia, SOB and presents with a low-grade fever, the nurse suspects:
Sickle Cell Crisis
Lab findings associated with DIC:
Thrombocytopenia (< 100,000)
PT = prolonged
PTT = prolonged
Plasma fibrinogen = decreased
Elevated D-dimer levels
Elevated fibrin degradation products (FDP)
The nurse is reviewing the medications for a client diagnosed with SLE, the nurse questions which medication?
Oral contraceptives d/t risk for hypercoagulability
Due to fear of rejection over disagreements clients with this personality disorder tend to be submissive or passive. They are at risk of staying in abusive relationships, tolerate exploitative and manipulative people, or stay in demeaning jobs:
Dependent personality disorder
Biopsies will have Reed-Sternberg cells present which indicates Hodgkins Lymphoma
The nurse is reviewing medications for a client with SCD - the nurse expects to see which medication in their chart?
Hydroxurea
When administering IV Heparin for the client with DIC, what is the therapeutic goal?
aPTT of 45
Keep that protamine sulfate handy :)
What are the desired goals in the treatment of Lupus?
Reduce inflammation caused by lupus
Suppress your overactive immune system
Prevent flares, and treat them when they occur
Control symptoms like joint pain and fatigue
Report signs of fever
Minimize damage to organs
On the scale of treatability for Personality Disorders, which disorders are deemed untreatable?
Which personality disorders are the most amenable (agreeable/successful) with treatment?
Untreatable: severe narcissistic and antisocial personality disorders, individuals with extreme entitlement, exploitativeness, sadism, and those who are serial killers
Most amenable:
Most Amenable for Treatment:
Cluster C personality disorders (avoidant, dependent, and obsessive-compulsive)
Borderline personality disorder with anxious or depressive features
Milder forms of histrionic personality disorder