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From other websitesContent disclaimerContent on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. 1, 2, 4, 5 ~ 1. During pregnancy, the woman needs increased amounts of protein to provide amino acids for fetal development. Nội dung chính
2. Iron deficiency anemia is associated with an increased incidence of preterm birth, low-birth-weight infants, and maternal and infant mortality. 4. Zinc is involved in RNA and DNA synthesis, and milk production during lactation. 5. Vitamin A promotes healthy formation and development of the fetal eyes. 1. During pregnancy, the woman needs increased amounts of protein to provide amino acids for fetal development. 2. Iron deficiency anemia is associated with an increased incidence of preterm birth, low-birth-weight infants, and maternal and infant mortality. 4. Zinc is involved in RNA and DNA synthesis, and milk production during lactation. 5. Vitamin A promotes healthy formation and development of the fetal eyes. Terms in this set (44)Using the five-digit system, determine the obstetric history in this situation: The client is 38 weeks into her fourth pregnancy. Her third pregnancy, a twin gestation, ended at 32 weeks with a live birth, her second
pregnancy ended at 38 weeks with a live birth, and her first pregnancy ended at 18 weeks. Sets found in the same folder1. ANS: C DIF: Cognitive Level: Analyze REF: p. 349 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: Other components of tissue that contribute to weight gain include: an increase in uterine tissue (0.9), increased tissue fluid (1.4 to 2.3), and increased fat stores (1.8 to 2.7). Because lactation can help gradually reduce maternal energy stores, it also provides an opportunity to promote breastfeeding. 2. ANS: E DIF: Cognitive Level: Analyze REF: p. 349 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: Other components of tissue that contribute to weight gain include: an increase in uterine tissue (0.9), increased tissue fluid (1.4 to 2.3), and increased fat stores (1.8 to 2.7). Because lactation can help gradually reduce maternal energy stores, it also provides an opportunity to promote breastfeeding. 3. ANS: A DIF: Cognitive Level: Analyze REF: p. 349 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: Other components of tissue that contribute to weight gain include: an increase in uterine tissue (0.9), increased tissue fluid (1.4 to 2.3), and increased fat stores (1.8 to 2.7). Because lactation can help gradually reduce maternal energy stores, it also provides an opportunity to promote breastfeeding. 4. ANS: D DIF: Cognitive Level: Analyze REF: p. 349 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: Other components of tissue that contribute to weight gain include: an increase in uterine tissue (0.9), increased tissue fluid (1.4 to 2.3), and increased fat stores (1.8 to 2.7). Because lactation can help gradually reduce maternal energy stores, it also provides an opportunity to promote breastfeeding. 5. ANS: B DIF: Cognitive Level: Analyze REF: p. 349 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity NOT: Other components of tissue that contribute to weight gain include: an increase in uterine tissue (0.9), increased tissue fluid (1.4 to 2.3), and increased fat stores (1.8 to 2.7). Because lactation can help gradually reduce maternal energy stores, it also provides an opportunity to promote breastfeeding. The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow after discharge. Which of the following foods should be included in the diet? A Eggs One of the microcytic, hypochromic anemias is iron-deficiency anemia. A rich source of iron is needed in the diet, and eggs are high in iron. Other foods high in iron include organ and muscle (dark) meats; shellfish, shrimp, and tuna; enriched, whole-grain, and fortified cereals and breads; legumes, nuts, dried fruits, and beans; oatmeal; and sweet potatoes. Dark green leafy vegetables and citrus fruits are good sources of vitamin C. Cheese is a good source of calcium. The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12? C Meats and dairy products Good sources of vitamin B12 include meats and dairy products. Whole grains are a good source of thiamine. Green leafy vegetables are good sources of niacin, folate, and carotenoids (precursors of vitamin A). Broccoli and Brussels sprouts are good sources of ascorbic acid (vitamin C). The nurse has just admitted a 35-year-old female client who has a serum B12 concentration of 800
pg/ml. Which of the following laboratory findings would cue the nurse to focus the client history on specific drug or alcohol abuse? D Folate, 1.5 ng/mL The normal range of folic acid is 1.8 to 9 ng/mL, and the normal range of vitamin B12 is 200 to 900 pg/mL. A low folic acid level in the presence of a normal vitamin B12 level is indicative of a primary folic acid-deficiency anemia. Factors that affect the absorption of folic acid are drugs such as methotrexate, oral contraceptives, antiseizure drugs, and alcohol. The total bilirubin, serum creatinine, and hemoglobin values are within normal limits. The nurse understands that the client with pernicious anemia will have which distinguishing laboratory findings? B Intrinsic factor, absent The defining characteristic of pernicious anemia, a megaloblastic anemia, is lack of the intrinsic factor, which results from atrophy of the stomach wall. Without the intrinsic factor, vitamin B12 cannot be absorbed in the small intestines, and folic acid needs vitamin B12 for DNA synthesis of RBCs. The gastric analysis was done to determine the primary cause of the anemia. An elevated excretion of the injected radioactive vitamin B12, which is protocol for the first and second stage of the Schilling test, indicates that the client has the intrinsic factor and can absorb vitamin B12 into the intestinal tract. A sedimentation rate of 16 mm/hour is normal for both men and women and is a nonspecific test to detect the presence of inflammation. It is not specific to anemias. An RBC value of 5.0 million is a normal value for both men and women and does not indicate anemia. The nurse devises a teaching plan
for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance? B Avoid exposure to others with acute infection Clients with aplastic anemia are severely immunocompromised and at risk for infection and possible death related to bone marrow suppression and pancytopenia. Strict aseptic technique and reverse isolation are important measures to prevent infection. Although diet, reduced stress, and rest are valued in supporting health, the potentially fatal consequence of an acute infection places it as a priority for teaching the client about health maintenance. Animal meat and dark green leafy vegetables, good sources of vitamin B12 and folic acid, should be included in the daily diet. Yoga and meditation are good complimentary therapies to reduce stress. Eight hours of rest and naps are good for spacing and pacing activity and rest. A client comes into the health clinic 3 years after undergoing a resection of the terminal ileum complaining of weakness, shortness of breath, and a sore tongue. Which client statement indicates a need for intervention and client teaching? D "I take a vitamin B12 tablet every day. Vitamin B12 combines with intrinsic factor in the stomach and is then carried to the ileum, where it is absorbed in the bloodstream. In this situation, vitamin B12 cannot be absorbed regardless of the amount of oral intake of sources of vitamin B12 such as animal protein or vitamin B12 tablets. Vitamin B12 needs to be injected every month, because the ileum has been surgically removed. Replacement of fluids and electrolytes is important when the client has continuous multiple loose stools on a daily basis. Warm salt water is used to soothe sore mucous membranes. Crohn's disease and small bowel resection may cause several loose stools a day. vegetarian client was referred to a dietitian for nutritional counseling for anemia. Which client outcome indicates that
the client does not understand nutritional counseling? The client: C Drinks coffee or tea with meals Coffee and tea increase gastrointestinal motility and inhibit the absorption of nonheme iron. Clients are instructed to add dried fruits to dishes at every meal because dried fruits are a nonheme or nonanimal iron source. Cooking in iron cookware, especially acid-based foods such as tomatoes, adds iron to the diet. Clients are instructed to add a rich supply of vitamin C to every meal because the absorption of iron is increased when food with vitamin C or ascorbic acid is consumed. A client was admitted with iron deficiency anemia and blood-streaked emesis. Which question is most appropriate for the nurse to ask in determining the extent of the client's activity
intolerance? A "What activities were you able to do 6 months ago compared with the present?" It is difficult to determine activity intolerance without objectively comparing activities from one time frame to another. Because iron deficiency anemia can occur gradually and individual endurance varies, the nurse can best assess the client's activity tolerance by asking the client to compare activities 6 months ago and at the present. Asking a client how long a problem has existed is a very open-ended question that allows for too much subjectivity for any definition of the client's activity tolerance. Also, the client may not even identify that a "problem" exists. Asking the client whether he is staying abreast of usual activities addresses whether the tasks were completed, not the tolerance of the client while the tasks were being completed or the resulting condition of the client after the tasks were completed. Asking the client if he is more tired now than usual does not address his activity tolerance. Tiredness is a subjective evaluation and again can be distorted by factors such as the gradual onset of the anemia or the endurance of the individual. The primary purpose of the Schilling
test is to measure the client's ability to: C Absorb vitamin B12 Pernicious anemia is caused by the body's inability to absorb vitamin B12. This results in a lack of intrinsic factor in the gastric juices. Schilling's test helps diagnose pernicious anemia by determining the client's ability to absorb vitamin B12. The nurse implements which of the following
for the client who is starting a Schilling test? B Starting a 24- to 48 hour urine specimen collection Urinary vitamin B12 levels are measured after the ingestion of radioactive vitamin B12. A 24-to 48- hour urine specimen is collected after administration of an oral dose of radioactively tagged vitamin B12 and an injection of non-radioactive vitamin B12. In a healthy state of absorption, excess vitamin B12 is excreted in the urine; in a malabsorption state or when the intrinsic factor is missing, vitamin B12 is excreted in the feces. Citrucel is a bulk-forming agent. Laxatives interfere with the absorption of vitamin B12. The client is NPO 8 to 12 hours before the test but is not NPO during the test. A stool collection is not part of the Schilling test. If stool contaminates the urine collection, the results will be altered. A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. What is the nurse's best response? B "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor." Most clients with pernicious anemia have deficient production of intrinsic factor in the stomach. Intrinsic factor attaches to the vitamin in the stomach and forms a complex that allows the vitamin to be absorbed in the small intestine. The stomach is producing enough acid, there is not an excessive excretion of the vitamin, and there is not a rapid production of RBCs in this condition. When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? A Bleeding tendencies Aplastic anemia decreases the bone marrow production of RBCs, WBCs, and platelets. The client is at risk for bruising and bleeding tendencies. A change in the intake and output is important, but assessment for the potential for bleeding takes priority. Change in the peripheral nervous system is a priority problem specific to clients with vitamin B12 deficiency. Change in bowel function is not associated with aplastic anemia. A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan? D "Take the medication on an empty stomach." Preferably, ferrous gluconate should be taken on an empty stomach. Ferrous gluconate should not be taken with antacids, milk, or whole-grain cereals because these foods reduce iron absorption. The nurse explains to the parents of a 1-year-old child admitted to the hospital in a sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following? C Obstruction to circulation Characteristic sickle cells tend to cause "log jams" in capillaries. This results in poor circulation to local tissues, leading to ischemia and necrosis. The basic defect in sickle cell disease is an abnormality in the structure of RBCs. The erythrocytes are sickle-shaped, rough in texture, and rigid. Sickle cell disease is an inherited disease, not an autoimmune reaction. Elevated serum bilirubin concentrations are associated with jaundice, not sickle cell disease. A clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions? C Fluid overload Pain crisis may be precipitated by infection, dehydration, hypoxia, trauma, or physical or emotional stress. The mother of a child with sickle cell disease should encourage fluid intake of 1 ½ to 2 times the daily requirement to prevent dehydration. mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the understanding of which of the following? d. Children with iron-deficient anemia are equally as susceptible to infection as are other children Rationale: Children with iron-deficiency anemia are more susceptible to infection because of marked decreases in bone marrow functioning with microcytosis The clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions? c. Fluid overload Rationale: When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions? a. Bleeding tendencies Aplastic anemia decreases the bone marrow production of RBCs, WBCs, and Platelets. The client is at risk for bruising and bleeding tendencies. A client was admitted with iron deficiency anemia and blood-streaked emesis. Which question is most appropriate for the nurse to ask in determining the extent of the client's
activity intolerance? a. What activities were you able to do 6 months ago compared with present? Rationale: It is difficult to determine activity intolerance without objectively comparing activities from one time frame to another. Because iron deficiency anemia can occur gradually and individual endurance varies, the nurse can best assess the clients activity tolerance by asking the client to compare activities 6 months ago and at the present When discussing appropriate food choices with a patient who has iron-deficiency anemia and follows a low-cholesterol diet, the nurse will encourage the patient to increase the dietary intake of d. legumes and dried fruits Rationale: Legumes and dried fruits are high in iron and low in fat and cholesterol. A client is beginning a regimen of ferrous sulfate or iron. As you prepare to administer the medication, it is important for you to advise the client that b. Her bowel movements will be dark and tarry A patient who is having a sickle cell crisis asks the nurse why the sickling causes such pain. The nurse explains that the pain of sickling is caused by c. Tissue hypoxia caused by small blood vessel occlusion The pain associated with sickle cell crisis is caused by ischemia as the sickled cells occlude small blood vessels and capillaries. A child suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the lab results, knowing that which of the following
would be increased in this disease? c. Reticulocyte count Rationale: A diagnosis is established based on a complete blood count, examination for sickled RBCs in the peripheral smear, and hemoglobin electrophoresis. Lab studies will show decreased HGB and HCT levels and a decreased platelet count, and increased reticulocyte count, and the presence of nucleated RBCS. Increased reticulocyte counts occur in children with sickle cell disease becuase the life span of their sickled RBCS is shortened The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow after discharge. Which of the following foods should be included in the diet? a. Eggs Eggs are high in Iron. Other foods high in iron are organ meats, muscle meats; shellfish, shrimp, and tuna; enriched, whole-grain, and fortified cereals and breads; legumes, nuts, dried fruits, and beans; oatmeal; and sweet potatoes. Which of the following disorders results from a deficiency of factor VIII? c. Hemophilia A Rationale: A client has been diagnosed with iron-deficiency anemia. The doctor has ordered an iron supplement but has also suggested a diet rich in iron. Which of the following foods should be included in the client's discharge iron-rich diet plan? a. Egg yolks The usual treatment for iron-deficiency anemia includes: b. Non-enteric-coated ferrous sulfate The usual tx is 325 mg p.o. daily. enteric-coated and sustained rls formulas should be avoided, as they are poorly absorbed A 52-year-old patient has a new
diagnosis of pernicious anemia. After teaching the patient about pernicious anemia, the nurse determines that the patient understands the disorder when the patient states, a. I will need to have cobalamin -B12 injections regularly for the rest of my life A patient with sickle cell anemia is admitted to the hospital with a sickle cell crisis. While caring for the patient during the crisis, it is important for the nurse to b. evaluate the effectiveness of opioid analgesics Pain is the most common clinical manifestation of a crisis and usually requires large doses of continuous opioids for control Which of the following symptoms is expected with hemoglobin of 10 g/dl? a. None Mild anemia usually has no clinical signs. Which of the following foods would the nurse encourage the mother to offer to her child with iron deficiency anemia? b. Potato, peas, and chicken Potato, peas, chicken, green vegetables, and rice cereal contain significant amounts of iron and therefore would be recommended. Milk and yellow vegetables are not good iron sources. Rice by itself also is not a good source of iron. The nurse is caring for a child admitted with sickle-cell anemia sequestration crisis. The nurse plans care for a child with c. Pooling of blood in the spleen The child with sickle-cell anemia who is in a sequestration crisis experiences pooling of blood in the spleen. Choice a is incorrect. Decreased red blood cell production occurs when the child with sickle-cell anemia is in an aplastic crisis. Choice b is incorrect. Petechia, tiny hemorrhagic spots on the skin and bruising occur with a decrease in white blood cells in diseases such as leukemia. Choice d is incorrect. Swollen hands and feet occur when the choice with sickle-cell anemia is in a vaso-occlusive crisis. Because of
the risks associated with administration of factor VIII concentrate, the nurse would teach the client's family to recognize and report which of the following? a. Yellowing of the skin Because factor VIII concentrate is derived from large pools of human plasma, the risk of hepatitis is always present. Clinical manifestations of hepatitis include yellowing of the skin, mucous membranes, and sclera. Use of factor VIII concentrate is not associated with constipation, abdominal distention, or puffiness around the eyes. A patient with a history of iron-deficiency anemia who has not taken iron supplements for several years is experiencing increased fatigue and occasional palpitations. The nurse would expect the patient's laboratory findings to include c. hgb 8.6 g/dL The patient's clinical manifestations indicate moderate anemia, which is consistent with a Hgb of 6 to 10 g/dl. The other values are all within the range of low-normal to normal. When caring for a client with a coagulation disorder, your primary focus should be on: d. Prevention of injury and hemorrhage During physical assessment of a patient, the nurse suspects a chronic, severe iron-deficiency anemia on finding c. Shiny, smooth tongue Loss of the papillae of the tongue occurs with chronic iron deficiency. Scleral jaundice is associated with hemolysis, gum bleeding and tenderness occur with thrombocytopenia or neutropenia, and extremity numbness is associated with vitamin B12 deficiency or pernicious anemia. A patient has a folic acid deficiency related to chronic alcohol abuse. The nurse would expect a complete blood cell count (CBC) to reveal a macrocytic, normochromic red cells With folic acid deficiency, the cells are larger than normal, but the iron levels are normal or elevated, leading to findings of a macrocytic, normochromic anemia. Microcytic anemia, hypochromic anemia is more typical of iron deficiency. Normocytic, normochromic RBC indicate that the patient does not have anemia or may occur in patients with anemia-related chronic disease. A client states that she is afraid of receiving vitamin B12 injections because of the potential toxic reactions. What is the nurse's best response to relieve these fears? d. Vitamin B12 is generally free of toxicity because it is water soluble Vitamin B12 is a water-soluble vitamin. When water-soluble vitamins are taken in excess of the body's needs, they are filtered through the kidneys and excreted. Vitamin B12 is considered to be nontoxic. Adverse reactions that have occurred are believed to be related to impurities or to the preservative in B12 preparations. Ringing in the ears, skin rash, and nausea are not considered to be related to vitamin B12 administration. The nurse understands that the client with pernicious anemia will have which distinguishing laboratory findings? b. intrinsic factor, absent The defining characteristic of pernicious anemia, a megaloblastic anemia, is lack of the intrinsic factor, which results from atrophy of the stomach wall. Without the intrinsic factor, vitamin B12 cannot be absorbed in the small intestines, and folic acid needs vitamin B12 for DNA synthesis of RBCs. The gastric analysis was done to determine the primary cause of the anemia. An elevated excretion of the injected radioactive vitamin B12, which is protocol for the first and second stage of the Schilling test, indicates that the client has the intrinsic factor and can absorb vitamin B12 into the intestinal tract. A sedimentation rate of 16 mm/hour is normal for both men and women and is a nonspecific test to detect the presence of inflammation. It is not specific to anemias. An RBC value of 5.0 million is a normal value for both men and women and does not indicate anemia. The nurse has provided nutritional teaching on foods high in folate to a client with folate deficiency related to malabsorption syndromes and poor nutrition. Which of the following foods, if chosen by the client,
indicates that the client understands the teaching? a. Liver, dark green leafy vegetables Foods high in folate are liver, orange juice, cereals, whole grains, beans, nuts, and dark leafy vegetables like spinach The nurse explains to the parents of a 1-year-old child admitted to the hospital in a sickle cell crisis that
the local tissue damage the child has on admission is caused by which of the following? c. Obstruction to circulation Characteristic sickle cells tend to cause "log jams" in capillaries. This results in poor circulation to local tissues, leading to ischemia and necrosis. The basic defect in sickle cell disease is an abnormality in the structure of RBCs. The erythrocytes are sickle-shaped, rough in texture, and rigid. Sickle cell disease is an inherited disease, not an autoimmune reaction. Elevated serum bilirubin concentrations are associated with jaundice, not sickle cell disease. A client with anemia may be tired due to a tissue deficiency of which of the following substances? c. Oxygen Anemia stems from a decreased number of RBCs and the resulting def in O2 and body tiss. Clotting factors, such as 8 relate to the bodies ability to form blood clots and arnt related to anemia, not is carbon dioxide of T antibodies From the following teaching tips, choose all that are appropriate for a client with thrombocytopenia. a. Use an electric razor for shaving A client
with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. What is the nurse's best response? b. "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor." Most clients with pernicious anemia have deficient production of intrinsic factor in the stomach. Intrinsic factor attaches to the vitamin in the stomach and forms a complex that allows the vitamin to be absorbed in the small intestine. The stomach is producing enough acid, there is not an excessive excretion of the vitamin, and there is not a rapid production of RBCs in this condition. The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12? c. Meats and dairy products Good sources of vitamin B12 include meats and dairy products. Whole grains are a good source of thiamine. Green leafy vegetables are good sources of niacin, folate, and carotenoids (precursors of vitamin A). Broccoli and Brussels sprouts are good sources of ascorbic acid (vitamin C). When planning discharge teaching for the patient who was admitted with a sickle cell crisis, which information
will the nurse include? d. Avoid exposure to crowds as much as possible Exposure to crowds increases the patient's risk for infection, the most common cause of sickle cell crisis. There is no restriction on caffeine use. Iron supplementation is generally not recommended. A high-fluid intake is recommended. When comparing the hematocrit levels of a post-op client, the nurse notes that the hematocrit decreased from 36% to 34% on the third day even though the RBC and hemoglobin values remained stable at 4.5 million and 11.9 g/dL, respectively. Which nursing intervention is most appropriate? c. Continue to monitor vital signs The nurse should continue to monitor the client, because this value reflects a normal physiologic response. The physician does not need to be called, and oxygen does not need to be started based on these laboratory findings. Immediately after surgery, the client's hematocrit reflects a falsely high value related to the body's compensatory response to the stress of sudden loss of fluids and blood. Activation of the intrinsic pathway and the renin-angiotensin cycle via antidiuretic hormone produces vasoconstriction and retention of fluid for the first 1 to 2 day post-op. By the second to third day, this response decreases and the client's hematocrit level is more reflective of the amount of RBCs in the plasma. Fresh bleeding is a less likely occurrence on the third post-op day but is not impossible; however, the nurse would have expected to see a decrease in the RBC and hemoglobin values accompanying the hematocrit. While obtaining a health history from a patient with numerous petechiae on the skin, the nurse asks the patient specifically about the patient's use of c. aspirin meds Salicylates interfere with platelet function and can lead to petechiae and ecchymosis. Anticonvulsants may cause anemia, but not bleeding. Oral contraceptives increase clotting risk. Antihypertensives do not commonly cause problems with decreased clotting. A client comes into the health clinic 3 years after undergoing a resection of the terminal ileum complaining of weakness, shortness of breath, and a sore tongue. Which client statement indicates a need for intervention and client teaching? d. I take a vitamin B12 tablet every day Vitamin B12 combines with intrinsic factor in the stomach and is then carried to the ileum, where it is absorbed in the bloodstream. In this situation, vitamin B12 cannot be absorbed regardless of the amount of oral intake of sources of vitamin B12 such as animal protein or vitamin B12 tablets. Vitamin B12 needs to be injected every month, because the ileum has been surgically removed. Replacement of fluids and electrolytes is important when the client has continuous multiple loose stools on a daily basis. Warm salt water is used to soothe sore mucous membranes. Crohn's disease and small bowel resection may cause several loose stools a day. Which of the following would the nurse identify as the priority nursing diagnosis during a toddler's vaso-occlusive sickle cell crisis? c. pain related to tissue anoxia For the child in a sickle cell crisis, pain is the priority nursing diagnosis because the sickled cells clump and obstruct the blood vessels, leading to occlusive and subsequent tissue ischemia. Although ineffective coping may be important, it is not the priority. Decreased cardiac output is not a problem with this type of vaso-occlusive crisis. Typically, a sickle cell crisis can be precipitated by a fluid volume deficit or dehydration. A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan? d. Take the meds on an empty stomach Preferably, ferrous gluconate should be taken on an empty stomach. Ferrous gluconate should not be taken with antacids, milk, or whole-grain cereals because these foods reduce iron absorption. The physician has ordered several laboratory tests to help diagnose an
infant's bleeding disorder. Which of the following tests, if abnormal, would the nurse interpret as most likely to indicate hemophilia? d. PTT PTT measures the activity of thromboplastin, which is dependent on intrinsic clotting factors. In hemophilia, the intrinsic clotting factor VIII (antihemophilic factor) is deficient, resulting in a prolonged PTT. Bleeding time reflects platelet function; the tourniquet test measures vasoconstriction and platelet function; and the clot retraction test measures capillary fragility. All of these are unaffected in people with hemophilia. The mother asks the nurse why her child's hemoglobin was normal at birth but now the child has S hemoglobin. Which of the following responses by the nurse is most appropriate? d. The newborn as a high concentration of fetal hgb in the blood for some time after birth. Sickle cell disease is an inherited disease that is present at birth. However, 60% to 80% of a newborns hemoglobin is fetal hemoglobin, which has a structure different from that of hemoglobin S or hemoglobin A. Sickle cell symptoms usually occur about 4 months after birth, when hemoglobin S begins to replace the fetal hemoglobin. The gene for sickle cell disease is transmitted at the time of conception, not passed through the placenta. Some hemoglobin S is produced by the fetus near term. The fetus produces all its own hemoglobin from the earliest production in the first trimester. Passive immunity conferred by maternal antibodies is not related to sickle cell disease, but this transmission of antibodies is important to protect the infant from various infections during early infancy. Which of the following assessments in a child with hemophilia would lead the nurse to suspect early hemarthrosis? a. Childs reluctance to move a body part Bleeding into the joints in the child with hemophilia leads to pain and tenderness, resulting in restricted movement. Therefore, an early sign of hemarthrosis would be the child's reluctance to move a body part. If the bleeding into the joint continues, the area becomes hot, swollen, and immobile—not cool, pale, and clammy. Ecchymosis formation around a joint would be difficult to assess. Instability of a long bone on passive movement is not associated with joint hemarthrosis. Which statements by the mother of a toddler would lead the nurse to suspect that the child has iron-deficiency anemia? Select all that apply. a He drinks over 3 cups of milk per day Toddlers should have between 2 and 3 cups of milk per day and 8 ounces of juice per day. If they have more than that, then they are probably not eating enough other foods, including iron-rich foods that have the needed nutrients A client is to receive epoetin (Epogen) injections. What laboratory value should the nurse assess before giving the injection? a. Hematocrit Epogen is a recombinant DNA form of erythropoietin, which stimulates the production of RBCs and therefore causes the hematocrit to rise. The elevation in hematocrit causes an elevation in blood pressure; therefore, the blood pressure is a vital sign that should be checked. The PTT, hemoglobin level, and PT are not monitored for this drug. Which foods would the nurse recommend to a client who is concerned with ensuring that her diet is not deficient in folic acid folate quizlet?Folate occurs naturally in the following foods: Beans and legumes. Citrus fruits and juices. Dark green leafy vegetables such as spinach, asparagus, and broccoli. Which foods would the nurse recommend to a client who is concerned with ensuring that her diet is not deficient in folic acid folate )?Folate occurs naturally in the following foods:. Beans and legumes.. Citrus fruits and juices.. Dark green leafy vegetables such as spinach, asparagus, and broccoli.. Liver.. Mushrooms.. Poultry, pork, and shellfish.. Wheat bran and other whole grains.. What foods are high in folic acid?Food Sources. Dark green leafy vegetables (turnip greens, spinach, romaine lettuce, asparagus, Brussels sprouts, broccoli). Beans.. Peanuts.. Sunflower seeds.. Fresh fruits, fruit juices.. Whole grains.. Liver.. Seafood.. Which food would the nurse recommend to a pregnant client to most significantly increase the clients intake of folic acid?Eat foods high in folic acid, such as dried beans, dark green leafy vegetables, wheat germ and orange juice. Which foods would the nurse recommend to a client who is concerned with ensuring that her diet is not deficient in folic acid folate quizlet?Folate occurs naturally in the following foods: Beans and legumes. Citrus fruits and juices. Dark green leafy vegetables such as spinach, asparagus, and broccoli.
Which food would the nurse recommend to a pregnant client to most significantly increase the client's intake of folic acid?You can find folate in green, leafy vegetables, liver, orange juice, legumes (beans, peas, lentils), and nuts. You must get at least 400 micrograms of folate daily before pregnancy and during the first 12 weeks of pregnancy to reduce the risk of neural tube defects.
What foods are appropriate to exclude from the pregnant clients to ensure good health?During pregnancy, the Food and Drug Administration (FDA) encourages you to avoid:. Bigeye tuna.. King mackerel.. Marlin.. Orange roughy.. Swordfish.. Shark.. Tilefish.. Which foods are appropriate to suggest to prevent calcium deficiency for the client who maintains a vegan diet?Good vegetarian food sources of calcium include:. dairy products.. plant-based milk drinks fortified with calcium (check the label). cereals and fruit juices fortified with calcium (check the label). tahini (sesame seed paste). some brands of tofu (check the label). leafy dark green vegetables (especially Asian greens). legumes.. |
Which foods would the nurse recommend to a client who is concerned with ensuring that her diet is not deficient in folic acid folate )? Select all that apply?
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