RNSG 2539 FINAL Exam Questions With
Correct Answers
Causes of anemia - answer✔● Blood loss
● Inadequate RBC production (hypoproliferative) ● Increased RBC destruction (hemolytic)
● Deficiency of necessary components such as folic acid, iron, erythropoietin, and/or vitamin
B12
anemia risk factors - answer✔acute or chronic blood loss, increased hemolysis, inadequate
dietary intake or malabsorption, bone marrow suppression, age
anemia expected findings - answer✔● Possibly asymptomatic in mild cases
● Pallor
● Fatigue
● Irritability
● Numbness and tingling of extremities
● Dyspnea on exertion
● Sensitivity to cold
● Pain and hypoxia with sickle-cell crisis
Anemia physical assessment findings - answer✔● Shortness of breath/fatigue, especially upon
exertion
● Tachycardia and palpitations
● Dizziness or syncope upon standing or with exertion
● Pallor with pale nail beds and mucous membranes
● Nail bed deformities (spoon-shaped nails)
● Smooth, sore, bright-red tongue (vitamin B12 deficiency
Anemia nursing care - answer✔Encourage increased dietary intake of the deficient nutrient
(iron, vitamin B12, folic acid).
● Monitor oxygen saturation to determine a need for oxygen therapy.
● Administer medications, as prescribed, at the proper time for optimal absorption, and using
an appropriate technique.
● Teach the client and family about energy conservation in the client and the risk of the client
experiencing dizziness upon standing.
● Teach the client about the time frame for resolution.
Iron supplements (Ferrous sulfate, ferrous fumarate, ferrous gluconate) - answer✔● Oral iron
supplements are used to replenish serum iron and iron stores. Iron is an essential component of
Hgb, and subsequently, oxygen transport.
● Parenteral iron supplements (iron dextran) are only given for severe anemia. NURSING
CONSIDERATIONS: Administer parenteral iron using the Z-track method
CLIENT EDUCATION
● Instruct to have hemoglobin checked in 4 to 6 weeks to determine efficacy.
● Vitamin C can increase oral iron absorption.
ALL RIGHTS RESERVED.
● Instruct the client to take iron supplements between meals to increase absorption, if
tolerated.
● Inform the client stools can appear green to black in color while taking iron
Erythropoietin: epoetin alfa - answer✔A hematopoietic growth factor used to increase
productionof RBCs
NURSING CONSIDERATIONS
● Monitor for an increase in blood pressure.
● Monitor Hgb and Hct twice per week.
● Monitor for a cardiovascular event if Hgb increases too rapidly (greater than 1 g/dL in 2
weeks).
CLIENT EDUCATION:
Reinforce the importance of having Hgb and Hct evaluated on a twice-per-week basis until
targeted levels are reached.
Vitamin B12 supplementation (cyanocobalamin) - answer✔● Vitamin B12 is necessary to
convert folic acid from its inactive form to its active form. All cells rely on folic acid for DNA
production.
● Vitamin B12 supplementation can be given orally if the deficit is due to inadequate dietary
intake. However, if deficiency is due to lack of intrinsic factor being produced by the parietal
cells of the stomach or malabsorption syndrome, it must be administered parenterally or
intranasally to be absorbed.
NURSING CONSIDERATIONS
● Administer vitamin B12 according to appropriate route related to cause of vitamin B12
anemia (parenteral vs. oral).
● Administer parenteral forms of vitamin B12 IM or deep subcutaneous to decrease irritation.
Do not mix other medications in the syringe.
CLIENT EDUCATION
● Clients who lack intrinsic factor or have an irreversible-malabsorption syndrome should be
informed that this therapy must be continued for the rest of their life.
● A client should receive vitamin B12 injections on a monthly basis
Folic Acid Supplements - answer✔Folic acid is a water-soluble, B-complex vitamin. It is
necessary for the production of new RBCs.
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ALL RIGHTS RESERVED.
NURSING CONSIDERATIONS:
Folic acid can be given orally or parenterally. CLIENT EDUCATION
● Large doses of folic acid can mask vitamin B12 deficiency.
● Large doses of folic acid will turn the client's urine dark yellow
Blood transfusion - answer✔● Blood transfusions lead to an immediate improvement in blood-
cell counts and manifestations of anemia.
● Typically only used when the client has significant manifestations of anemia, because of the
risk of blood-borne infections
Anemia complications heart failure - answer✔Heart failure can develop due to the increased
demand on the heart to provide oxygen to tissues. A low Hct decreases the amount of oxygen
carried to tissues in the body, which makes the heart work harder and beat faster (tachycardia,
palpitations).
NURSING ACTIONS
● Administer oxygen, and monitor oxygen saturation.
● Monitor cardiac rhythm.
● Obtain daily weight.
● Administer blood transfusion as prescribed.
● Administer cardiac medications as prescribed (diuretics, antidysrhythmics).
● Administer antianemia medications as prescribed
Posterior fontanel closes - answer✔by 8 weeks of age
birth weight typically doubles by - answer✔6 months of age
acute respiratory distress syndrome (ARDS) - answer✔ARDS is a state of acute respiratory
failure with a mortality rate of about 60%.
● A systemic inflammatory response injures the alveolar-capillary membrane. It becomes
permeable to large molecules, and the lung space is filled with fluid.
● A reduction in surfactant weakens the alveoli, which causes collapse or filling of fluid, leading
to worsening edema.
Acute respiratory distress syndrome (ARDS) risk factors - answer✔● Can result from localized
lung damage or from the effects of other systemic problems
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