NUR 347 Exam 3
- Pernicious anemia
Answer
paresthesia, numbness/tingling, associated with B12 defi- ciency, administer nasal instead of IM in thrombocytopenia (risk for bleeding)
- B 12 (Cobalamin)
Answer
B12 gives us energy. Patients that need B12 replacement --> Pregnancy, celiac disease, crohn's disease, GI disorders, gastric bypass (usually need B12 will get IM injections or nasally due to malabsorption through GI tract)
- Iron deficiency
Answer
Replace iron through PO, transfusions of packed RBC, nutrition (foods high in iron)-->beefy red tongue
- Foods high in iron
Answer
eggs, beans, wheat, spinach
- Ferrous sulfate
Answer
PO causes constipation, increase fluid and fiber intake, expect- ed side effect of oral ferrous 1 / 3
sulfate is tarry (black) stools --> Patient needs to be educated that this is a normal side effect
- principles of blood transfusion
Answer
Principles of blood transfusion
- Don't use dextrose/ lactated ringers ’ RBC hemolysis
- Transfuse with 0.9 % normal saline
- Don't give additives (meds) in same blood tubing
- Use 20 G or larger due to blood viscosity and could cause hemolysis.
- Blood should be given within 4 hours
- Recognition of transfusion reactions and appropriate nursing interven- tions
Answer
Blood transfusion ’CNA takes vitals (delegation) temp, bp and pulse prior to the infusion
Febrile (nonhemolytic anemia) ’ NOT life-threatening, chills, fever, anxiety
Administer Tylenol (antipyretics) or Benadryl usually occurs more than 15 minutes from starting infusion
Hemolytic (acute reaction) will happen within first 15 minutes of starting the infu- sion’STOP transfusion, remove tubing, administer 0.9% normal saline
- Precautions for low RBC's,WBC's, and Platelets
Answer
First sign and symptom that would concern you that a patient has low platelets
Answer 2 / 3
difficult to arouse, change in loc
Neutropenic precautions ’ wbc, neutrophil count, patient at increased risk for infection (important to check patients temperature every 4 hours) is the patient has a temp of 100 degrees of more that patient is a priority; no fresh flowers, uncooked foods, etc., anything with possible bacteria.
Check vital signs every 4 hours.
No IM ’ thrombocytopenia (low platelets)-risk for bleeding
Thrombocytopenia-complication is bleeding (if the patient has a decreased in loc and is difficult to arouse this would be something you would communicate to the physician
- PTT Lab
Answer
(30-40) --> Heparin
- PTT info
Answer
If a patient's PTT is 50 means it is taking longer to clot. If it is 20, then you worry about thrombus formation.
- Why is Heparin given?
Answer
Can be given after a patient has an MI, DVT, etc. The reason you give this is to make sure a patient takes longer to clot
- Meds that will increase PTT
- / 3
Answer