A nurse is reinforcing teaching with a client has a new diagnosis of aplastic anemia. When discussing the pathology of this disease, which of the following instructions should the nurse include in the teaching?
"Aplastic anemia results from decreased bone marrow production of RBCs."
"Aplastic anemia is directly related to impaired liver function."
"Aplastic anemia is associated with the decreased intake of iron."
"Aplastic anemia results in an increased rate of RBC destruction."
The Correct Answer is A
A. "Aplastic anemia results from decreased bone marrow production of RBCs." Aplastic anemia is characterized by the failure of bone marrow to produce adequate red blood cells (RBCs), white blood cells, and platelets. This results in pancytopenia, which increases the risk of infections, anemia, and bleeding.
B. "Aplastic anemia is directly related to impaired liver function." Aplastic anemia is not related to liver function; it originates from the bone marrow’s inability to produce sufficient blood cells.
C. "Aplastic anemia is associated with the decreased intake of iron." Aplastic anemia is not caused by iron deficiency; it is primarily due to bone marrow failure. Iron deficiency anemia, on the other hand, results from a lack of iron intake or absorption.
D. "Aplastic anemia results in an increased rate of RBC destruction." Increased RBC destruction is characteristic of hemolytic anemia, not aplastic anemia.
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Correct Answer is C
Explanation
A. Hip: While “hip” can sometimes colloquially refer to the iliac crest, it is not commonly used to describe the specific site for aspiration outside of the iliac crest.
B. Cervical spine: The cervical spine is not a site used for bone marrow aspiration due to its inaccessibility and proximity to critical structures.
C. Sternum: The sternum is a common site for bone marrow aspiration in adults as it provides direct access to the marrow.
D. Humerus: The humerus is generally not used for bone marrow aspirations as it does not provide as accessible or large an area for aspiration.
Correct Answer is D
Explanation
A. Heat relaxes the muscles and distracts the patient from the pain. While warmth can provide comfort, the main goal is to improve circulation rather than distraction.
B. Sickle cell crisis pain can be exacerbated with shivering. Although shivering may be uncomfortable, it is not the primary reason for using heat during a sickle cell crisis.
C. Heat promotes proper formation of red blood cells (RBCs) and prevents sickling. Heat does not affect RBC formation or prevent sickling. The condition of sickling is due to genetic factors, not temperature.
D. Heat increases circulation by preventing vasoconstriction. In sickle cell crisis, warmth helps prevent vasoconstriction, which can reduce blood flow to areas already compromised by sickled cells. Preventing vasoconstriction may help alleviate pain and improve circulation.