A client with polycythemia reports several symptoms.
Which statement made by the client is indicative of the condition?
"I've been feeling fatigued and weak lately.”
"I've had some itching on my skin.”
"I've been experiencing chest pain.”
"I've been coughing up blood.”
The Correct Answer is B
Choice A rationale:
"I've been feeling fatigued and weak lately." Rationale: Fatigue and weakness are common symptoms of polycythemia due to the increased viscosity of the blood resulting from elevated red blood cell counts, making it more difficult for the heart to pump blood efficiently.
Choice B rationale:
"I've had some itching on my skin." Rationale: Itching, particularly after exposure to warm water or a hot shower, is a classic symptom of polycythemia vera (primary polycythemia)
This itching is known as pruritus, and it occurs due to the release of histamines and other substances from white blood cells.
Choice C rationale:
"I've been experiencing chest pain." Rationale: While chest pain can be associated with polycythemia in severe cases due to an increased risk of thrombosis and ischemia, it is not as specific of a symptom as itching in the context of polycythemia.
Choice D rationale:
"I've been coughing up blood." Rationale: Coughing up blood is not a typical symptom of polycythemia.
It may be associated with other conditions or complications, but it is not a direct indication of polycythemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Hyperthyroidism can lead to an increase in red blood cell production, known as secondary polycythemia.
However, it is not the most likely cause in this scenario.
The primary cause of secondary polycythemia is usually related to hypoxia or conditions that increase erythropoietin production.
Choice B rationale:
Renal cysts can lead to polycythemia due to increased erythropoietin production by the kidneys.
When the kidneys detect low oxygen levels in the blood (hypoxia), they release erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow.
Renal cysts can disrupt the normal function of the kidneys and trigger excessive erythropoietin release, causing secondary polycythemia.
Choice C rationale:
Smoking can lead to chronic obstructive pulmonary disease (COPD), which can cause secondary polycythemia due to chronic hypoxia.
However, renal cysts are a more direct cause in this scenario.
Choice D rationale:
Obesity can lead to sleep apnea, which can cause secondary polycythemia due to chronic hypoxia during sleep.
However, renal cysts are a more likely cause of secondary polycythemia than obesity alone.
Correct Answer is A
Explanation
Choice A rationale:
Reduce blood volume and viscosity.
Rationale: The primary goal of treatment for a patient with primary polycythemia is to reduce blood volume and viscosity.
This helps prevent complications such as thrombosis, which can occur due to increased blood thickness.
Phlebotomy is commonly used to achieve this goal by removing excess red blood cells.
Choice B rationale:
Administer low-dose aspirin.
Rationale: Administering low-dose aspirin may be a part of the treatment plan to reduce the risk of blood clots, but it is not the primary goal.
The primary goal is to decrease blood volume and viscosity.
Choice C rationale:
Correct dehydration and fluid loss.
Rationale: Correcting dehydration and fluid loss is important but not the primary goal of treatment for primary polycythemia.
The primary goal is to address the increased red blood cell production and thickened blood.
Choice D rationale:
Perform phlebotomy to reduce hematocrit.
Rationale: This is a correct statement and aligns with the primary goal of treatment for primary polycythemia.
Phlebotomy is a key intervention to reduce hematocrit levels and, consequently, blood volume and viscosity.
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