A nurse is conducting a nursing assessment for a patient with suspected hemolytic anemia.
Which aspect of the patient's history should the nurse prioritize?
"I'm feeling so weak lately.”
"I had a blood transfusion a few years ago.”
"I think I might have an autoimmune disorder.”
"My family has a history of hemolytic disorders.”
The Correct Answer is D
Choice A rationale:
The statement, "I'm feeling so weak lately," is important information, but it does not prioritize the assessment.
Weakness is a common symptom of anemia, but in a patient with suspected hemolytic anemia, obtaining a family history of hemolytic disorders is more critical.
Choice B rationale:
The statement, "I had a blood transfusion a few years ago," is relevant to the patient's history but does not take priority over obtaining information about the family history of hemolytic disorders.
Choice C rationale:
The statement, "I think I might have an autoimmune disorder," is relevant and should be explored further, but it does not take priority over obtaining a family history of hemolytic disorders.
Choice D rationale:
The statement, "My family has a history of hemolytic disorders," is the most crucial aspect of the patient's history to prioritize.
Hemolytic disorders often have a genetic component, so family history can provide valuable information for diagnosis and management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
"I have noticed that my urine has become very dark lately." Dark urine is a common clinical manifestation of hemolysis, as it indicates the presence of hemoglobin in the urine, known as hemoglobinuria.
This is a result of the breakdown of red blood cells and release of hemoglobin into the bloodstream.
Choice B rationale:
"My abdomen feels swollen and uncomfortable." Abdominal discomfort or swelling is not a specific clinical manifestation of hemolytic anemia.
It may be associated with conditions like splenomegaly but is not a characteristic sign of hemolysis.
Choice C rationale:
"I have been experiencing painful episodes in my bones." Painful episodes in the bones are not typically associated with hemolytic anemia.
Bone pain may be related to other conditions but is not a direct result of hemolysis.
Choice D rationale:
"I have been having severe headaches and chest pain." Severe headaches and chest pain are not specific clinical manifestations of hemolytic anemia.
These symptoms may have other causes and should be evaluated separately.
Correct Answer is B
Explanation
Choice A rationale:
Elevated bilirubin levels.
Elevated bilirubin levels are not a specific clinical manifestation of intravascular hemolysis.
Bilirubin levels may be elevated in various types of anemia, but it is not a characteristic sign of intravascular hemolysis.
Choice B rationale:
Hemoglobinuria.
Hemoglobinuria is a clinical manifestation consistent with intravascular hemolysis.
When red blood cells are destroyed within blood vessels, hemoglobin is released into the bloodstream, and it can be filtered by the kidneys and excreted in the urine, leading to hemoglobinuria.
Choice C rationale:
Splenomegaly.
Splenomegaly can occur in some types of anemia, but it is not a specific clinical manifestation of intravascular hemolysis.
It may be more commonly associated with conditions like hereditary spherocytosis or thalassemia.
Choice D rationale:
Increased ferritin levels.
Increased ferritin levels are not a specific clinical manifestation of intravascular hemolysis.
Ferritin is a marker of iron storage in the body and is not directly related to the destruction of red blood cells.
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