A nurse is caring for a client with hemolytic anemia.
The client presents with pallor, fatigue, tachycardia, and jaundice.
Which of the following additional clinical manifestations should the nurse anticipate in this client?
"I have noticed that my urine has become very dark lately.”
"My abdomen feels swollen and uncomfortable.”
"I have been experiencing painful episodes in my bones.”
"I have been having severe headaches and chest pain.”
The Correct Answer is A
"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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
A complete blood count (CBC) with differential can provide information about the overall red blood cell count and indices but may not confirm the presence of immune-mediated hemolysis.
Choice B rationale:
A peripheral blood smear can show abnormalities in the shape and structure of red blood cells but may not confirm the presence of immune-mediated hemolysis or identify the underlying cause.
Choice D rationale:
Serum bilirubin and haptoglobin levels can provide indirect evidence of hemolysis, but they do not confirm the presence of immune-mediated hemolysis or identify the underlying cause.
Choice C rationale:
The direct antiglobulin test (DAT), also known as the Coombs test, is used to detect the presence of antibodies or complement proteins on the surface of red blood cells.
A positive DAT result indicates immune-mediated hemolysis, confirming the suspicion raised by the clinical presentation of pallor, fatigue, and splenomegaly.
This test is crucial for diagnosing the specific type of immune-mediated hemolytic anemia and guiding further management.
Correct Answer is C
Explanation
Choice A rationale:
The statement, "My skin looks paler than usual," is a valid physical examination finding, but it is a general symptom of anemia and not specific to hemolytic anemia.
Other types of anemia can also cause pale skin.
Choice B rationale:
The statement, "I've been having chest pain occasionally," is important to assess, but it is not a specific physical examination finding related to hemolytic anemia.
Chest pain may have various causes, and additional information is needed to determine its significance.
Choice C rationale:
The statement, "I've noticed my urine is getting darker," is a specific physical examination finding that is highly relevant to hemolytic anemia.
Dark urine can result from the breakdown of red blood cells and the release of hemoglobin into the urine, a characteristic feature of hemolytic anemia.
Choice D rationale:
The statement, "I've been experiencing abdominal pain," is important to assess, but it is not a specific physical examination finding related to hemolytic anemia.
Abdominal pain can have various causes, and further evaluation is needed to determine its association with the patient's condition.
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