The nurse devices a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?

Get 8 hours of sleep at night and take naps during the day

Practice yoga and meditation to decrease stress and anxiety

Eat animal protein and dark leafy vegetables each day

Avoid exposure to others with acute infection

Answer and Explanation

The Correct Answer is D

A. Get 8 hours of sleep at night and take naps during the day:

While adequate sleep is generally important for overall health, it may not be the most critical factor for a patient with aplastic anemia. Aplastic anemia primarily affects blood cell production, and managing infection risk and blood counts are more crucial in this context.

B. Practice yoga and meditation to decrease stress and anxiety:

Stress reduction techniques, such as yoga and meditation, can be beneficial for anyone's overall well-being, but it's not the top priority for someone with aplastic anemia. Managing stress is essential, but again, reducing the risk of infections and maintaining adequate blood counts are more critical.

C. Eat animal protein and dark leafy vegetables each day:

Proper nutrition is essential for patients with aplastic anemia, as it can help support the production of red blood cells and maintain overall health. However, while a balanced diet is important, avoiding infections and minimizing exposure to contagions is more pressing.

D. Avoid exposure to others with acute infection:

This is the most crucial concept for patients with aplastic anemia. Aplastic anemia leads to a weakened immune system, making the patient highly susceptible to infections. Exposure to individuals with acute infections can be life-threatening for these patients. Preventing infections and maintaining adequate blood counts are paramount in the care of individuals with aplastic anemia.

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Correct Answer is D

Explanation

A. Appropriate dose of aspirin and rest: Aspirin is an antiplatelet medication that can worsen bleeding in individuals with hemophilia. It should be avoided. Rest alone is not sufficient in this situation.

B. Immobilization of the leg and a dose of ibuprofen: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding. Immobilizing the leg may help prevent further injury, but it does not address the underlying bleeding issue or provide the necessary clotting factor.

C. Heating pad and administration of factor VIII concentrate: While the administration of factor VIII concentrate is appropriate, the use of a heating pad is not advisable, as it can potentially worsen bleeding by dilating blood vessels in the area.

D. Pressure on the site and administration of the required clotting factor.

Hemophilia is a bleeding disorder in which the blood doesn't clot properly. When a hemophilic child has a significant bruise or bleeding, it is crucial to administer the specific clotting factor that they are deficient in (Factor VIII or IX) to stop the bleeding. Applying pressure to the site can also help control bleeding.

In summary, option D is the priority because it directly addresses the bleeding issue in the child with hemophilia by applying pressure to the site and administering the necessary clotting factor. This is crucial in preventing further bleeding and complications.

A. Shunted past the pulmonary circulation, causing pulmonary hypoxia B. Circulated through the lungs again, causing pulmonary circulatory congestion C. Circulated through the ductus from the pulmonary artery to the aorta bypassing the left side of me heart D. Shunted past cardiac arteries, causing myocardial hypoxia

Correct Answer is C

Explanation

A. Shunted past the pulmonary circulation, causing pulmonary hypoxia: This option is not the primary reason for dyspnea in PDA. While there is shunting, it doesn't directly cause pulmonary hypoxia.

B. Circulated through the lungs again, causing pulmonary circulatory congestion: This option is partially correct but does not address the primary reason for dyspnea, which is the bypassing of the left side of the heart.

C. Circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

In patent ductus arteriosus (PDA), a fetal blood vessel called the ductus arteriosus fails to close after birth. This allows oxygenated blood from the left atrium to be shunted directly from the aorta to the pulmonary artery, bypassing the normal route through the left side of the heart and into the systemic circulation. The shunting of oxygenated blood back into the pulmonary circulation can lead to increased pulmonary blood flow and circulatory congestion, causing symptoms such as dyspnea.

D. Shunted past cardiac arteries, causing myocardial hypoxia: PDA primarily affects the pulmonary circulation and left side of the heart, not the coronary arteries. Myocardial hypoxia is not the primary mechanism of dyspnea in PDA.

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