Description:Auto splenectomy refers to the gradual destruction of the spleen that occurs in certain conditions, leading to its eventual disappearance. In sickle cell anemia, the abnormal hemoglobin S causes red blood cells to become rigid and sickle-shaped, which can block blood vessels and impair blood flow. These sickled cells are more prone to being trapped and destroyed in the spleen, leading to chronic hemolysis (breakdown of red blood cells) and eventually causing the spleen to shrink and become non-functional. This process is known as auto splenectomy. Iron deficiency anemia (a) is not associated with auto splenectomy. Thalassemia (b) can lead to splenomegaly (enlarged spleen) due to increased red blood cell destruction, but auto splenectomy is not a characteristic feature. Hemophilia (d) is a bleeding disorder caused by a deficiency in specific clotting factors and does not involve the spleen.

Description:Hemolytic anemias are a group of disorders characterized by the premature destruction of red blood cells (hemolysis). This results in a decreased red blood cell lifespan, which is known as shortened red cell survival (a). The bone marrow responds to the increased demand for red blood cells by undergoing erythroid hyperplasia, meaning there is an increased production of red blood cell precursors (b). In hemolytic anemias, the destruction of red blood cells leads to the release of immature red blood cells called reticulocytes into the circulation. Therefore, the reticulocyte count will be elevated in hemolytic anemias (c). Additionally, the breakdown of hemoglobin from the destroyed red blood cells results in increased levels of unconjugated bilirubin, which can be detected in the blood, leading to elevated unconjugated bilirubin levels (c).

Description:Megaloblastic anemia is not a type of hemolytic anemia. Megaloblastic anemia is primarily caused by a deficiency of vitamin B12 or folate, leading to impaired DNA synthesis and resulting in the production of abnormally large red blood cells (megaloblasts). Hemolytic anemias, on the other hand, are characterized by the premature destruction of red blood cells. Sickle cell anemia, G6PD deficiency, and thalassemia are all examples of hemolytic anemias.

Description:Pernicious anemia is a type of megaloblastic anemia that occurs due to the lack of intrinsic factor, a protein that is necessary for the absorption of vitamin B12 in the intestines. Vitamin B12 is essential for the production of healthy red blood cells. Without intrinsic factor, vitamin B12 deficiency develops, leading to anemia. Therefore, in pernicious anemia, the intrinsic factor is absent. The other options listed do not specifically correspond to pernicious anemia: a. Hemoglobin >12.5 g%: Pernicious anemia is characterized by low levels of hemoglobin, so this option is incorrect. b. ESR, 17 mm/hour: The erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation. Although it can be elevated in various conditions, it is not a specific finding for pernicious anemia. d. Microcytic hypochromic RBCs: Microcytic hypochromic red blood cells are characteristic of a different type of anemia called iron deficiency anemia, not pernicious anemia. In pernicious anemia, the red blood cells may be macrocytic (larger than normal) due to impaired DNA synthesis.

Description:Vitamin B12 deficiency is not limited to any specific group of individuals, and it can affect people regardless of their dietary habits or age. While it is true that strict vegetarians, also known as vegans, are at a higher risk of developing vitamin B12 deficiency because this vitamin is primarily found in animal-derived foods, they are not the only ones who can be affected. Non-vegetarians can also develop a vitamin B12 deficiency if they have poor absorption of the vitamin or if their diet lacks sufficient amounts of it. Additionally, elderly individuals may be more susceptible to vitamin B12 deficiency due to decreased absorption of the vitamin from food as they age. It's important for everyone, regardless of dietary preferences or age, to be aware of their vitamin B12 intake and, if necessary, consider supplementation or consume fortified foods to meet their daily requirements. Regular check-ups and blood tests can help identify and address any potential deficiencies.

Description:Meats and dairy products are the richest sources of vitamin B12. Vitamin B12 is primarily found in animal-based foods, including meat (such as beef, pork, and poultry), fish, eggs, and dairy products (such as milk, cheese, and yogurt). These sources provide the most bioavailable form of vitamin B12, which is essential for various bodily functions, including nerve function and the production of red blood cells. While plant-based foods like grains, green leafy vegetables, and mushrooms may contain trace amounts of vitamin B12, they are not considered reliable sources, particularly for individuals following a strict vegetarian or vegan diet. In such cases, it is recommended to consider vitamin B12 supplements or fortified plant-based foods.

Description:The schilling test is a medical investigation used for patient with vitamin B12 (cobalamin) deficiency. The purpose of the test is to determine whether the patient has pernicious anemia. This test is performed in four stages and patient preparation like NPO is required for this procedure.

Description:The best nursing response would be option c: "Life long." Pernicious anemia is a condition in which the body is unable to absorb vitamin B12 from the gastrointestinal tract. Therefore, the patient requires lifelong treatment with vitamin B12 injections. This is necessary to maintain normal B12 levels in the body and prevent the symptoms of pernicious anemia from recurring.

Description:While it is possible for a patient with mild anemia to exhibit no obvious clinical signs, it is more likely that at least some of the symptoms mentioned above would be present.

Description:The nutritional education given to a client with an Hb (hemoglobin) level of 10g/dL would include all of the options mentioned: a. Prepare food in iron-containing vessels: Cooking food in iron pots or pans can help increase the iron content in the food. This can be beneficial for individuals with low hemoglobin levels, as iron is an essential nutrient for the production of hemoglobin. b. Use green leafy vegetables and legumes: Green leafy vegetables and legumes are good dietary sources of iron, as well as other important nutrients such as vitamins and minerals. Including these foods in the client's diet can help increase their iron intake and improve their hemoglobin levels. c. Take deworming tablets: Worm infestations can contribute to iron deficiency anemia by affecting the absorption and utilization of iron in the body. In some cases, deworming tablets may be recommended to eliminate any intestinal parasites that may be causing or exacerbating the anemia. By implementing all of these measures, the client can improve their iron intake, optimize iron absorption, and address potential factors contributing to their low hemoglobin levels. It's important to note that individual dietary and medical needs may vary, so it's always best to consult a healthcare professional for personalized advice and guidance.

Description:CPDA is a common anticoagulant solution used for preserving blood for transfusion. It is a combination of citrate, phosphate, dextrose, and adenine. This solution helps prevent blood clotting and provides nutrients to maintain the viability and function of red blood cells during storage. CPDA is widely used because it allows for the storage of blood for an extended period, typically up to 35 to 42 days, while maintaining the quality and safety of the blood for transfusion purposes.

Description:Polycythemia is a condition characterized by an abnormally high number of red blood cells (RBCs) in the bloodstream. This can result in an increase in hematocrit, which is the percentage of blood volume occupied by red blood cells. Polycythemia can be primary (polycythemia vera) or secondary to other underlying conditions, such as chronic hypoxia or certain tumors. Anemia, on the other hand, refers to a decrease in the number of red blood cells or a decrease in the amount of hemoglobin in the blood, leading to a reduced ability of the blood to carry oxygen. Leukemia is a cancer of the blood and bone marrow, characterized by an abnormal increase in the number of white blood cells. Thalassemia is a genetic disorder that affects the production of hemoglobin, leading to anemia.

Description:People living at high altitudes have absolute polycythemia due to increased erythropoietin synthesis (not relative polycythemia)

Description:In relative polycythemia, the Hemoglobin and RBC is abnormally high due to an increased concentration of blood (e.g., dehydration, vomiting, diarrhea, etc.). Absolute polycythemia is due to increased in the number of RBC. Relative polycythemia – loss of plasma volume Absolute polycythemia – increased RBC in circulation So, relative and absolute polycythemia can be differentiated by measuring red cell mass and plasma volume.

Description:Pruritus, or itching, is a late symptom of polycythemia vera. Polycythemia vera is a rare blood disorder characterized by the overproduction of red blood cells in the bone marrow. Early symptoms of polycythemia vera may include headaches, dizziness, and shortness of breath, which are due to increased blood viscosity. However, as the disease progresses, pruritus or itching, particularly after exposure to warm water, may develop. Other late symptoms of polycythemia vera can include fatigue, abdominal pain, weight loss, enlarged spleen, and bleeding or clotting problems. It is important to consult a healthcare professional for a proper diagnosis and management of the condition.

Description:Neutropenia is a condition characterized by a decreased number of neutrophils, which are a type of white blood cell important for fighting infections. While conditions like typhoid, viral infections, and cancer chemotherapy can all cause neutropenia, granulocyte transfusion is not a cause of neutropenia. Granulocyte transfusion is actually a treatment option for severe neutropenia or infections in individuals with neutropenia.

Description:Explanation: The specific causes of neutropenia includes chemotherapy, chronic idiopathic neutropenia in adults, Knostman’s syndrome, Leukemia, myelodysplastic syndrome, myelofibrosis, Myelokathexis, Radiation therapy and vitamin deficiencies. Certain infections which cause neutropenia include Hepatitis A, B, C AIDS, Malaria, Lyme disease, Salmonella infection, Sepsis, Hypersplenism and Rheumatoid arthritis and other immune disorders.

Description:The patient with neutropenia is at a higher risk of pseudomonas infection. Neutropenia refers to a low level of neutrophils, which are a type of white blood cell that plays a crucial role in fighting off bacterial infections. Since pseudomonas is a bacteria, a compromised immune system due to neutropenia can increase the susceptibility to pseudomonas infection. Neutropenic patients have a reduced ability to effectively clear bacterial pathogens, including Pseudomonas aeruginosa, which is a common cause of infections in this population.

Description:When caring for a client with neutropenia, which is a low level of neutrophils (a type of white blood cell), one of the most important nursing actions is infection prevention. Neutropenic clients have a weakened immune system, making them more susceptible to infections. Therefore, it is crucial to take precautions to reduce the risk of infections. Some specific nursing actions related to infection prevention for neutropenic clients include: Hand hygiene: Ensuring proper hand hygiene by washing hands thoroughly with soap and water or using alcohol-based hand sanitizers before and after every client interaction. Strict aseptic technique: Following strict aseptic technique during invasive procedures, such as dressing changes or catheter insertions, to minimize the introduction of microorganisms. Environmental cleanliness: Maintaining a clean and sanitized environment by regularly disinfecting surfaces and equipment to reduce the risk of infection. Isolation precautions: Implementing appropriate isolation precautions, such as placing the client in a private room or a room with other neutropenic clients, and wearing personal protective equipment (PPE) like gloves, gowns, masks, and eye protection. Educating the client and family: Providing education to the client and their family about infection prevention measures, including proper hand hygiene, avoiding crowded places or individuals with infectious illnesses, and recognizing signs and symptoms of infection. While pain management, prevention of fatigue, and maintaining mobility are important aspects of nursing care for neutropenic clients, infection prevention takes precedence due to the increased risk of life-threatening infections in these individuals.

Description:The laboratory result expected in a client with an infection is typically leukocytosis, which is option b. Leukocytosis refers to an increased white blood cell (WBC) count in the bloodstream. It is a common response to infection as the body's immune system releases more white blood cells to combat the infectious agent. Leukocytosis helps to indicate an ongoing infection or an inflammatory response in the body. The other options listed (pancytopenia, thrombocytopenia, and anemia) may be seen in certain infections or conditions but are not typically the expected laboratory findings in a client with an infection.

Description:Febrile neutropenia refers to the development of fever (body temperature of 38.3°C or higher) in a patient with neutropenia, which is an abnormally low level of neutrophils (a type of white blood cell) in the blood. Neutropenia is a common side effect of chemotherapy, which can suppress the bone marrow's ability to produce neutrophils. The risk of developing febrile neutropenia is highest when the patient's absolute neutrophil count (ANC) is at its lowest point, which typically occurs around 7-10 days after starting chemotherapy. Therefore, patients are considered most susceptible to febrile neutropenia after approximately 7 days of chemotherapy. Options a, b, and d are not as accurate because they either underestimate or overestimate the time required for a patient to become susceptible to febrile neutropenia.

Description:Antibiotic prophylaxis decrease febrile neutropenia. Antibiotic prophylaxis to patients receiving chemotherapy for acute leukemia and high dose chemotherapy for solid tumors is recommended. It should also be offered to those receiving moderately myelosuppressive chemotherapy for solid tumors and lymphomas during the first cycle of chemotherapy.

Description:Among the options provided, the most probable diagnosis if RBC, WBC, and platelet counts are depressed is b. Aplastic anemia. Aplastic anemia is a condition characterized by a reduction in the production of red blood cells (RBCs), white blood cells (WBCs), and platelets in the bone marrow. This can lead to low counts of all three blood cell types, resulting in anemia, increased susceptibility to infections, and increased risk of bleeding. Other conditions, such as lymphoma (a type of cancer affecting the lymphatic system), DIC (disseminated intravascular coagulation, a condition characterized by abnormal blood clotting and bleeding), and thalassemia (an inherited blood disorder affecting the production of hemoglobin) may not necessarily cause a simultaneous depression of RBC, WBC, and platelet counts.

Description:Pancytopenia is most commonly associated with aplastic anemia (option a). Aplastic anemia is a condition characterized by a decrease in the number of red blood cells, white blood cells, and platelets in the blood. Pancytopenia refers to the simultaneous reduction in all three types of blood cells. In aplastic anemia, the bone marrow fails to produce enough new blood cells, leading to low levels of red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia). While other types of anemia, such as hemolytic anemia (option b), pernicious anemia (option c), and sickle cell anemia (option d), can cause low red blood cell count, they do not typically result in simultaneous reductions in white blood cells and platelets, which are characteristic of pancytopenia.

Description:Aplastic anemia is a condition characterized by a deficiency of all types of blood cells (red blood cells, white blood cells, and platelets) in the bone marrow. While aplastic anemia itself is not a type of cancer, it can sometimes progress to other types of hematological malignancies, including acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and lymphoma. AML is a type of cancer that affects the myeloid cells in the bone marrow, leading to the overproduction of immature and abnormal white blood cells. Aplastic anemia can transform into AML in some cases. ALL is a type of cancer that affects the lymphoid cells, which are responsible for producing white blood cells that fight infections. Although ALL is more commonly associated with precursor cells in the bone marrow, it is possible for aplastic anemia to progress to ALL. Lymphoma refers to a group of cancers that develop from lymphocytes, a type of white blood cell. While the exact mechanisms are not fully understood, aplastic anemia has been linked to an increased risk of developing lymphoma. Therefore, it is important for individuals with aplastic anemia to be monitored closely and receive appropriate medical care to manage the condition and detect any potential progression to other hematological malignancies.