A 2-year-old malnourished child is diagnosed with vitamin B12 and folate deficiencies. A blood smear suggests the deficiency is macrocytic and normochromic. The nurse would expect the he-moglobin to be:
a. normal.
b. sporadic.
c. low.
d. high.
ANS: A
The macrocytic (megaloblastic) anemias are characterized by unusually large stem cells (megalo-blasts) in the marrow that mature into erythrocytes that are unusually large in size (macrocytic), thickness, and volume. The hemoglobin content is normal, thus allowing them to be classified as normochromic.
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What will be an ideal response?
You are called to a residence for a 74-year-old woman who fainted. During your assessment, the patient's son tells you that he was standing next to his mother when she fainted and that he caught her before she fell to the floor. He further tells you that his mother has angina and kidney disease. The patient is now conscious but confused. Her blood pressure is 80/50 mm Hg, pulse is 110 beats/min and weak, and respirations are 22 breaths/min and regular. As your partner administers supplemental oxygen to the patient, you should:
A) assess for the presence of a nitroglycerin patch on the patient and remove it if she is wearing one. B) quickly establish vascular access and administer a 20-mL/kg bolus of an isotonic crystalloid. C) obtain a detailed list of all of the patient's medical problems and the medications that she is taking. D) perform a rapid head-to-toe assessment to determine if she has gross injuries or any hidden conditions.