Author Question: A woman at 30 weeks' gestation and a history including sickle cell anemia presents to the clinic ... (Read 42 times)

ss2343 · **on:** Jun 28, 2018

A woman at 30 weeks' gestation and a history including sickle cell anemia presents to the clinic complaining of fever, chills, and diarrhea for three days. What are the most serious potential complications faced by this patient?

1. Electrolyte imbalance
2. Sickle cell crisis
3. Fetal neural tube defects
4. Severe lethargy

Question 2

A patient who is at 18 weeks' gestation has been newly diagnosed with megaloblastic anemia. Which statement by the patient indicates that she understands the teaching?

1. I should include fresh leafy green vegetables, red meat, fish, poultry, and legumes in my diet.
2. Whenever possible, I should boil my vegetables in at least 2 quarts of water.
3. Megaloblastic anemia is not known to cause any serious risks to my baby.
4. My body makes red blood cells that are smaller than they should be.

Amiracle · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: While the patient may experience electrolyte imbalance, sickle cell crisis is the most serious potential complication of dehydration and fever.
Rationale 2: Dehydration and fever can trigger sickling and crisis; for this reason, maternal infections are treated promptly.
Rationale 3: Fever, chills, and dehydration in the patient with sickle cell anemia are not associated with an increased incidence of neural tube defects.
Rationale 4: While the patient may develop severe lethargy, her greatest risk concerns development of sickle cell crisis.

Answer to Question 2

Correct Answer: 1
Rationale 1: Folic acid, which is used to treat megaloblastic anemia, is readily available in foods such as fresh leafy green vegetables, red meat, fish, poultry, and legumes.
Rationale 2: Folic acid, which is crucial for inclusion in the diet of patients with megaloblastic anemia, is easily destroyed by overcooking or cooking with large quantities of water.
Rationale 3: Maternal folic acid deficiency has been associated with an increased risk of neural tube defects (NTDs) such as spina bifida, meningomyelocele, and anencephaly in the newborn.
Rationale 4: In megaloblastic anemia, red blood cells become enlarged and are fewer in number.