A female client with iron-deficiency anemia is experiencing increased fatigue and a shiny red tongue. The nurse would anticipate seeing which additional assessment finding(s) (SELECT ALL THAT APPLY)

Bottle spoon-shaped finger nails

Platelets 400.000/0

Rea blood cell count 4.5 million/mm3

Hemoglobin 8.0 g/di

Tachypnea

Answer and Explanation

Correct Answer : A,D,E

A. Bottle spoon-shaped fingernails: This is a classic sign associated with iron deficiency anemia, known as koilonychia. The nails may appear thin, brittle, and spoon-shaped, indicating a deficiency in iron.

B. Platelets 400,000/µL: This platelet count is within the normal range (typically 150,000 to 450,000/µL) and does not specifically indicate iron deficiency anemia. Thus, it is not an expected finding.

C. Red blood cell count 4.5 million/mm³: This value is within the normal range for females (approximately 4.2 to 5.4 million/mm³). In iron deficiency anemia, one would expect the RBC count to be low or at least on the lower end of normal.

D. Hemoglobin 8.0 g/dL: This low hemoglobin level is indicative of anemia. In iron deficiency anemia, hemoglobin levels are often significantly decreased, so this finding aligns with the client's condition.

E. Tachypnea: Increased respiratory rate can occur in response to anemia, as the body attempts to compensate for decreased oxygen-carrying capacity by increasing breathing rate. Therefore, tachypnea is a likely finding in this client.

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Correct Answer is A

Explanation

A) Second intercostal space right of sternum: This is the correct location for auscultating an aortic murmur. The aortic area is best heard at the second intercostal space on the right side of the sternum, where the sound of blood flow through the aortic valve is most prominent.

B) Fourth intercostal space, left mid-clavicular line: This location is typically associated with the mitral valve area, not the aortic area. While important for other heart sounds, it does not correspond to where an aortic murmur would be heard loudest.

C) Third intercostal space, left of sternum: This area is generally associated with the pulmonic area, not the aorta. Murmurs from the aortic valve would not be best heard here.

D) Second intercostal space left of sternum: This location is associated with the pulmonic area as well. An aortic murmur would not be best auscultated here, making this option incorrect for identifying an aortic murmur specifically.

A. express no complaints of chest discomfort or shortness of breath. B. discuss which lifestyle modifications will be necessary to maintain health. C. have clear breath sounds bilaterally upon auscultation. D. have a urinary output of greater than 30 ml per hour for 24 hours.

Correct Answer is A

Explanation

A) Express no complaints of chest discomfort or shortness of breath: This outcome directly relates to the goal of improving tissue perfusion. Chest discomfort and shortness of breath can indicate inadequate perfusion, particularly in a client with coronary artery disease. By achieving this outcome, the nurse can assess that tissue perfusion is sufficient and the client is stable.

B) Discuss which lifestyle modifications will be necessary to maintain health: While this is an important aspect of ongoing care and management for coronary artery disease, it does not directly address the immediate concern of impaired tissue perfusion. The priority is to ensure the client is currently experiencing effective perfusion rather than just planning for future health modifications.

C) Have clear breath sounds bilaterally upon auscultation: Clear breath sounds are a positive indicator of pulmonary function but do not directly measure tissue perfusion related to coronary artery disease. While this is important for overall health, it does not specifically target the issue of impaired perfusion in cardiac tissue.

D) Have a urinary output of greater than 30 ml per hour for 24 hours: While adequate urinary output can be a sign of good kidney perfusion and overall fluid balance, it is not a direct indicator of cardiac tissue perfusion. The priority in this scenario is more closely tied to the client’s cardiac status and symptoms related to coronary artery disease.

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A female client with iron-deficiency anemia is experiencing increased fatigue and a shiny red tongue. The nurse would anticipate seeing which additional assessment finding(s) (SELECT ALL THAT APPLY)

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Correct Answer is A

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