Hematologic Disorders and Anemia Q 10 - Gyan Darpan : Learning Portal
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Wednesday, 27 April 2022

Hematologic Disorders and Anemia Q 10

Which of the following nursing assessments is a late symptom of polycythemia vera?
     A. Headache
     B. Dizziness
     C. Pruritus
     D. Shortness of breath

Correct Answer: C. Pruritus

Pruritus is a late symptom that results from abnormal histamine metabolism. Aquagenic pruritus, which occurs during or after a hot shower, is a complaint in 40% of patients. The mechanism is likely from mast cell and basophil degranulation, causing a histamine surge. In a 2013 study with 1545 patients, pruritus was associated with better survival.

Option A: Symptoms are related to hyperviscosity and thrombosis, impairing oxygen delivery. Physical complaints can include fatigue, headache, dizziness, tinnitus, vision changes, insomnia, claudication, pruritus, gastritis, and early satiety.
Option B: Dizziness is an early symptom of engorged veins. On physical exam, patients can display plethora and flushing of the face and palms, conjunctival injection, and skin excoriation from pruritus. Splenomegaly and hepatomegaly are also often observed.
Option D: Shortness of breath is an early symptom from the congested mucous membrane and ineffective gas exchange. Thrombotic events can include deep venous thrombosis (DVT), pulmonary embolism (PE), Budd-Chiari syndrome, splanchnic vein thrombosis, stroke, and arterial thrombosis.

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