When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following physiological functions?
A. Bleeding tendencies
B. Intake and output
C. Peripheral sensation
D. Bowel function
Correct Answer: A. Bleeding tendencies
Aplastic anemia decreases the bone marrow production of RBCs, WBCs, and platelets. The client is at risk for bruising and bleeding tendencies. A low platelet count or thrombocytopenia is caused by a bone marrow malfunction resulting from nutritional deficiencies, drugs, certain viral causes, or aplastic anemia. The risk for bleeding is increased as platelet count is decreased.
Option B: A change in the intake and output is important, but assessment for the potential for bleeding takes priority. Monitor stool (guaiac) and urine (Hemastix) for occult blood. These tests help identify the site of bleeding.
Option C: Change in the peripheral nervous system is a priority problem specific to clients with vitamin B12 deficiency. Vitamin B12 injections used to treat low levels (deficiency) of this vitamin. They are given monthly for the remainder of the client’s life. It elevates levels of vitamin B12, a deficiency caused by a lack of intrinsic factor that impairs the vitamin absorption.
Option D: Change in bowel function is not associated with aplastic anemia. Instruct the client on dietary modifications to reduce constipation. Eating a diet high in fiber and drinking a lot of fluids to avoid constipation or using a stool softener and other laxatives as prescribed if having difficulty passing stool.
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