32: Assessment of Hematologic Function
A nurse cares for a client with megaloblastic anemia who had a total gastrectomy three years ago. What statement will the nurse include in the client's teaching regarding the condition?
"The condition is likely caused by a vitamin B12 deficiency."
A client with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells (RBCs). If the nurse hangs the blood at 12:00 pm, by what time must the infusion be completed?
4:00
A client with Hodgkin disease had a bone marrow biopsy yesterday and reports aching at the biopsy site, rated a 5 (on a 1-10 scale). After assessing the biopsy site, which nursing intervention is most appropriate?
Administer acetaminophen 500 mg po, as ordered
The physician performs a bone marrow biopsy from the posterior iliac crest on a client with pancytopenia. What intervention should the nurse perform after the procedure?
Apply pressure over the site for 5-7 minutes
The nurse should be alert to which adverse assessment finding when transfusing a unit of packed red blood cells (PRBCs) too rapidly?
Crackles auscultated bilaterally
A client receiving a unit of packed red blood cells (PRBCs) has been prescribed morphine 1 mg intravenously now for pain. What is the best method for the nurse to administer the morphine?
Disconnect the blood tubing, flush with normal saline, and administer morphine.
A client receiving a blood transfusion reports shortness of breath, appears anxious, and has a pulse of 125 beats/minute. What is the best action for the nurse to take after stopping the transfusion and awaiting further instruction from the health care provider?
Ensure there is an oxygen delivery device at the bedside.
Which term describes the percentage of blood volume that consists of erythrocytes?
Hematocrit
A client is receiving platelets. In order to decrease the risk of circulatory overload in this client, what action should the nurse take?
Infuse each unit over 30-60 minutes per client tolerance.
Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?
Liver
Place the order of the steps of primary hemostasis in correct order.
The severed blood vessel constricts. The circulating platelets aggregate at the site and adhere to the vessel. An unstable hemostatic plug is formed. Circulating inactive clotting factors convert to active forms.
While caring for a client, the nurse notes petechiae on the client's trunk and lower extremities. What precaution will the nurse take when caring for this client?
Use an electric razor when assisting client with shaving.
