Anemia Prepu

Aluminum hydroxide

A client being treated for iron deficiency anemia with ferrous sulfate continues to be anemic despite treatment. The nurse should assess the client for use of which medication? Prednisone Tegretol Amoxicillin Aluminum hydroxide

Blood loss Abnormal erythrocyte production Destruction of normally formed red blood cells

A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. Infection Inadequate formed white blood cells Blood loss Abnormal erythrocyte production Destruction of normally formed red blood cells

Ensures that epinephrine is available

A client is prescribed an intravenous dose of iron dextran. What is the nurse's best action? Informs the client that one dose will reverse iron-deficiency anemia Ensures that epinephrine is available Checks the client's hemoglobin level the following day Realizes that use of this medication will produce a false-positive when checking stool for blood

Dyspnea, tachycardia, and pallor

A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia? Itching, rash, and jaundice Nights sweats, weight loss, and diarrhea Dyspnea, tachycardia, and pallor Nausea, vomiting, and anorexia

Cryoprecipitate

A client with disseminated intravascular coagulation (DIC) has a critically low fibrinogen level and is beginning to hemorrhage. To increase the amount of fibrinogen in the body, the nurse anticipates administering which blood product? Packed red blood cells Albumin Fresh frozen plasma Cryoprecipitate

"Eat small amounts of bland, soft foods frequently."

A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms? "Eat cold, bland foods with a large amount of water." "Eat larger amounts of bland, soft foods less frequently." "Eat low-fiber blended foods only." "Eat small amounts of bland, soft foods frequently."

Administering and evaluating the effectiveness of opioid analgesics

A client with sickle cell crisis is admitted to the hospital in severe pain. While caring for the client during the crisis, which is the priority nursing intervention? Administering and evaluating the effectiveness of opioid analgesics Limit foods that contain folic acid Limiting the client's intake of oral and IV fluids Encouraging the client to ambulate immediately

Lungs Spleen Central nervous system

A client with sickle cell disease is treated for a thrombotic event. Which organs or body systems does the nurse recognize as being at greatest risk for thrombosis in a client with sickle cell disease? Select all that apply. Lungs Spleen Central nervous system Liver Cardiac system

Mean corpuscle volume of 70 Total iron-binding capacity of 450 mcg/dL Hemoglobin of 11.0 Ferritin level of 20

A client with weakness, fatigue, and general malaise is being tested for iron deficiency anemia. Which laboratory values will the nurse expect to confirm this diagnosis? Select all that apply. Mean corpuscle volume of 70 Hematocrit of 56% Total iron-binding capacity of 450 mcg/dL Hemoglobin of 11.0 Ferritin level of 20

Bone marrow aspiration

A nurse cares for a client suspected of having iron deficient anemia. Which diagnostic test will the nurse expect the health care provider to order in order to definitively diagnose the condition? Complete blood count Blood smear Bone marrow aspiration Serum ferritin

Tingling in the fingers Poor coordination

A nurse cares for a client with anemia after having a total gastrectomy a year ago. Which unique assessment findings will the nurse likely find when assessing this client that may not be present in another client with anemia? Select all that apply. Tingling in the fingers Weakness Poor coordination Fatigue Shortness of breath

Neutrophil count 1200/microliter Platelets 35,000 microliters Hemoglobin 7 g/dL

A nurse cares for a client with aplastic anemia. Which laboratory results will the nurse expect to find with this client? Select all that apply. Neutrophil count 1200/microliter Neutrophil count 17,000/microliter Platelets 35,000 microliters White blood cell count 10,000/microliter Hemoglobin 7 g/dL

Glucose-6-phosphate dehydrogenase deficiency

A nurse cares for a client with severe hemoglobinuria (hemoglobin in the urine) after an upper respiratory infection and fever. Diagnostic testing reveals degraded hemoglobin within the client's erythrocytes. Which hematological condition does the nurse suspect the client has? Polycythemia vera Aplastic anemia Sickle cell disease Glucose-6-phosphate dehydrogenase deficiency

Women lose iron through menstrual cycles

A nurse cares for clients with hematological disorders and notes that women are diagnosed with hemochromatosis at a much lower rate than men. What is the primary reason for this? Women have lower hemoglobin levels Women lose iron through menstrual cycles Women require grater folic acid supplementation Women rarely manifest the gene expression

Decreased cognitive function.

A nurse cares for older adult clients in a long-term care facility. The nurse notices that many of the clients have chronic anemia. What long-term impact does the nurse associate with this population and the presence of anemia? Decreased cognitive function. Decreased immune function. Increased risk of gastrointestinal disease. Increased risk of infection.

I.M.

A nurse is caring for a client with a history of GI bleeding, sickle cell anemia, and a platelet count of 22,000/μl. The client, who is dehydrated and receiving dextrose 5% in half-normal saline solution at 150 ml/hour, complains of severe bone pain and is scheduled to receive a dose of morphine sulfate. For which administration route should the nurse question an order? Oral I.V. I.M. Subcutaneous (subQ)

Peripheral edema

A nurse is caring for a client with severe anemia. The client is tachycardic and reports dizziness and exertional dyspnea. What signs and symptoms might develop if this client goes into heart failure? Migraine Fever Peripheral edema Nausea and vomiting

Heart rate does not increase as much as in younger clients. Fatigue is often greater than in younger clients. Confusion is often greater than in younger clients.

A nurse is reviewing the various manifestations of anemia across the lifespan and notes a significant difference in how the older adult client responds to anemia versus a younger individual. Which concepts related to aging and the response to anemia does the nurse recognize? Select all that apply. Heart rate does not increase as much as in younger clients. Fatigue is often greater than in younger clients. Cardiac output increases more than in younger clients. Confusion is often greater than in younger clients. Dyspnea is not reported as often as in younger clients.

Start an intravenous line with dextrose 5% in 0.25 normal saline

A patient with sickle cell disease comes to the emergency department and reports severe pain in the back, right hip, and right arm. What intervention is important for the nurse to provide? Administer ibuprofen Start an intravenous line with dextrose 5% in 0.25 normal saline Begin oxygen at 2 L/M Administer aspirin

"I will call the doctor if my stools turn black."

After teaching a client about taking daily oral iron preparations for a moderate iron deficiency anemia, which statement by the client indicates to the nurse that additional instruction is needed? "I will take the iron with orange juice about an hour before eating." "I will increase my fluid and fiber intake while I am taking the iron tablets." "I will occasionally take a stool softener if I feel constipated." "I will call the doctor if my stools turn black."

Intestinal disorders Alcoholism Not eating vegetables Poor nutrition

An older adult client at the free clinic has a history of seizures and presents with severe fatigue, frequent headaches, and a sore and beefy red tongue. Which of the following does the nurse suspect as causes of the client's current condition? Select all that apply. Intestinal disorders Alcoholism Not eating vegetables Poor nutrition

Osteoporosis

A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. The client is taking prednisone daily and reported feeling pain after manually opening the garage door. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain? Osteoporosis Hypertension Truncal obesity Muscle wasting

hemoglobin S

A client has a history of sickle cell anemia with several sickle cell crises over the past 10 years. What blood component results in sickle cell anemia? hemoglobin S hemoglobin A hemoglobin F hemoglobin M

dementia

A client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults? dementia stomatitis glossitis ataxia

Assesses the hemoglobin level

A client in end-stage renal disease is prescribed epoetin alfa and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, what is the priority action taken by the nurse? Ensures the client has completed dialysis treatment Assesses the hemoglobin level Holds the epoetin alfa if the BUN is elevated Questions the administration of both medications

Closely monitor intake and output.

A client is being treated for DIC and the nurse has prioritized the nursing diagnosis of Risk for Deficient Fluid Volume Related to Bleeding. How can the nurse best determine if goals of care relating to this diagnosis are being met? Assess for edema. Assess the client's level of consciousness frequently. Closely monitor intake and output. Assess skin integrity frequently.

Aplastic anemia

A client is brought to the ED reporting fatigue, large amounts of bruising on the extremities, and abdominal pain localized in the left upper quadrant. A health history reveals the client has been treated for a sore throat three times in the past 2 months. Laboratory tests indicate severe anemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, what could be the client's diagnosis? Hemolytic anemia Aplastic anemia Sickle cell anemia Iron deficiency anemia

Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.

A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client? Vascular occlusion in small vessels decreasing blood and oxygen to the tissues. The client has a decreased tolerance of pain related to the chronic nature of the illness. Bone marrow decreases the erythrocyte production causing decrease in hypoxia. Overhydration enlarges the red blood cells.

There is a strong correlation between iron stores and hemoglobin levels.

A client is treated for anemia. What is the nurse's best understanding about the correlation between anemia and the client's iron stores? There is a strong correlation between iron stores and hemoglobin characteristics. There is a strong correlation between iron stores and hemoglobin levels. There is an inverse relationship between iron stores and hemoglobin levels. There is a weak correlation between iron stores and hemoglobin levels.

CBC

A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order? ECG CBC antibiotic chest radiograph

Folic acid deficiency

A client was admitted to the hospital with the following laboratory values: hemoglobin 5 g/dL, leukocyte count 2000/mm3, and a platelet count of 48,000/mm3; abnormally shaped erythrocytes and hypersegmented neutrophils were seen. The platelets appear abnormally large. A bone marrow biopsy was competed and revealed hyperplasia. Based on this information, the nurse determines that client most likely has which diagnosis? Hemolytic anemia Sickle cell anemia Thalassemia Folic acid deficiency

Adequate nutrition

A client's low prothrombin time (PT) was attributed to low vitamin K levels and the client's PT normalized after administration of vitamin K. When performing discharge education in an effort to prevent recurrence, what should the nurse emphasize? Meticulous hygiene Adequate nutrition Constant access to clotting factor concentrates Avoidance of NSAIDs

Ulcerated corners of the mouth Jaundice Concave nails

A nurse assesses a client diagnosed with megaloblastic anemia. Which clinical findings will the nurse most likely find? Select all that apply. Ulcerated corners of the mouth Jaundice Restless leg syndrome Smooth, red tongue Concave nails

Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints.

A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure? Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. Ask if taking a blood pressure has ever produced pain in the upper arm. Ask if taking a blood pressure has ever caused bruising in the hand and wrist. Ask if taking a blood pressure has ever produced the need for medication.

Pallor, tachycardia, and a sore tongue

A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client? Sore tongue, dyspnea, and weight gain Pallor, tachycardia, and a sore tongue Angina pectoris, double vision, and anorexia Pallor, bradycardia, and reduced pulse pressure

Use a disposable razor when shaving.

A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which would not be included in the client's discharge instructions? Use a disposable razor when shaving. Avoid contact with family/friends who are sick. Plan for frequent periods of rest. Encourage frequent handwashing.

Pneumovax 23

A nurse should expect to administer which vaccine to the client after a splenectomy? Pneumovax 23 Attenuvax Recombivax HB Tetanus toxoid

Neutrophil count of 50%

A nurse suspects that a patient may have aplastic anemia based on clinical manifestations and assessment. Which one of the following lab results would be consistent with this diagnosis? Neutrophil count of 50% Platelet level of 275,000/mm3 Erythrocyte count of 5.3 m/?L Hemoglobin level of 15 g/dL

Colder temperatures slows the blood flow.

A nurse working with clients diagnosed with sickle cell disease notices that sickle cell crisis cases increase in the winter months. What is the primary pathophysiological reason for this? Colder temperatures impairs oxygen uptake. Colder temperatures slows the blood flow. Colder temperatures worsens sickling. Colder temperatures increases vessel pressures.

Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential

A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention? Monitoring the client's breathing and reviewing the client's arterial blood gases Monitoring the client's heart rate and reviewing the client's hemoglobin Monitoring the client's blood pressure and reviewing the client's hematocrit Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential

B12

A patient describes numbness in the arms and hands with a tingling sensation. The patient also frequently stumbles when walking. What vitamin deficiency does the nurse determine may cause some of these symptoms? B12 Iron Folate Thiamine

Gradually taper the dose and frequency of medication.

A patient has been diagnosed with thrombocytopenia. What are the primary nursing interventions while instituting corticosteroid therapy in this patient? Gradually taper the dose and frequency of medication. Palpate the lymph nodes and tonsils every shift. Eliminate aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Examine the extremities for redness.

The onset of a bacterial infection

A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for? Diarrhea Bleeding The onset of a bacterial infection Abdominal pain

Hemoglobin level

A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication? Creatinine level Hemoglobin level Folate levels Potassium level

Lower incidence of acute chest syndrome Decreased need for blood transfusions Fewer painful episodes of sickle cell crisis

A patient with sickle cell anemia is to begin treatment for the disease with hydroxyurea. What does the nurse inform the patient will be the benefits of treatment with this medication? Select all that apply. Ability to reverse the damage done from sickling of cells Decreased need for other analgesic medications Lower incidence of acute chest syndrome Decreased need for blood transfusions Fewer painful episodes of sickle cell crisis

Reports joint pain less than 3 on a scale of 0 to 10

A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client? Takes hydroxyurea during her pregnancy Describes the importance of staying cool Exhibits a temperature more than 100.3°F Reports joint pain less than 3 on a scale of 0 to 10

Fresh frozen plasma

A teenaged client with hemophilia sustains a leg laceration after falling off a skateboard and is brought to the emergency department. The laceration is bleeding profusely even with direct pressure to the site. What does the nurse anticipate will be prescribed for administration to control bleeding? A colloid solution such as hetastarch (Hespan) Albumin A crystalloid solution such as lactated Ringer's Fresh frozen plasma

Employs the Z-track technique

A thin client is prescribed iron dextran intramuscularly. What is most important action taken by the nurse when administering this medication? Rubs the site vigorously Uses a 23-gauge needle Injects into the deltoid muscle Employs the Z-track technique

Uncooked vegetables

Folate deficiency occurs in people who rarely eat which of the following? Meat Uncooked vegetables Fruit Bread

Assigns the client to a private room

The client has been diagnosed with myelodysplastic syndrome with an absolute neutrophil count less than 1000/mm³ and is being admitted to the hospital. The nurse Changes the water in the humidifier for oxygen therapy every 48 hours Allows unlicensed assistive personnel who reports having a sore throat to provide care Assigns the client to a private room Places the client in isolation and allows no visitors

bleeding.

The most common cause of iron deficiency anemia in men and postmenopausal women is bleeding. chronic alcoholism. iron malabsorption. menorrhagia.

Trauma and microabrasions from a non-electric razor may contribute to anemia.

The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. What is the rationale for this statement by the nurse? Strong tissues and intact clotting mechanisms may prevent hemorrhage. The client is at risk for spontaneous and uncontrolled bleeding. Trauma and microabrasions from a non-electric razor may contribute to anemia. The client is not at risk for infection from microorganisms.

Direct pressure

The nurse is caring for a client with external bleeding. What is the nurse's priority intervention? Elevation of the extremity Direct pressure Pressure point control Application of a tourniquet

C

The nurse is educating a client about iron supplements. The nurse teaches that what vitamin enhances the absorption of iron? C A D E

Observe the client's stools for blood.

The nurse provides care for an older adult client, diagnosed with anemia, who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine the cause of the client's blood loss, which is the priority nursing action? Evaluate the client's dietary intake. Monitor the client's blood pressure. Observe the client's stools for blood. Monitor the client's body temperature.

Health history, including menstrual history in women

When assessing a client with anemia, which assessment is essential? Lifestyle assessments, such as exercise routines Age and gender Health history, including menstrual history in women Family history

Beans, dried fruits, and leafy, green vegetables

When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods? Berries and orange vegetables Fruits high in vitamin C, such as oranges and grapefruits Beans, dried fruits, and leafy, green vegetables Dairy products

Lamb and peaches

Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat? Shrimp and tomatoes Lamb and peaches Lobster and squash Cheese and bananas

vitamin k

Which medication is the antidote to warfarin?

Nitric oxide

vasodilator that may reduce sickling. What medication is the nurse instructing the client about? Nitrous oxide Terbutaline Nitric oxide Betamethasone

Decreased MCV Decreased reticulocytes

The nurse cares for a client with iron deficiency anemia. What findings will the nurse expect to find when reviewing the client's CBC results? Select all that apply. Increased MCV Decreased MCV Fragmented RBCs Increased reticulocytes Decreased reticulocytes

Infection Bleeding

The nurse cares for several clients with hematological conditions. Which assessment needs will the nurse prioritize for the client with aplastic anemia? Select all that apply. Injury Infection Perfusion Bleeding Oxygenation

Megaloblastic anemia

The nurse is assessing a patient who is a strict vegetarian. What type of anemia is the nurse aware that this patient is at risk for? Megaloblastic anemia - pernicious anemia Iron deficiency anemia Aplastic anemia Sickle cell anemia

B12

The nurse is caring for a client with type 2 diabetes who take metformin to manage glucose levels. The nurse recognizes the client may be most at risk for which vitamin deficiency? Folate B12 C A

Eating calf's liver with a glass of orange juice

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption? Eating a steak with mushrooms Eating leafy green vegetables with a glass of water Eating calf's liver with a glass of orange juice Eating apple slices with carrots

administering stool softeners, as ordered, to prevent straining during defecation

The nurse is planning care for a client diagnosed with immune thrombocytopenia. Which nursing intervention should be included in the plan of care? giving aspirin, as ordered, to control body temperature administering platelets, as ordered, to maintain an adequate platelet count administering stool softeners, as ordered, to prevent straining during defecation teaching coughing and deep-breathing techniques to help prevent infection

Increase the intake of fluids to 3 L per day. Avoid working in the garden. Use the incentive spirometer every 4 hours. Report a new onset of fever to the health care provider.

The nurse is preparing information to help a client with neutropenia and limited mobility reduce the risk of infection. Which information will the nurse include in this teaching? Select all that apply. Increase the intake of fluids to 3 L per day. Avoid working in the garden. Use the incentive spirometer every 4 hours. Report a new onset of fever to the health care provider. Encourage socialization with others.

Refuse to administer the blood

The nurse obtains a unit of blood for the client, Donald D. Smith. The name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. What action should the nurse take? Ask the client if he was ever known as Donald A. Smith Refuse to administer the blood Check with the blood bank first and then administer the blood with their permission Administer the unit of blood

Dilute liquid preparations of iron with juice and drink with a straw

The nurse should advise a client with iron deficiency anemia to take which action in order to prevent staining of the teeth? Do not combine iron with other prescribed or over-the-counter medications Avoid taking iron simultaneously with an antacid Take iron with or immediately after meals Dilute liquid preparations of iron with juice and drink with a straw

An adolescent with bulimia nervosa A client with Crohn's disease An older adult client on a fixed income

The registered nurse (RN) and licensed practical nurse (LPN) are preparing an educational program for clients who may be at risk for the development of iron-deficiency anemia. Which client(s) would receive the greatest benefit from this program? Select all that apply. An adolescent with bulimia nervosa A client with Crohn's disease A client who lives in a nursing home An older adult client on a fixed income A client who is a vegetarian

Epistaxis Hematemesis Bleeding gums

Which of the following are assessment findings associated with thrombocytopenia? Select all that apply. Epistaxis Hematemesis Bradypnea Bleeding gums Hypertension

Hypochromic

Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents? Normocytic Hyperchromic Hypochromic Microcytic

They decrease the macrophages ability to clear the antibody-coated RBCs. If the hemoglobin returns to normal, the corticosteroid dose can be lowered.

Which of the following is accurate regarding the use of corticosteroids for immune hemolytic anemia? Select all that apply. They decrease the macrophages ability to clear the antibody-coated RBCs. If the hemoglobin returns to normal, the corticosteroid dose can be lowered. Corticosteroids are not effective in the treatment of immune hemolytic anemia. They produce lasting effects. The treatment consists of low doses of corticosteroids.

Pallor

While assessing a client, the nurse will recognize what as the most obvious sign of anemia? Pallor Flow murmurs Tachycardia Jaundice

Platelet count, prothrombin time, and partial thromboplastin time

While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters? Thrombin time, calcium levels, and potassium levels Platelet count, blood glucose levels, and white blood cell (WBC) count Platelet count, prothrombin time, and partial thromboplastin time Fibrinogen level, WBC, and platelet count

Orange juice

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron? Orange juice Leafy green vegetables Kidney beans Milk

Wear a medical identification bracelet.

A young client is diagnosed with a mild form of hemophilia and is experiencing bleeding in the joints with pain. In preparing the client for discharge, what instructions should the nurse provide? Undergo genetic testing and counseling if the client is male. Wear a medical identification bracelet. Take ibuprofen for joint pain. Take warm baths to lessen pain.

Supplement the diet with vitamin B12.

An older adult client who is a vegetarian has a hemoglobin of 10.2 gm/dL, vitamin B12 of 68 pg/mL (normal: 200-900 pg/mL), and MCV of 110 cubic micrometers. After interpreting the data, what instruction should the nurse give to the client? Change the vegetarian diet and begin to eat red meat. Ingest a diet higher in vitamin B12 sources. Continue with the diet but include more sources of iron. Supplement the diet with vitamin B12.

Neurologic involvement

A client with a diagnosis of pernicious anemia comes to the clinic and reports numbness and tingling in the arms and legs. What do these symptoms indicate? Severity of the disease Insufficient intake of dietary nutrients Neurologic involvement Loss of vibratory and position senses

The client's activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value.

A client with a pulmonary embolism is being treated with a heparin infusion. What diagnostic finding suggests to the nurse that treatment is effective? The client's PT is within reference ranges. The client's activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value. Arterial blood sampling tests positive for the presence of factor XIII. The client's platelet level is below 100,000/mm3.

Decreased protein stores lead to decreased immune response

A nurse cares for a client with a hematological disorder and malnutrition. What is the nurse's best understanding of how the client's nutritional status may worsen the client's hematological condition? Decreased carbohydrates lead to decreased oxygen affinity of the hemoglobin Decreased protein stores lead to decreased immune response Decreased fat stores lead to decreased ability for red blood cells Decreased calories lead to decreased immune response

Pernicious anemia

A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The patient takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this patient at risk for? Iron deficiency anemia Aplastic anemia Sickle cell anemia Pernicious anemia

Hematocrit of 60%

A patient has a probable diagnosis of polycythemia vera. The nurse reviews the patient's lab work for which diagnostic indicator? Leukocyte count of 11,500/mm3 Erythrocyte count of 6.5 m/?L Platelet value of 350,000/mm3 Hematocrit of 60%

Febrile nonhemolytic reactions

A patient with chronic anemia has had many blood transfusions over the last 3 years. What type of transfusion reaction should the nurse monitor for that is commonly found in patients who frequently receive blood transfusions? Allergic reactions Circulatory overload Febrile nonhemolytic reactions Acute hemolytic reaction

Consult a health care provider about ingesting trimethoprim/sulfamethoxazole for a urinary tract infection.

A young client is diagnosed with glucose-6-phosphate dehydrogenase deficiency (G-6-PD). After reviewing the client's recent activities, what instruction should the nurse recommend to the client? Stop drinking excessive caffeinated beverages in less than 24 hours. Discontinue exposure on a sun tanning bed. Consult a health care provider about ingesting trimethoprim/sulfamethoxazole for a urinary tract infection. Quit cigarette smoking.

Thrombocytopenia

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count? Leukopenia Thrombocytopenia Anemia Neutropenia

intrinsic factor

An client has pernicious anemia and has been receiving treatment for several years. What is the client lacking that results in pernicious anemia? hemoglobin extrinsic factor intrinsic factor vitamin B

slow the rate of the transfusion and obtain an order for furosemide

An older adult client is to receive 2 units of packed red blood cells. During the transfusion of the first unit at 125 mL/hour, the client reports shortness of breath 30 minutes into the process. The client exhibits the vital signs shown in the accompanying table. What is the nurse's best intervention? slow the rate of the transfusion and obtain an order for furosemide contact the health care provider and obtain an order for diphenhydramine (Benadryl) obtain blood and urine specimens for a transfusion reaction administer oxygen through nasal cannula at 2 L/minute

Megaloblastic

During a routine assessment of a patient diagnosed with anemia, the nurse observes the patient's beefy red tongue. The nurse is aware that this is a sign of what kind of anemia? Iron deficiency Megaloblastic Autoimmune Folate deficiency

Low ferritin level concentration

During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding? Enlarged mean corpuscular volume (MCV) Elevated red blood cell (RBC) count Elevated hematocrit concentration Low ferritin level concentration

Monitoring temperature every 4 hours

For a client with Hodgkin disease who has developed neutropenia, what is an appropriate nursing intervention to include in the care plan? Monitoring temperature every 4 hours Avoiding intramuscular (IM) injections Omitting fresh fruits and vegetables from the diet Positioning the client to increase lung expansion

amount and quality of factor VIII

Hemophilia A is the most common of the three types of hemophilia. What is diminished in the less serious form of hemophilia A, known as von Willebrand's disease? quality of factor XI amount and quality of factor VIII quality of factor VIII amount and quality of factor IX

Menorrhagia

The most common cause of iron-deficiency anemia in premenopausal women includes which of the following? Lack of vitamin B12 Inadequate iron supplementation Menorrhagia Iron malabsorption

Drink liquid iron preparations with a straw.

The nurse and the client are discussing some strategies for ingesting iron to combat the client's iron-deficiency anemia. Which is among the nurse's strategies? Take iron with an antacid to avoid stomach upset. Avoid vitamin C as it prevents absorption. Drink liquid iron preparations with a straw. Taking iron pills with milk aids in absorption.

Abdominal pain

The nurse is caring for a client with an exacerbation of sickle cell disease (SCD). Which finding indicates to the nurse that the client is experiencing a liver complication from this condition? Weakness Abdominal pain Glucose intolerance Fatigue

Blood loss from the gastrointestinal or genitourinary tract

The nurse is caring for an older adult client who has been admitted to the unit with anemia. What would the nurse expect the client to possibly exhibit? Decrease in the total body iron stores with age Excessive consumption of coffee or tea Elimination of iron by the body Blood loss from the gastrointestinal or genitourinary tract

Administer factor VIII intravenously at the first sign of bleeding

The nurse is talking with the parents of a toddler who was diagnosed with hemophilia A. What instruction should the nurse give to the parents? Use nasal packing for any nose bleeds Encourage the toddler to participate in playground activities with other toddlers Administer factor VIII intravenously at the first sign of bleeding Administer over-the-counter preparations for a cold

Erythrocytes that are microcytic and hypochromic

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia? Clustering of platelets with sickled red blood cells An increased number of erythrocytes Erythrocytes that are microcytic and hypochromic Erythrocytes that are macrocytic and hyperchromic

Participate in regular phlebotomy procedures to decrease blood viscosity.

The nurse's role in the management of polycythemia vera is primarily that of an educator. Choose the best health promotion advice that a nurse could give. Use compression stockings when walking to prevent deep vein thrombosis (DVT). Take antiplatelets on a regular basis. Take aspirin daily to prevent clot formation. Participate in regular phlebotomy procedures to decrease blood viscosity.

Notify the physician

The nurse, caring for a client in the emergency room with a severe nosebleed, becomes concerned when the client asks for a bedpan. The nurse documents the stool as loose, tarry, and black looking. The nurse suspects the client may have thrombocytopenia. What should be the nurse's priority action? Notify the physician Stop the nosebleed Put in an IV line Ask someone to clean the bedpan

Bronzing of the skin

Which is a symptom of hemochromatosis? Inflammation of the mouth Inflammation of the tongue Weight gain Bronzing of the skin

Hypochromic

Which of the following describes a red blood cell (RBC) that has pale or lighter cellular contents? Hypochromic Normocytic Hyperchromic Microcytic

Drink at least 8 glasses of water every day.

You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client? Stay on oxygen therapy 24/7. Avoid any activity that makes you short of breath. Drink at least 8 glasses of water every day. Avoid any sports that tire you out.

It will remove the major site of red blood cell (RBC) destruction.

A client admitted to the hospital in preparation for a splenectomy to treat autoimmune hemolytic anemia asks the nurse about the benefits of splenectomy. Which statement best explains the expected effect of splenectomy? It will increase red blood cell (RBC) production to compensate for blood loss. It will increase production of platelets by the bone marrow. It will remove the major site of red blood cell (RBC) destruction. It will reduce the destruction of platelets by macrophages.

onto the bedpan.

A client admitted to the hospital with abdominal pain, anemia, and bloody stools reports feeling weak and dizzy. The client has rectal pressure and needs to urinate and move their bowels. The nurse should help them: to a standing position so he can urinate. to the bathroom. to the bedside commode. onto the bedpan.

Rich sources of vitamin C

A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron? Vitamin E Rich sources of vitamin C Meat, egg yolks, oysters, and shellfish Sources of vitamin B12

Aplastic anemia

A client comes to the walk-in clinic complaining of weakness and fatigue. While assessing this client, the nurse finds evidence of petechiae and ecchymoses. The nurse notes that the spleen appears enlarged. What would the nurse suspect is wrong with this client? Iron-deficiency anemia Agranulocytosis Pernicious anemia Aplastic anemia

Remove the prescribed one unit of blood.

A client has hereditary hemochromatosis. Laboratory test results indicate an elevated serum iron level, high transferrin saturation, and normal complete blood count (CBC). What is most important action for the nurse to take? Educate about precautions to follow after a liver biopsy. Instruct the client to limit iron intake in the diet. Inform the client to limit ingestion of alcohol. Remove the prescribed one unit of blood.

Administer the prescribed enoxaparin (Lovenox).

A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, which action should the nurse take? Monitor partial thromboplastin (PTT) time. Encourage a diet high in vitamin K. Administer the prescribed enoxaparin (Lovenox). Have the client limit physical activity.

Take 1 hour before breakfast

A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching? Decrease intake of dietary fiber Decrease intake of fruits and juices Take 1 hour before breakfast Take with dairy products

Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI

A client is receiving chemotherapy for cancer. The nurse reviews the client's laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority? Activity intolerance Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI Impaired oral mucous membranes Impaired tissue integrity

"I will take it in the morning with orange juice."

A client with anemia is prescribed an oral iron supplement. Which statement indicates that teaching about this supplement has been effective? "I will limit my intake of raw fruit and vegetables." "I will take it in the morning with orange juice." "I will stop taking it if my stool turns black." "I will be sure to take this medication with food."

Takes over-the-counter iron supplements

A client with chronic anemia has received multiple transfusions. Which client action would the nurse be concerned about relative to the client's condition? Takes a daily multiple vitamin pill Eliminates use of alcohol Takes 60 grams of protein each day Takes over-the-counter iron supplements

10,000/?l.

A client with idiopathic thrombocytopenic purpura (ITP) is admitted to an acute care facility. The nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral hemorrhage when the platelet count falls below what number? 135,000/?l. 75,000/?l. 10,000/?l. 20,000/?l.

Obtain the pain medication and delay the bath and position change until the medication reaches its peak.

A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse? Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration. Obtain the pain medication and delay the bath and position change until the medication reaches its peak. Inform the client that she will feel better after receiving a bath and clean sheets. Inform the client that the position must be changed, and then you will give her pain medication and omit the bath

Checks the client's BUN and creatinine

A client with multiple myeloma reports pain along the spinal column. The client is prescribed naproxen (Aleve) and oxycodone. Prior to administering these medications, the nurse Teaches the client to bend at the back when lifting objects Instructs the client not to lift more than 20 pounds Questions the physician about the use of both medications Checks the client's BUN and creatinine

"I will receive parenteral vitamin B12 therapy for the rest of my life."

A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy? "I will receive parenteral vitamin B12 therapy for the rest of my life." "I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear." "I will receive parenteral vitamin B12 therapy monthly for 6 months to a year." "I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal."

Urine output greater than or equal to 30 mL/hour

A client with sepsis is experiencing disseminated intravascular coagulation (DIC). The client is bleeding from mucous membranes, venipuncture sites, and the rectum. Blood is present in the urine. The nurse establishes the nursing diagnosis of Risk for deficient fluid volume related to bleeding. The most appropriate and measurable outcome for this client is that the client exhibits Systolic blood pressure greater than 70 mm Hg Stable level of consciousness Decreased bleeding Urine output greater than or equal to 30 mL/hour

Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit

A client with severe anemia reports symptoms of tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Laboratory test results reveal low hemoglobin and hematocrit levels. Based on the assessment data, which nursing diagnoses is most appropriate for this client? Fatigue related to decreased hemoglobin and hematocrit Risk for falls related to complaints of dizziness Imbalanced nutrition, less than body requirements, related to inadequate intake of essential nutrients Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit

"DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs."

A client's family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC? "DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs." "DIC is caused when hemolytic processes destroy erythrocytes." "DIC is a complication of an autoimmune disease that attacks the body's own cells." "DIC occurs when the immune system attacks platelets and causes massive bleeding."

A-positive blood to an A-negative client.

A clinical nurse specialist (CNS) is orienting a new graduate registered nurse to an oncology unit where blood product transfusions are frequently administered. In discussing ABO compatibility, the CNS presents several hypothetical scenarios. The new graduate knows that the greatest likelihood of an acute hemolytic reaction would occur when giving: O-positive blood to an A-positive client. O-negative blood to an O-positive client. B-positive blood to an AB-positive client. A-positive blood to an A-negative client.

Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels

A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify? Electrolyte imbalance that could affect the blood's ability to coagulate properly Low levels of urine constituents normally excreted in the urine Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels

A high number of pregnancies can increase the risk of reaction.

A female patient has a hemoglobin of 6.4 g/dL and is preparing to have a blood transfusion. Why would it be important for the nurse to obtain information about the patient's history of pregnancy prior to the transfusion? Obtaining information about gravidity and parity is routine information for all female patients. If the patient has been pregnant, she may have developed allergies. If the patient has never been pregnant, it increases the risk of reaction. A high number of pregnancies can increase the risk of reaction.

A hemolytic allergic reaction caused by an antigen reaction

A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the health care provider immediately because the client probably is experiencing which problem? A hemolytic reaction caused by bacterial contamination of donor blood A hemolytic reaction to mismatched blood A hemolytic reaction to Rh-incompatible blood A hemolytic allergic reaction caused by an antigen reaction

6 to 12 months

A health care provider prescribes one tablet of ferrous sulfate daily for a 15-year-old girl who experiences heavy blood flow during her menstrual cycle. The nurse advises the patient and her parent that this over-the-counter preparation must be taken for how many months before stored iron replenishment can occur? 6 to 12 months 3 to 5 months Longer than 12 months 1 to 2 months

"I'll eat four servings of fresh, dark green vegetables every day."

A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching? "I'll report unexplained or severe bruising to my doctor right away." "I'll eat four servings of fresh, dark green vegetables every day." "I'll watch my gums for bleeding when I brush my teeth." "I'll use an electric razor to shave."

Have you experienced abdominal pain?

A male client has a hemoglobin count of 10.2 gm/dl, a hematocrit value of 36%, and a low ferritin level. What question should the nurse ask first? Have you experienced abdominal pain? Are you taking iron supplements? How much alcohol do you drink? Can you explain your typical diet?

Consult with the physician about discontinuing heparin.

A male client has been receiving a continuous infusion of weight-based heparin for more than 4 days. The client's PTT is at a level that requires an increase of heparin by 100 units per hour. The client has the laboratory findings shown above. What is the most important action for the nurse to take? Consult with the physician about discontinuing heparin. Begin treatment with the prescribed warfarin (Coumadin). Continue with the present infusion rate of heparin. Increase the heparin infusion by 100 units per hour.

Assist the client to incorporate the therapeutic regimen into daily activities.

A nurse cares for a client with anemia requiring nutritional supplementation. Which nursing intervention best promotes client adherence with the prescribed therapy? Assist the client to use a medication reminder system for the therapeutic regimen. Assist the client to incorporate the therapeutic regimen into daily activities. Develop a therapeutic regimen based on the client's understanding of the medication. Develop a therapeutic regimen recommendation for the client.

To closely monitor the rate of administration

A nurse is caring for a client with thalassemia who is being transfused. What is the nurse's role during a transfusion? To instruct the client to rest immediately if chest pain develops To assess for enlargement and tenderness over the liver and spleen To closely monitor the rate of administration To administer vitamin B12 injections

Use the smallest needle possible for injections.

A nurse is caring for a client with thrombocytopenia. What is the best way to protect this client? Use the smallest needle possible for injections. Limit visits by family members. Maintain accurate fluid intake and output records. Encourage the client to use a wheelchair.

Place a pressure-reducing mattress on the client's bed.

A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which nursing intervention should the nurse include? Provide mouth care every 4 hours with lemon-glycerin swabs. Administer aspirin daily as ordered. Place a pressure-reducing mattress on the client's bed. Administer meperidine (Demerol) I.M. as needed for pain.

To detect the abnormal sounds suggestive of acute chest syndrome and heart failure

A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse? To detect the evidence of dehydration that might have triggered a sickle cell crisis To detect the evidence of infection such as fever and tachycardia To detect the abnormal sounds suggestive of acute chest syndrome and heart failure To detect the motor strength and stroke-related signs and symptoms

Creatinine level of 6 mg/100 mL

A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia? Creatinine level of 6 mg/100 mL Potassium level of 5.2 mEq/L Calcium level of 9.4 mg/dL Magnesium level of 2.5 mg/dL

"I have difficulty breathing when walking 30 feet."

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia? "I feel hot all of the time." "I have a difficult time falling asleep at night." "I have an increase in my appetite." "I have difficulty breathing when walking 30 feet."

Eating calf's liver with a glass of orange juice

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption? Eating apple slices with carrots Eating a steak with mushrooms Eating calf's liver with a glass of orange juice Eating leafy green vegetables with a glass of water

Dilute the liquid preparation with another liquid such as juice and drink with a straw.

The nurse is instructing a client about taking a liquid iron preparation for the treatment of iron-deficiency anemia. What should the nurse include in the instructions? Dilute the liquid preparation with another liquid such as juice and drink with a straw. Do not take medication with orange juice because it will delay absorption of the iron. Discontinue the use of iron if your stool turns black. Iron may cause indigestion and should be taken with an antacid such as Mylanta.

It may indicate deficiencies in essential nutrients.

The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient? It is important for the nurse to determine what type of foods the patient will eat. It will determine what type of anemia the patient has. It may indicate deficiencies in essential nutrients. It is part of the required assessment information.

Assisting in prioritizing activities.

The nurse is planning care for a client with severe fatigue secondary to anemia. What concept will the nurse use as the basis for planning interventions? Assisting in prioritizing activities. Keeping long activity periods to build client stamina. Encouraging early and frequent activities. Determining what days to be active.

Schilling test

The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for? Bone marrow aspiration Magnetic resonance imaging (MRI) study Schilling test Bone marrow biopsy

a client admitted with sepsis

The nurse is reviewing plans of care for several clients. The nurse recognizes that which client is most at risk for developing disseminated intravascular coagulation (DIC)? a client admitted with suspected cocaine overdose a client with a stage IV pressure ulcer a client with heart failure and renal failure a client admitted with sepsis

Iron deficiency anemia

The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned the co-worker may have? Megaloblastic anemia Iron deficiency anemia Aplastic anemia Sickle cell anemia

Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements

When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that all leukemias have which common feature? Increased blood viscosity, resulting from an overproduction of white cells Reduced plasma volume in response to a reduced production of cellular elements Compensatory polycythemia stimulated by thrombocytopenia Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements

Applying prolonged pressure to needle sites or other sources of external bleeding

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia? Implementing neutropenic precautions Monitoring temperature at least once per shift Eliminating direct contact with others who are infectious Applying prolonged pressure to needle sites or other sources of external bleeding

Protamine sulfate

Which of the following is considered an antidote to heparin? Ipecac Protamine sulfate Narcan Vitamin K

Anemia

Which of the following is the most common hematologic condition affecting elderly patients Bandemia Thrombocytopenia Leukopenia Anemia

Pancytopenia

Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets? Thrombocytopenia Pancytopenia Leukopenia Anemia

Iron deficiency anemia

While assessing a client, the nurse discovers the client has a history of restless leg syndrome. Which hematological condition does the nurse associate with this condition? Folate deficiency anemia Sickle cell disease Thalassemia Iron deficiency anemia