ATI, Saunders, Textbook, Pretest, Workbook Qs & Terms/Abbreviations: Chapter 82 Blood & Lymph

The nurse is caring for a client with a diagnosis of aplastic anemia. Which are the most likely signs/symptoms associated with aplastic anemia? Select all that apply.

Fatigue, infection, petechiae, SOB

The lack of a gastric substance called intrinsic factor causes ______ anemia.

pernicious

PPF

plasma protein fraction

Agranulocytosis

production of WBCs decreases, causing severe neutropenia

The nurse explains to a client receiving packed RBCs that the blood product is produced by centrifuging (spinning) whole blood, which forces the RBCs to the bottom of the container. For which client would packed RBCs be the best choice?

A client who has anemia

A client with sickle cell disease has been admitted to the hospital complaining of a sudden onset of severe pain in the extremities, abdomen, back, and chest. Which interventions would the nurse expect to be included in the care of the client? Select all that apply.

Administer oxygen per nasal cannula, Administer the prescribed opioid analgesic, Encourage the client to keep extremities extended, Hydrate the client with 0.9% normal saline 125 mL/hr intravenously.

The nurse is caring for a client with bleeding disorder. What interventions would the nurse include in the client's care plan? Select all that apply.

Avoid constipation, Report any excessive bleeding from brushing teeth, Avoid any aspirin products, Avoid exposure to infection

The nurse is caring for a client with a suspected diagnosis of aplastic anemia. Which test would the nurse anticipate to be performed to confirm the diagnosis?

Bone marrow aspiration

Why should the nurse encourage the client prescribed an iron supplement to eat a high-fiber diet?

Decreases the side effects of iron supplements

to detect antibodies attached to RBC

Direct Coombs test

In which disease would the D antigen be particularly important?

Erythroblastosis fetalis

The nurse is caring for a client receiving chemotherapy and determines that the client has developed myelosuppression. Which laboratory value would support the client's diagnosis of myelosuppression?

Hemoglobin 9.4 g/dL, Hematocrit 26%

A nurse in a clinic is caring for a client who has suspected anemia. Which of the following lab test results should the nurse expect?

Hgb 10 g/dL (normal range F: 12-16g/dL M: 14-18g/dL)

HD

Hodgekins disease

What should the nurse assess for in a client with multiple myeloma?

Increase in body temperature

A nurse is assisting the charge nurse with the admin of a blood transfusion to an older adult client. Which of the following actions by the nurse indicates an understanding of the procedure?

Obtain vital signs every 15 mins throughout the procedure.

The nurse is preparing to administer a blood transfusion to a client who experienced postoperative hemorrhaging. Which guideline should be followed for this procedure?

Two licensed personnel must identify the unit of blood.

The nurse is preparing a transfusion for a client with type AB blood. Which blood type is considered the universal donor? Group of answer choices

Type O

A client has been diagnosed with pernicious anemia. In planning care for the client, the nurse anticipates that the client will be treated with which vitamin or mineral?

Vitamin B12

A nurse is caring for a client who reports mood swing, weakness, tingling and numbness, of the finger and feet and a sore tongue. What vitamin deficiency would the nurse further assess in this client?

Vitamin B12

A client has experienced several episodes of sickle cell crisis. Which reinforced instructions would be included in the client's teaching plan to prevent recurrence? Select all that apply.

Wear shoes and socks when walking outside to prevent damage to the feet, Recognize early symptoms of infection and contact the primary health care provider (PHCP).

A female client has chronic myeloid leukemia. What signs and symptoms should the nurse monitor in such a client? Select all that apply

Weight gain, Night sweats, Enlarged spleen

Leukopenia

a reduction in the number of wbc in the blood, typical of various diseases.

aPTT

activated partial thromboplastin time

A decrease in the number of WBCs is called _____________.

leukpnea

ESR

measures the speed at which RB settle to the bottom of a tube of unclotted blood thats used to detect inflammatory processes, neoplasms, and necrotic processes

hematology

medical specialty concerned with the hematologic and lymphatic systems

Hodgkin's disease

most common type of cancer in young adults that presents with enlarged lymph nodes and accompanying pain, fever, fatigue, night sweats, itching and weight loss

Multiple ________________ is a malignant cancer of bone marrow in which the B lymphocytes proliferate, causing bone pain and anemia

mylenoma

Thrombocytopenia

occurs when a client's platelet count falls below 150,000/mm3

PBSC

peripheral blood stem cell

sickle cell anemia

genetic disease in which the person's RBCs become crescent shaped when exposed to decreased oxygen

NHL

group of lymphatic neoplasms

IG

immune globulin

hemophilia

sex-linked genetic disorder in which the person's blood is slow to coagulate owing to lack of factor VIII or factor IX in the plasma

bone marrow biopsy

this procedure is done to evaluate the number, size, and shape of RBCs, WBCs and megakaryocytes

An increase in the number of thrombocytes is called ____________.

thrombocythemia

The intravenous administration of blood and blood products is called a blood __________.

transfusion

AML

type of acute leukemia most commonly found in adults

ALL

type of acute leukemia most commonly found in children

Lukemia

Malignant hematologic disorder characterized by an abundance of abnormal WBCs

The nurse is interacting with client who has been in treatment for leukemia for several months. What statement by the client would alert the nurse to refer the client to social service.

"I notice my spouse is not interested in attending my doctor's appointment as much as before."

A nurse is reinforcing teaching for a client who is scheduled for a bone marrow biopsy of the iliac crest. Which of the following statements made by the client indicates an understanding of the information?

"I will need to stay in bed for about an hr after the test." (30-60min following the test to prevent bleeding)

A nurse is reinforcing preop teaching for a client who requests autologous donation in preparation for a schedule orthopedic surgical procedure. Which of the follow statements should the nurse include?

"You can donate blood each week if your hemoglobin is stable

The client diagnosed with pernicious anemia asks the nurse, "why do I have to have a shot of Vit b12? I would rather just eat foods in high in the vitamin or take supplements." What is the nurse's best response?

"You lack intrinsic factor, which is required to absorb the vitamin B12 orally."

The nurse is reviewing the laboratory results of a client receiving chemotherapy. The nurse prepares to initiate neutropenic precautions when the nurse notes which laboratory result?

A white blood cell (WBC) count of 2000 mm3 (Normal range: 5,000-10,000)

A client with iron-deficiency anemia has been prescribed iron supplements. What nursing care measures should be employed when administering iron supplements to a client? Select all that apply

Administer liquid iron with the help of straw, Give citrus juices along with the iron, Inform the client that iron will change the color of stool to black

A nurse is caring for a client with peptic ulcer. The client show symptoms of anemia. The client show symptoms of anemia. Which term should the nurse use to describe the anemic condition of the client?

Chronic hemorrhagic anemia

The nurse is caring for a client following a total hip replacement. The client has been diagnosed with iron deficiency anemia. The nurse instructs the client to increase intake of which foods? Select all that apply.

Clams and mussels, Lean beef and chicken liver

A client has been diagnosed with disseminated intravascular coagulation (DIC). Which laboratory tests would the nurse anticipate being prescribed? Select all that apply.

D-dimer, Hemoglobin, Prothrombin Time

The nurse is reinforcing instructions to a client with iron deficiency anemia about eating a diet with iron-rich foods. Which food sources would the nurse include in the discharge teaching plan of a client with iron deficiency anemia? Select all that apply.

Eggs, liver

Which food sources would the nurse include in the discharge teaching plan of a client with vitamin B12 deficiency anemia? Select all that apply.

Eggs, liver, red meats

Which nursing care measure should be employed when caring for a client with relative polycythemia?

Encourage the client to drink plenty of fluids, especially water

A nurse is caring for a client with non-Hodgkin lymphoma. When assessing the client, what sign and symptom should the nurse look for?

Enlargement of the liver

A nurse is caring for a client with secondary polycythemia. Which would show an increase in the laboratory report for this client?

Erythropoietin (EPO)

A direct Coombs test helps to detect the chance of developing erythroblastosis fetalis in the fetus.

False

Both anti-A and anti-B antibodies are present in type AB blood.

False

Hemophilia is a sex-linked genetic disorder caused by the clotting of blood in major blood vessels.

False

A nurse is reinforcing teaching with a client who has a new prescription for ferrous sulfate, Which of the following information should the nurse include?

Foods high in Vit C will promote absorption

A nurse is monitoring a client who began receiving a unit of packed RBCs 10 min ago. Which of the following findings should the nurse Identify as an indication of a febrile transfusion reaction? Select all that apply

HR change from 88/min pretransfusion to 120/mm, client appears flushed

To identify the percentage of RBCs in the blood

Hematorcrit (Hct)

to screen circulating Rh antibodies

Indirect Coombs test

The nurse is doing discharge teaching with a client who has sickle cell disease. The nurse reinforces instructions to the client to avoid which factors that could precipitate a sickle cell crisis? Select all that apply.

Infection, emotional stress

A client diagnosed with leukemia is receiving high-dose chemotherapy to kill cancerous cells and promote sites for new noncancerous cells to grow before bone marrow transplant. For what complication of chemotherapy is this client at risk?

Infections

The nurse is caring for a client who has leukemia. Which blood test result for white blood cells (WBCs) is useful in diagnosing and monitoring the response to treatment for this condition?

Lymphocytosis

A nurse is assisting with administration of packed RBCs to a client who has Hgb of 8g/dL. Which of the follow action should the nurse plan to take during the first 15 min of the transfusion?

Monitor for an acute hemolytic reaction

The nurse is providing teaching to the client following a new diagnosis of aplastic anemia. What would the nurse include in the teaching plan? Select all that apply.

Monitor for signs of bleed (gum, intestinal, neuro), Avoid crowds and exposure to people who are sick, Invasive procedures will be done using sterile technique.

Which of the following should the nurse keep in mind when caring for the client who is receiving warfarin therapy? Select all that apply

Monitor the PT twice a week after stabilization of the blood anticoagulant level, Avoid the administration of intramuscular injections, Avoid monitoring the rectal temperature of the client

A client is admitted to the hospital with vitamin B12 deficiency. When taking the client's history, which symptoms would the nurse expect the client to report? Select all that apply.

Muscle weakness, difficulty in walking, Numbness in hands

A nurse is caring for a client who is receiving warfarin for anticoag. Therapy. Which of the following lab test results indicates to the nurse that the client needs an increase in dosage?

NR 1.1 (Desired goal for warfarin therapy 2-3)

A nurse is educating a client being treated for lymphoma about the side effects of antineoplastic drugs used for the treatment. Which is a common side effect of antineoplastic drug therapy?

Neutropenia

A client is diagnosed with granulocytopenia. A decrease in which blood component is the nurse likely to notice in the client's hematology report?

Neutrophils

A blood culture is ordered for a client with pneumonia to discover the presence of bacteria in the blood and to choose an antibiotic. Which is a key nursing intervention when this test is ordered?

Notify the laboratory when the client's temperature elevates.

A client who had excessive hemorrhaging as a result of gastrointestinal bleeding is ordered a blood transfusion. What nursing care measure should be employed during blood transfusion?

Observe for transfusion reactions during the first 15 minutes of transfusion.

The nurse has conducted dietary teaching with the client diagnosed with iron deficiency anemia. The nurse determines that the client understands the information if the client states the intention to increase intake of which foods? Select all that apply.

Oysters, spinach, kidney beans

to monitor clot formation pathway

Partial Thromboplastin Time (PTT)

A nurse is contributing to the plan of care for a client who has Hgb 7.5 g/dL and Hct 21.5%. Which of the following actions should the nurse include in the plan of care? Select all that apply

Provide assistance with ambulation, Monitor O2 sat, Obtain stool specimen for occult blood, Schedule daily rest periods

The nurse is caring for a client with thrombocytopenia. Which data would the nurse monitor for related to this condition? Select all that apply.

Purpura, Ecchymoses, Platelet count less than 150,000mm3

A nurse is caring for a client who is receiving a blood transfusion. The nurse notices a transfusion reaction in the client. Which of the following measures should the nurse take to manage the transfusion reaction? Select all that apply

Report the reaction to the transfusion service, Stop the blood transfusion procedure, Collect blood and urine samples and send to the laboratory

The nurse is caring for a client with thrombocytopenia. What assessment finding would alert the nurse to notify the provider?

Restlessness and anxiety

Which test would the nurse expect to have done for a client suspected of having pernicious anemia?

Schilling test

A nurse is caring for an anemic client admitted to the healthcare facility. What signs and symptoms would the nurse expect to assess in this client? Select all that apply.

Shortness of breath, Pulse rate of 110, Activity intolerance

The nurse is caring for a 5-year-old male African American client who reports severe pain in his arms and legs and stomach. The nurse notes that the client has jaundice, fever, dyspnea, and swelling of the hands and feet. What blood disorder would the nurse suspect?

Sickle Cell Disease (SCD)

A nurse is collecting data from a client who has anemia, Which of the following findings should the nurse expect?

Spoon shaped nails

A nurse is caring for a client who is receiving a blood transfusion. Which of the following action should the nurse place to take if an allergic transfusion reaction is suspected? Select all that apply

Stop the transfusion, Maintain IV infusion with .9% NaCl, Administer diphenhydramine

A client is admitted to a healthcare facility in a stage of hemorrhagic shock. What should be the primary concern of the nurse?

Sustain the blood pressure by providing fluids

A nurse is a clinic received a phone call from a client seeking information about a new prescription for erythropoietin. Which of the follow information should the nurse review with the client?

The client should have their Hemoglobin check 2x/wk

Write the correct sequence of the various stages of Hodgkin disease. (Read carefully, Sequence may be different from the workbook)

The disease is limited to a single extraymphatic site, The disease is present on one side of the diaphragm and involves more than one lymph node, The disease is present both above and below the diaphragm, The disease is spread to one or more extralymphatic organs or tissues

The client is diagnosed with neutropenia secondary to cancer treatment. What action by the family would alert the nurse to provide additional teaching?

The family avoids wearing a mask and gown during visit

A bone marrow aspiration and biopsy can be done to evaluate the number, size, and shape of megakaryocytes.

True

IgD is the major component of anti-Rh antibody, which can be used to prevent erythroblastosis fetalis.

True

A nurse is reinforcing discharge teaching to a client who had a gastrectomy for stomach cancer. Which of the follow information should the nurse include? Select all that apply

You will need a monthly INJ of vitamin B12 for the rest of your life, Using the nasal spray form of Vit B12 on a daily basis can be an option

PT

blood test that can indicate the activity of certain factors found in the plasma that are important in blood clotting (factors V, VII, X, prothrombin, and fibrinogen)

BMT

bone marrow transplanatation

allogenic

bone marrow transplantation in which the client receives the bone marrow from someone else

autologous

bone marrow transplantation that uses client's own bone marrow

oncologist

cancer specialist

CLL

chronic lymphocytic leukemia type of chronic leukemia that appears to result from genetic influences and autoimmune diseases, it is incurable

CML

chronic myelogenous leukemia type of chronic leukemia whose only cure is stem cell transplantation

APTT

complex test used to monitor the pathway of clot formation