Chapter 12
A client presents with symptoms of fever, night sweats, pain in the chest due to a cough that has lasted for the past 3 weeks, and recent blood in the sputum. An x-ray reveals tubercles in the lungs and a diagnosis of active tuberculosis is made. Which statement is the most appropriate explanation for why tubercles formed in the lungs?
"Tubercles are formed by macrophages in the body when there is material that cannot be easily digested and removed."
A mother brings her child to the pediatric clinic because of irritability, loss of appetite, low-grade fever, pallor, and leg pain. Blood tests reveal anemia, thrombocytopenia, and an elevated leukocyte count with atypical lymphocytes. A diagnosis of acute lymphocytic leukemia (ALL) is confirmed with bone marrow studies. The child undergoes aggressive, high-dose chemotherapy with plans for a possible stem cell transplant. Which question is most appropriate for the nurse to ask the mother?
"When your child was born, did you save the umbilical cord blood in a blood bank?"
What is normal hematopoiesis?
- WBC result from hematopoietic stem cells - Hematopoietic stem cells differentiate into committed progenitor cells - Committed progenitor cells develop into myelogenous and lymphocytic lineages - Stem cell reproduction is controlled by colony-stimulating factors (CSF's)
Which plasma protein is considered the most abundant type?
Albumin
A client comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is the most likely cause of the symptoms?
Allergic reaction
The globulins that make up part of the plasma of the blood have three distinct purposes. What are the gamma globulins?
Antibodies of the immune system
Which type of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions?
Basophils
What's the best description of the production of T lymphocytes
Bone marrow ---> thymus ---> lymph nodes
Which is considered a function of plasma?
Carrying nutrients
A nurse is caring for a newborn that has developed a low platelet count. What could be the cause?
Decreased thrombopoietin (TPO)
A client with kidney failure has been admitted to the hospital for severe anemia. The client has refused a blood transfusion. The nurse anticipates administering which drug to stimulate the production of red blood cells?
Erythropoietin (EPO)
The nurse is caring for a pediatric client who will be having bone marrow aspiration from the posterior iliac crest. The parent asks why the sternum is not used to obtain the sample as this is the site used for another relative. How does the nurse respond?
In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs
Which type of macrophages are found in the liver?
Kupffer cells
A nurse sends a blood sample to the lab for analysis. Assuming the sample is normal, the nurse anticipates which white blood cells will account for the highest percentage?
Neutrophils
Which type of cell is the most common leukocyte in normal blood?
Neutrophils
When a white blood cell with differential count reveals an acute infection, which statement is correct regarding the client's neutrophils?
Neutrophils are the first white blood cell to elevate in an acute infection.
A client with bone marrow failure asks the nurse how it is possible to still have blood cells being produced. How does the nurse respond?
Organs that were active in blood cell production while you were a fetus are reactivated when bone marrow fails
The nurse is caring for a client with leukemia who is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding?
Platelets
A client is diagnosed with acute leukemia. Which treatment therapy can be used to correct bone marrow failure and treat malignancies?
Stem Cell Transplant
Which statement about natural killer (NK) cells is the best explanation of their function when reviewing laboratory work for a 10-year-old child?
The primary job of natural killer (NK) cells is to hunt down and destroy foreign cells in the body.
A 45-year-old client requires a bone marrow sampling to examine hematopoietically active marrow. The nurse informs the client that the sample may be obtained from what sites? Select all that apply.
The upper arm (humerus) and the thigh bone (femur)
The nurse is teaching a client about how a vaccine can help create immunity to a virus. What information does the nurse provide?
The vaccine causes B lymphocytes to create antibodies against the virus
A 6-year-old child is having a stem cell transplant using umbilical cord blood. What benefit does the nurse understand that this type of transplant will have for the child?
This type of transplant creates less risk of graft versus host disease
Stem cell transplantation has been shown to provide potential cures for diseases such as aplastic anemia and the leukemias. What are the sources of stem cells used for transplant?
Umbilical cord blood and bone marrow
A nurse is reviewing the laboratory data for a hospitalized client. The nurse would notify the health care provider about which results as most concerning
White blood cell count of 2800/uI (2.80 x 10 to the power of 9/I)
The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider?
White blood cells 18,500/uI
A client with severe anemia asks, "What happens if my bone marrow cannot produce sufficient numbers of red blood cells due to my bleeding?" Which response(s) by the nurse correctly identifies the organs that can resume hematopoiesis? Select all that apply. a) Liver b) Pancreas c) Spleen d) Gall bladder e) Kidneys
a) and c)
Which function is the main job of lymphocytes?
immune reaction
The nurse is reviewing a laboratory analysis of fluid collected from a client's wound. Which characteristic does the nurse use to determine if the fluid was from the interstitial versus the intravascular space?
presence of proteins supports that the fluid is from the intravascular space