Hematology

A client with pernicious anemia asks why she must take vit B12 injections for the rest of her life. What is the nurse's best response?

The reason for your vit deficiency is an inability to absorb the vit because the stomach is not producing sufficient intrinsic factor.

What is sickle cells?

A condition in which there aren't enough healthy RBC to carry oxygen.

The primary purpose of the Schilling test is to measure the clients ability to

Absorb Vit. B12

When a client is diagnosed with aplastic anemia, then nurse monitors for the changes in which of the following physiological functions?

Bleeding tendencies

A client with macrocytic anemia has a burn on her foot and states that she had been watching television while lying on a heating pad. What is the nurse's first response?

Check for diminished sensations

A mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the understanding of which of the following?

Children with iron deficiency anemia are more susceptible to infection than other children.

Which of he following assessments in a child with hemophilia would lead the nurse to suspect early hemarthrosis?

Childs reluctance to move a body part

When comparing the hematocrit levels of a post-op client, the nurse notes that the hematocrit decreases from 36% to 34% on the third day even though the RBC and hemoglobin values remained stable at 4.5 million and 11.9 g/dL, respectively. Which nursing intervention is most appropriate?

Continue to monitor vital signs.

Which of the following diagnostic findings are most likely for a client with aplastic anemia?

Decreased levels of WBC, RBC, and platelets

What is wrong with the cells?

They are sickle shaped and blocked blood flow depriving the body of oxygen

The nurse is teaching a client with polycythemia Vera about potential complications from this disease. Which manifestations would the nurse include in the client's teaching plan?

Visual disturbance Headache Orthopnea Gout

A client states that she is afraid of receiving vit B12 injections because of the potential toxic reactions. What is the nurse's response to relieve these fears?

Vit B12 is generally free of toxicity because it is water soluble.

A client was admitted with iron deficiency anemia and blood streaked emesis. Which question is most appropriate for the nurse to ask in determining the extent of the client's activity intolerance?

What activities were you able to do 6 months ago compared to the present?

Because of the risks associated with administration of the factor VIII(8) concentrate, the nurse would teach the clients family to recognize and report which of the following?

Yellowing of the skin

A client comes into the health clinic 3 years after undergoing a resection of the terminal ileum complaining of weakness, shortness of breath, and a sore tongue. Which client statement indicated a need for intervention and client teaching

I take a vitamin B12 tab every day

The nurse understands that the client with pernicious anemia will have which distinguishing lab findings?

Intrinsic factor, absent.

The nurse would instruct the client to eat which of the following foods to obtain the best supply of vit B12?

Meat and dairy products

What are some side effects for this medication?

Nausea, gas, bloating, Poor appitite Funny taste in mouth Trouble sleeping Depressed and over excited

WHich of the following symptoms is expected with hemoglobin of 10 g/dL?

None

The nurse explains to the parents of a 1 year old child admitted to the hospital in a sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following?

Obstruction to circulation

A client with anemia may be tired due to a tissue deficiency of which of the following substances?

Oxygen

Which of the following would the nurse identify as the priority nursing diagnosis during a toddles Vado occlusive sickle cell crisis?

Pain related to tissue anoxia

The physician has ordered several labs test to help diagnose an infants bleeding disorder. Which of the following tests if abnormal, would the nurse interpret as most likely to indicate hemophilia ?

Partial Thromboplasttin time (PTT)

Which of the following foods would the nurse encourage the mother to off to her child with iron define you anemia?

Potato Peas Chicken

Which of the following nursing assessments is a late symptom of polycythemia Vera?

Pruritus

What is the treatment for Sickle cell?

Antibiotics Pain relieving narcotics, Hydroxyyurea Blood transfusion

The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?

Avoid exposure to others with acute infection

What medication could a sickle cell pt take other than iron to make a new RBC?

Folic Acid

Which statements by the mother of a toddle would lead the nurse to suspect that the child has iron-defiance anemia?

He drinks over 3 cups of milk per day? I cant keep enough apple juice in the house: he must drink over 10 oz per day

A client is to receive Epoetin injections. That lab value should the nurse assess before giving the injections.

Hematocrit

Which of the following disorders results from a deficiency of factor VIII (8)

Hemophilia A

A vegetarian client was referred to a dietitian for nutritional counseling for anemia. Which client outcome indicates that the client does not understand nutritional counseling? The client:

Drinks coffee or tea with meals

The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow after discharge. Which of the following foods should be included int the diet?

Eggs

Which of the following blood components is decreased in anemia?

Erythrocytes

A client nurse instructs the mother of a child with sickle cell disease about the precipiting factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions?

Fluid overload

The nurse just admitted a 35 year old female client who has a serum b12 concentration of 800 pg/ml. Which of the following lab finding would cue the nurse to focus the client history on specific drug or alcohol abuse?

Folate, 1.5 ng/ ML

Laboratory studies are performed for a child suspected of having iron deficiency anemia. The nurse reviews the laboratory results, knowing that which of the following results would indicate this type of anemia?

REB that are microcytic and hypochromic

The nurse is assessing a client's activity intolerance by having the client walk on a treadmill for 5 mins. Which of the following indicates an abnormal response?

Respiratory rate decrease by 5 breaths/ minute

A child suspected of having sickle cell disease is seen in a clinic, and laboratory studies are performed. A nurse checks the lab results, knowing that which of the following would be increased in this disease?

Reticulocyte count

The nurse implements which of the following for the client who is starting a Schilling test?

Starting a 24-48 hour urine specimen collection

Which of the following cells is the precursor to the RBC?

Stem cells

A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan?

Take the meds on an empty stomach

The mothers asks the nurse why her child's hemoglobin was normal at birth but now the child has S hemoglobin. Which of the following responses by the nurse is most appropriate?

The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth