Lymphatic System Test 6

lifestyle modification and prevention of thromboembolism

A 63-year-old woman has been diagnosed with polycythemia vera (PV) after undergoing a series of diagnostic tests. When the woman's nurse is providing health education, what subject should the nurse prioritize?

vitamin b

A 79-year-old client has been diagnosed with pernicious anemia. In your client education, as his nurse, you emphasize the importance of lifelong intramuscular administration of which of the following?

weight, hemoglobin, africa

A client arrives for an appointment at the community blood bank to donate a unit of B- blood. The nurse knows that which reasons may be why the client cannot donate at this time? Select all that apply. Age 64 Weight 48 kg (105.6 lbs.) Hemoglobin 11.3 g/dL (113 g/L) Returned from a trip to Africa a month ago Received a blood transfusion for surgery 2 years ago

iron deficiency anemia

A client comes to the clinic reporting fatigue and the health interview is suggestive of pica. Laboratory findings reveal a low serum iron level and a low ferritin level. With what would the nurse suspect that the client will be diagnosed?

discard additional unite

A client donated two units of blood to be used for transfusion during spinal fusion surgery. The client received one unit of autologous blood during the procedure but the second unit is not needed during the procedure. The nurse knows which action will come after the procedure is completed?

leukocytosis

A client has a leukocyte count of 13,000/mm3. How would the nurse document the client's condition?

there will most likely be a brief sharp pain when the marrow is aspirated

A client has been scheduled for a bone marrow aspiration and admits to the nurse being worried about the pain involved with the procedure. Which statement by the nurse when providing client education would be most accurate?

O, rh -

A client in critical condition arrives to the ED needing an immediate blood transfusion, but there isn't time to perform a type and crossmatch. Which blood type can be safely transfused until lab results are obtained?

platelets break down and migrate to the injury

A client is admitted to a healthcare facility with minor lacerations on the leg. The nurse caring for this client observes swelling in the tissues surrounding the affected area. A blood clot is suspected. The nurse should know that which of the following is the first step when the formation of a blood clot begins?

monitor I and O

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?

notify physician

A client is being treated in the hospital for hypovolemia related to a bleeding peptic ulcer. The nurse obtains a blood pressure reading of 88/62 mm Hg, heart rate of 112 beats/minute, and a respiratory rate of 24 breaths/minute. What is the first action by the nurse?

blood loos, abnormal, destruction

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

report s and s of infection promptly

A client is scheduled for a splenectomy. During discharge education, which teaching point should the nurse prioritize?

vascular occlusion in small vessels

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?

fever, sore throat and chills

A client is taking a medication that has the side effect of depressing the hematopoietic system. What signs of leukopenia should the nurse monitor for while the client is taking this drug?

strong correlation

A client is treated for anemia. What is the nurse's best understanding about the correlation between anemia and the client's iron stores?

decreased platelets

A client newly diagnosed with thrombocytopenia is admitted to the medical unit. After the admission assessment, the client asks the nurse to explain the condition. The nurse explains to this client that this condition occurs due to which factor?

CBC

A client reports feeling tired, cold, and short of breath at times. Your assessment reveals tachycardia and reduced energy. What would you expect the physician to order?

gives o2 and picks up co2

A client undergoing a complete blood cell (CBC) count for the detection of anemia wants to know more about hemoglobin. Which of the following should the nurse explain to the client as being the main function of hemoglobin?

temp, bp, o2

A client who received 2 units of packed red blood cells 3 hours ago reports a new onset of dyspnea. Which additional assessment findings indicate to the nurse that the client is developing transfusion-related acute lung injury (TRALI)? Select all that apply. Jugular vein distention Temperature 102oF (38.8oC) Blood pressure 78/50 mm Hg Bilateral lower extremity edema Oxygen saturation 88% on room air

1.5 to 2. 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? ptt

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?

lung disease

A client's electronic health record notes that the client has previously undergone treatment for secondary polycythemia. The nurse should assess for which factor?

discontinue subcutaneous

A night nurse is reviewing the next day's medication administration record (MAR) of a hospital client who has hemophilia. The nurse notes that the MAR specifies both oral and subcutaneous options for the administration of a PRN antiemetic. What is the nurse's best action?

sit the client down w/ head between knees

A nurse at a blood donation clinic has completed the collection of blood from a client. The client reports feeling "light-headed" and appears pale. Which action by the nurse is most appropriate?

iron

A nurse cares for a client with myelodysplastic syndrome who requires frequent PRBC transfusions. What blood component does the nurse recognize as being most harmful if accumulated in the tissues due to chronic blood transfusions?

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?

fall prevention plan

A nurse in a long-term care facility is admitting a new resident who has a bleeding disorder. When planning this resident's care, the nurse should include which action?

universal recipients

A nurse in the ED is caring for a trauma client following a motor vehicle accident. The client's blood donor card indicates type AB blood. People with type AB blood are:

sufas, aspriin, nsaids

A nurse is admitting a client with immune thrombocytopenic purpura to the unit. In completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function? Select all that apply. Antihypertensives Penicillins Sulfa-containing medications Aspirin-based drugs NSAIDs

prone

A nurse is assisting a client into position prior to bone marrow aspiration. Which position will the nurse place the client prior to the procedure?

pallor, tachycardia and 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?

Factor V leiden

A nurse is caring for a client who has been diagnosed with an autosomal dominant hematologic disorder. Which disease does the nurse suspect?

90% water, 10% proteins

A nurse is discussing the difference between blood and plasma with a client. Which best represents the components of plasma?

BCDE

A nurse is obtaining a health history on a client suspected of having a hematopoietic disorder, particularly involving red blood cells and white blood cells. Which abnormalities would be consistent with this diagnosis? Select all that apply. a. frequently warm and flushed b. frequent infections c. discomfort in the axilla, groin, or neck d. prolonged bleeding from an obvious injury e. easily bruised

hemochromatosis

A nurse is performing an initial assessment and notes the client's skin is a gray-tan color, especially on the scars of the client's arms. Which hematological condition does the nurse suspect?

NSAIDs

A nurse is planning the care of a client who has a diagnosis of hemophilia A. When addressing the nursing diagnosis of Acute Pain Related to Joint Hemorrhage, what principle should guide the nurse's choice of interventions? What would be contraindicated

I will eat animal products

A nurse is teaching a client with a vitamin B12 deficiency about appropriate food choices to increase the amount of B12 ingested with each meal. The nurse knows the teaching is effective based on which statement by the client?

use disposable razors

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?

reports pain at a 3/10

A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client?

family donations are safer

A preoperative client is discussing blood donation with the nurse. Which statement by the client indicates to the nurse the need for further teaching?

interstitial fluid and carries it to the veins

A woman recovering from a recent mastectomy is talking with her nurse about lymphedema. She asks the nurse to explain the purpose of the lymphatic system. The nurse would explain that the system of lymphatics circulates:

med 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?

thrombocytopenia

After receiving chemotherapy for lung cancer, a client's platelet count falls to 20 x109L. What term should the nurse use to describe this low platelet count?

difficulty swallowing

An 8-year-old client is scheduled to undergo a tonsillectomy for chronic tonsillitis. The symptoms given below are related to tonsil disorders. The nurse caring for this client should know that which of the following symptoms is specifically related to tonsillitis?

dementia

An 82-year-old client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults?

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?

A

Can receive from A and O only

stage 4

During physical examination, the nurse notes that a client's tonsils are touching. How would the nurse grade these findings?

identify appropriate subcutaneous injection sites

G-CSF (filgrastim) is prescribed for a client with bone marrow suppression. What medication administration teaching should the nurse provide to the client?

1 in 355 US

Prevalence of Sickle Cell Anemia African Americans

give o2 NC

The LPN is following a plan of care for a client who is being treated for hypovolemic anemia and is at risk for hypovolemic shock. The nurse assesses vital signs and O2 saturation and observes the saturation at 89% for 3 minutes. What should the first action by the nurse be?

disposing the blood

The charge nurse should intervene when observing a new nurse perform which action after a client has suffered a possible hemolytic blood transfusion reaction?

iron

The client's CBC with differential reveals small-shaped hemoglobin molecules. The nurse expects to administer which medication to this client?

pain

The home health nurse is caring for a patient with multiple myeloma. What does the nurse know is a priority issue to be managed in a patient with multiple myeloma?

smooth tongue

The nurse expects which assessment finding of the oral cavity when the client is diagnosed with pernicious anemia?

hemorrhage; thrombocytopenia

The nurse in the oncology clinic is caring for a 42-year-old female client receiving chemotherapy with fludarabine for acute myeloid leukemia who has developed petechiae, epistaxis, and ecchymosis. The nurse anticipates the client has developed ___ and that the lab results will reveal ____

hydration and sufficient urination

The nurse is assigned to care for a client with polycythemia vera. When the nurse encourages the client to drink 3 L of fluid per day, the client states, "Why do I have to drink so much?" What is the best response by the nurse?

petechiae

The nurse is aware that a patient has been diagnosed with thrombocytopenia. Which of the following is the most typical first indicator of the diagnosis that a patient will exhibit?

A high B normal C normal

The nurse is caring for three clients who have the following blood count values: Client A has 24,500/mm3 white blood cells (WBCs), client B has 13.4 g/dL hemoglobin, and client C has a 250,000/mm3 platelet count. Which statement correctly describes the condition of each client?

ABDE

The nurse is completing a physical assessment on a client's lymphatic system. The nurse should palpate for enlarged nodes in which areas? Select all that apply. A. Popliteal B. Inguinal C. Spinal D. Submental E. Neck

hypercalcemia

The nurse is currently planning the care of a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood work, what value would the nurse pay particular attention to?

hemoglobin

The nurse is describing normal erythrocyte physiology to a client who has a diagnosis of anemia. The nurse should explain that the erythrocytes consist primarily of which substance?

muscles compress veins to increase circulation

The nurse is instructing the client with polycythemia vera how to perform isometric exercises such as contracting and relaxing the quadriceps and gluteal muscle during periods of inactivity. What does the nurse understand is the rationale for this type of exercise?

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?

less increase in blood production upon sudden demand

The nurse is providing care for a 73-year-old client who has a hematologic disorder. Which change in hematologic function is age-related?

Remain for observation after eating and drinking

The nurse is working at a blood donation clinic. What teaching should the nurse provide to the donor immediately after blood donation?

rbc 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?

ab assessment

The nurse reviewing laboratory results of a client recovering from abdominal surgery notices an elevated number of reticulocytes. What is the nurse's first action?

bilateral crackles

The nurse should be alert to which adverse assessment finding when transfusing a unit of packed red blood cells (PRBCs) too rapidly?

JVD

The nurse should notify the healthcare provider before administering fresh frozen plasma (FFP) based on which assessment finding?

chronic overproduction of RBC

The nurse's brief review of a client's electronic health record indicates that the client regularly undergoes therapeutic phlebotomy. Which of the following rationales for this procedure is most plausible?

hypercalcemia

The nursing instructor is talking with the students about the care of a patient with multiple myeloma who is experiencing bone destruction. What would the instructor tell the students the patient should be assessed for signs of?

age, gender, altitude, exercise

The nursing student is reviewing erythrocytes for an upcoming test. Which of the following would the nurse correctly identify as influencing erythrocyte count? Age Gender Altitude Exercise Body weight

diet, med, ethnicity, herbal supplements

When conducting a health assessment on a client suspected for having a hematological disorder, the nurse should collect which data? Select all that apply. Dietary intake Medication use Ethnicity Herbal supplements Hair color

HR 120

When obtaining vital signs from a client who has reduced erythrocyte production and a hemoglobin level of 8.2 g/dL, what results would be indicative of these lab studies?

avoid cold, and ensure hydration

When teaching a client with sickle cell disease about strategies to prevent crises, what measures should the nurse recommend?

leukocyte

Which blood cell type fights infection

b lymphocytes

Which cells are capable of differentiating into plasma cells?

lymphocytes

Which cells are white blood cells with immune functions?

leukocytes

Which cells have the lifespan of 1 to 2 days and perform phagocytosis?

bronzing the skin

Which is a symptom of hemochromatosis?

phagocytosis

Which is the major function of neutrophils?

bleeding, oozing, dark stools

Which of the following signs would the nurse recognize as signs of thrombocytopenia? Select all that apply. Fever Sore throat Bleeding of the gums Oozing from injection sites Dark, tarry stools

hematocrit

Which term describes the percentage of blood volume that consists of erythrocytes?

sickle cell anemia

Which type of hemolytic anemia is categorized as inherited disorder

pallor

While assessing a client, the nurse will recognize what as the most obvious sign of anemia?

use an electric razor

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?

nutrition affects production

Why would it be important for the nurse to obtain information regarding dietary history of a client with a possible abnormality of the hematopoietic or lymphatic system?

lymphoma

a group of cancers that affect the lymphatic system

Vitamin K

antidote for warfarin

Iron

basic nutritional component of heme in hemoglobin

Protein

building block of hemoglobin and the enzymes involved in RBC production

myeloid stem cells

converted to rbc, wbc and platelets

hemophiliac bleed tx

fresh frozen plasma, aminocaproic acid (amicar), direct pressure, cold compresses/ice pack

Erythropoietin, Epoetin Alfa

growth/production of RBCs

Assessment findings with hematopoietic disorders

hx of prolonged bleeding, unexplained blood loss, fatigue, dizziness, fainting, bruising easily, easily chilled, frequent infections, discomfort in axilla or groin or neck, difficulty swallowing, lymph node removal hx, splenectomy, cancer treatment, renal failure

infection

implication of decreased lymphocyte count

blood transfusion rxn

increased blood pressure and pulse, flushed

Iron, B12, B6, B9 and kidney function

influence our erythrocyte counts

Copper

involved in the transfer of iron from storage to plasma

infection

low neutrophil counts

hematopoiesis

manufacturing and development of blood cells

Fribinogen

plasma protein converted to fibrin in blood clotting, aids in clotting

Vitamin E

protects blood cells from vitamin e deficient hemolytic anemia

thrombocytopenia

purpura, small hemorrhages in skin, mucous membranes or subcutaneous tissues, bleeding from other areas

mono

s/s: o Fatigue o Fever o Sore throat o Headache o Cervical lymph node enlargement o White or greenish gray oozing from tonsils o Pharyngeal swelling o Faint red rash on hands or abdomen o Liver and spleen may become enlarged

B6

serves as a coenzyme in hemoglobin formation

support, blood transfusion, medication

sickle cell nursing care

elephantiasis s/s

swelling, skin changes such as darker, thicker, ulcerated or pitted

CBC, Schilling Test

tests associated with infection and B12 deficiency

phagocytosis

the ingestion and digestion of bacteria and foreign substances

infection

the most common cause of death from leukemia

bone marrow

the nurse is caring for a patient with a hematologic disorder. The patient asks the nurse where the body forms blood cells. Where should the nurse tell the patient that blood cells are formed?

Rights w blood transfusions

to be typed and crossmatched, vitals to be taken often, Tylenol and Benadryl given before

RBC fxn

transport oxygen and CO2

mono risk factors

young adults, close living quarters, armed services, college

mono teaching

- Don't share foods or drink - Don't frequently intimately kiss many people - Rest in bed - Take analgesics and antipyretics - Increase fluid intake - Possible begin corticosteroid therapy - education w/ that

assessment for lymphatic disorders

- Hx of fatigue, dizziness, fainting, bruising easily, easily chilled, frequent infections, discomfort in axilla, groin or neck, difficulty swallowing, lymph node removal, splenectomy, cancer treatment, renal failure.

complete blood count

A 75-year-old woman visited her health care provider for an annual check-up. She told the doctor that she feels exhausted all the time and barely has the energy to go out of her home, run errands, and visit friends. The nurse expects that the health care provider will order which of the following lab studies based on the most common hematologic condition affecting the elderly?

Allergy

A client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have?

elevated eosinophils

A client informs the nurse that he is having a difficult time coping with seasonal allergies and has taken some over-the-counter medications to assist with control of symptoms. What results would indicate to the nurse that the client does have allergies?

avoid heavy lifting for several hours

A client is preparing to leave the blood bank after donating a unit of blood. Which teaching will the nurse provide to the client at this time?

disconnect blood, flush with NS and administer morphine

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?

4:00 pm

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?

chelation therapy

A client with myelodysplastic syndromes (MDS) receives routine blood transfusions. Which treatment will the nurse expect to be prescribed to prevent the development of iron overload?

epoetin alfa

A client with severe anemia is admitted to the hospital. Because of religious beliefs, the client is refusing blood transfusions. The nurse anticipates pharmacologic therapy with which drug to stimulate the production of red blood cells?

review the INR

A client's diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin. When assessing the therapeutic response to this medication, which action by the nurse is the most appropriate?

hemophilia

A client's electronic health record states that the client receives regular transfusions of factor IX. The nurse would be justified in suspecting that this client has what diagnosis?

Assess baseline vitals

A client's low hemoglobin level has necessitated transfusion of packed red blood cells. Prior to administration, which action should the nurse perform?

This is likely caused by a B12 deficiency

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?

severe fatigue

A nurse is caring for a client who is undergoing preliminary testing for a hematologic disorder. Which sign or symptom of a hematologic disorder is most common?

may have infection

A nurse is reviewing a client's morning laboratory results and notes a left shift in the band cells. Based on this result, the nurse can interpret that the client

t lymphocytes

A nurse, caring for a client with human immunodeficiency virus (HIV), reviews the client's differential WBC count. What type of WBC will the nurse check the level of?

coagulopathy

A nursing instructor in a BSN program is preparing for a lecture on disorders of the hematopoietic system. Included in the lecture are conditions caused by reduced levels or absence of blood-clotting proteins. Which of the following is the instructor most likely referring to?

hematopoiesis

A nursing student is interested in working with children who have blood disorders. Which of the following terms would the student recognize as "the manufacture and development of blood cells."

essential thrombocytopenia

A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is the most likely clinical disorder the patient is being treated for?

iron chelation therapy

A patient who has long-term packed RBC (PRBC) transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that can help prevent organ damage?

decreased rbc

A patient with chronic kidney disease is being examined by the nurse practitioner for anemia. The nurse has reviewed the laboratory data for hemoglobin and RBC count. What other test results would the nurse anticipate observing?

Z track technique

A thin client is prescribed iron dextran intramuscularly. What is most important action taken by the nurse when administering this medication?

iliac crest and sternum

Bone marrow aspiration sites

strenuous activity = more rbc

In the surgical group where you practice nursing, knowledge regarding hematopoiesis is used frequently in regards to client post-surgical care. Which of the following is true for the variation in the normal number of erythrocytes?

neutropenic precautions

Isolation procedures to protect an immunocompromised patient from infections. Things we do for them (wearing masks, etc.)

albumin

Plasma proteins play an essential role in maintaining water balance and blood pressure. Select the laboratory analysis that a nurse should review to check the levels of the most abundant plasma protein.

a fibrin sponge

The nurse is assisting the physician to control the bleeding for a client who has had an insertion of a vascular access. What can the nurse obtain for the physician to use to control the bleeding?

liver and spleen

The nurse is caring for a client who has developed scar tissue in many of the areas that normally produce blood cells. What organs can become active in blood cell production by the process of extramedullary hematopoiesis?

support client and monitor status

The nurse is caring for a client who is undergoing bone marrow aspiration to determine the blood cell formation status. What nursing intervention should the nurse provide to the client during the test?

Kidneys, erythropoietin, bone marrow

The nurse is caring for a client with hypoxia. What does the nurse understand is true regarding the client's oxygen level and the production of red blood cells? The _____ sense low oxygen levels in the blood and produce ___, stimulating the ____ to produce more red blood cells.

hemogolobin

The nurse is describing normal erythrocyte physiology to a client who has a diagnosis of anemia. The nurse should explain that the erythrocytes consist primarily of which substance?

vitamin c

The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron?

anemia

The nurse is obtaining the health history of a client suspected of having a hematological condition. The nurse notes the client has a history of alcohol abuse. Which clinical presentation is related to alcohol consumption?

transfer of iron from storage to plasma

The nurse is reviewing laboratory studies that determine a client is deficient in copper. What does the nurse understand is the importance of copper in the body?

3

Using a penlight and tongue blade, the nurse inspects the client's tonsils for size and appearance. Tonsils are present and touch the uvula. How should the nurse grade these findings?

megaloblasts

Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called

platelets

Which cells have the lifespan of approximately 7.5 days, and one-third of their population remains in the spleen (unless needed to fight significant bleeding)?

ABC

Which of the following reports from the client during the health history would lead the nurse to suspect that the client has a disorder of the hematopoietic or lymphatic system? Select all that apply. A. Experiences prolonged bleeding from an obvious injury. B. Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. C. Feels fatigued with normal activities. D. Rarely bruises. E. Feels discomfort in the stomach.

Rh -

can only receive -

Rh+

can receive - or +

AB

can receive from A, B, and O

B

can receive from B and O only

O

can receive from O only

coagulopathy

conditions in which a component is necessary to control bleeding is mission or inadequate

thrombocytopenia tx

eliminate cause, corticosteroid treatment, platelet transfusion or whole blood, splenectomy

Vitamin C

enhances absorption of folic acid and iron

pluripotential stem cells

may produce lymphocytes, erythrocytes, leukocytes or platelets

12-17.4

normal Hgb

5000-10000

normal WBC count

150000 to 350000

normal platelet count

stop transfusion, call physician, save blood

nursing process blood transfusion rxn

elephantiasis risk factors

o Foreign travel o Subtropical and tropical areas o High exposure to mosquitos

Multiple Myeloma

o Pain in the pelvis, spine, or ribs o Pain intensifies with activity and relieved with rest o Pathologic fractures develop o High incidence of infection (especially pneumonia) o Weakness, fatigue, chills o Bruising, nosebleeds o Renal calculi

Megaloblastic anemia

o Pallor o Decreased appetite o Irritability o Fatigue o Diarrhea o Difficulty walking o Numbness or tingling in feet and hands o Smooth and tender tongue Beefy red tongue

Chronic Hypovolemic anemia

o Pallor o Fatigue o Chills o Postural hypotension o Rapid heart and respiratory rates

Aplastic anemia

o Weakness, fatigue o Frequent opportunistic infections o Coagulation abnormalities o Small skin hemorrhages (petechiae) o Bruises (ecchymoses) o Enlarged spleen

family history, African heritage

sickle cell risk factors

IM injection B12

treatment for pernicious anemia

O-

universal donor

AB+

universal recipient