UDM PREP U 32

The patient may be developing an infection.

A nurse is reviewing a patient's morning lab results and notes a left shift in the band cells. Based on this observation, what interpretation can the nurse make from these results?

I understand your concern. The blood is carefully screened but is not completely risk free."

A patient will need a blood transfusion for the replacement of blood loss from the gastrointestinal tract. The patient states, "That stuff isn't safe!" What is the best response from the nurse?

Liver

Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?

RBC count

An older adult patient presents to the physician's office with a complaint of exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows that which laboratory values should be assessed?

Resume the transfusion

One hour after a transfusion of packed red cells is started; a patient develops redness on his trunk and complains of itching. The nurse stops the red blood cell (RBC) infusion and administers the ordered diphenhydramine (Benadryl) 25 mg po. Thirty minutes later, the redness and itching is gone. What is the next action the nurse should take?

Neutrophils

The body responds to infection by increasing the production of white blood cells (WBCs). The nurse knows to evaluate the differential count for the level of __________, the first WBCs to respond to an inflammatory event.

Decreased hematocrit

The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see which lab result?

Contraction of skeletal muscle compresses the walls of veins and increases the circulation of venous blood as it returns to the heart.

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?

Lateral position with one leg flexed

The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in?

Refuses 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. The nurse

Verify the patient identification according to hospital policy

The physician orders a transfusion with packed red blood cells (RBCs) for a patient hospitalized with severe iron deficiency anemia. When blood is administered, what is the most important action the nurse can take to prevent a transfusion reaction?

Phagocytosis

Under normal conditions, the adult bone marrow produces approximately 70 billion neutrophils. What is the major function of neutrophils?

Myeloid stem cell

Which cell of haematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?

Number of pregnancies

the nurse is completing a pretransfusion assessment to determine the history of previous transfusions as well as previous reactions to transfusions for a female patient. From the following list, what is the most important information to obtain from this patient prior to the transfusion?

Basophils

which type of leukocyte contains histamine and is an important part of hypersensitivity reactions?

Alcoholism Intestinal disorders

A 67-year-old client at the free clinic where you practice nursing has a history of seizures and presents with severe fatigue, frequent headaches, and a sore and beefy red tongue. Which of the following could be causing her current condition? Select all that apply.

Assesses the hemoglobin level

A client in end-stage renal disease is prescribed epoetin alfa (Epogen) and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, the nurse

Ensure there is an oxygen delivery device at the bedside.

A client receiving a blood transfusion complains of shortness of breath, appears anxious, and has a pulse of 125 beats/minute. What is the best action for the nurse to take after stopping the transfusion and awaiting further instruction from the healthcare provider?

Chelation therapy

A client with a history of sickle cell anemia has developed iron overload from repeated blood transfusions. What treatment does the nurse anticipate will be prescribed?

T lymphocytes

A nurse, caring for a patient with human immunodeficiency virus (HIV), reviews the patient's differential WBC count to check the level of which of the following?

The liver and spleen can resume production of blood cells through extramedullary haematopoiesis.

A nursing instructor is reviewing the role and function of stem cells in the bone marrow with a group of nursing students. Following the explanation, the instructor asks the students to use their knowledge of anatomy and physiology to determine an alternate way in which adults with diseases that causes marrow destruction can resume production of blood cells. Which of the students' explanations is correct?

Administer the ordered paracetamol 500 mg po

A patient with Hodgkin's disease had a bone marrow biopsy yesterday and is complaining of aching, rated at a 5 (on a 1-10 scale), at the biopsy site. After assessing the biopsy site, which of the following nursing interventions is most appropriate?

4:00 pm

A patient with a history of congestive heart failure has an order to receive one 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?

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?

Decreased level of erythropoietin

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?

The patient is having a febrile nonhemolytic reaction.

The nurse is administering a blood transfusion to a patient over 4 hours. After 2 hours, the patient complaints of chills and has a fever of 101°F, an increase from a previous temperature of 99.2°F. What does the nurse recognize is occurring with this patient?

26 year old female with hemoglobin 11.0 g/dL

Which client is not a candidate for blood donation according to the American Heart Association?

Vitamin B12 deficiency

A patient comes into the emergency room with complaints of an enlarged tongue. The tongue appears smooth and beefy red in color. The nurse also observes a 5-cm incision on the upper left quadrant of the abdomen. When questioned, the patient states, "I had a partial gastrostomy 2 years ago." Based on this information, the nurse attributes these symptoms to which of the following problems?

Obtain appropriate blood specimens. Collect a urine sample to detect hemoglobin. Document the reaction according to policy

A patient develops a hemolytic reaction to a blood transfusion. What actions should the nurse take after this occurs? (Select all that apply.)

Administer eltrombopag (Promacta)

A patient who has idiopathic thrombocytopenia purpura (ITP) has a critically low platelet count. Which nursing intervention will be included in the care plan for a patient with ITP?

Essential thrombocythemia

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?