Chapter 15

Which clinical health history question would the nurse ask when determining a patient's risk for hematologic dysfunction and the inability to reduce or eliminate the risk?

"Does anyone in your family bleed a lot?"

Which statement would the nurse utilize when explaining an iatrogenic blood disorder to a patient?

"It is a blood disorder brought on by medical treatment."

When administering medication to change a patient's clotting processes, which statements would the nurse utilize to teach the role of platelets in the clotting of blood?

"The bone marrow produces platelets." "Each platelet has a life span of 10 days." "Platelets in the blood initiate the clotting process."

Which statement would the nurse utilize when responding to a patient's question about low platelet count and why platelets are important?

"The clotting process begins with your platelets."

Which would the nurse response utilize when a patient with anemia asks why the health care provider prescribed an iron preparation?

"The iron will help your body manufacture hemoglobin."

Which would the nurse response utilize to explain the hematocrit measurement when a patient asks why the health care provider prescribed a hematocrit test?

"The measurement indicates volume of blood cells in relation to the volume of plasma."

Which would the nurse response utilize when a patient with anemia asks, "Do most people have the same number of red blood cells?"

"The number varies with gender, age, and general health."

Which would the nurse response give when an older patient reports experiencing more frequent upper respiratory infections than in the past?

"There is a change in the bone marrow with aging, which affects the immune response."

Which would the nurse response utilize when a patient receiving vitamin B 12 injections for treatment of pernicious anemia asks how long these injections will continue?

"You will need the injection for the rest of your life."

When preparing to administer an injection to a patient with a blood dyscrasia, how long after administering the medication would the nurse plan to apply pressure to the injection site to prevent bruising?

5 to 10 minutes

Which disorder would the nurse associate with patient's leukocyte count of 20,000/mm ??

Active infection

A patient with a hematologic disorder is experiencing altered nutrition related to iron deficiency. Which interventions would the nurse recommend adding to this patient's plan of care?

Administering a liquid iron preparation with a straw Giving iron with food or juice containing vitamin C Reminding the patient that stool may appear greenish-black because of iron

Which condition would the nurse associate with a laboratory finding reflecting an increased number of eosinophils?

Allergy

Which condition would the nurse correlate to a female patient's erythrocyte sedimentation rate (ESR) of 25 mm/h?

An inflammatory process

When reviewing the hematologic system, which definition would the nurse associate with anemia?

Anemia means there is an insufficient number of functioning red blood cells (RBCS).

When administering medications to older adults, which medications would the nurse associate with potentially causing ecchymosis (bruising)?

Aspirin Vitamin E Ginkgo biloba Omega-3 fatty acids

When reviewing laboratory reports, which laboratory result would the nurse link to assisting in the diagnosis of multiple myeloma?

Bence-Jones protein

Which important findings would the nurse associate with the of presence a hematologic condition when assessing a patient's elimination patterns?

Black-colored stools Coffee-ground emesis Dark, smoky-colored urine

Which laboratory reports would the nurse associate with a large loss of blood volume from a gunshot wound?

Decreased hematocrit Decreased hemoglobin

Which laboratory value would the nurse correlate with a patient's clinical manifestations of pale mucous membranes and complaints of fatigue?

Decreased hematocrit count

Which laboratory result would the nurse anticipate when a patient who is bleeding profusely from the nose arrives at the emergency department?

Decreased platelets

When waiting for test results, which interventions would the nurse implement to reduce the patient's anxiety?

Encouraging the patient to verbalize fears Providing teaching regarding each diagnostic test Offering emotional support to the patient and family

Which information collected from a patient would lead the nurse to suspect possible hematologic disorder?

Epigastric tenderness Pale mucous membranes Enlarged cervical lymph nodes Shortness of breath on exertion

Which would the nurse process explain when describing development of blood cells?

Erythropoiesis

Which nutrients would the nurse instruct the patient to consume to build red blood cells?

Folic acid Vitamin C Vitamin B 6 Amino acids

Which known medications would the nurse associate with the potential of causing blood disorders?

Furosemide (Lasix) Oral contraceptives Phenytoin (Dilantin) Antineoplastic drugs

Which condition would the nurse implement plan of care interventions for a patient with hemophilia?

Hemarthrosis

Which known hematologic function would the nurse associate with an alteration in genetics?

Hemophilia

When assisting with data collection on a patient's family history, for which conditions would the nurse request information related to an existing hematologic condition?

Hemophilia Thalassemia Clotting disorders

Which condition would the nurse associate with a patient's complete blood count (CBC) reflecting a white blood cell (WBC) count of 15,000/mm 3?

Infection

When providing care for older adults, which age-related changes in the older adult's hematologic system places them at a higher risk for developing infections?

Infiltration of bone marrow with fibrotic tissue

Which interventions would the nurse teach patients to implement to prevent blood disorders? t

Informing patients about medications that potentially cause blood disorders Suggesting genetic counseling to adult patients who have genetic blood disorders Cautioning the public about the dangers of exposure to ionizing radiation and harmful chemicals

When reviewing the hematologic system, which elements would the nurse identify as necessary for erythropoiesis?

Iron Folic acid Vitamin C Vitamin B 12

Which teaching point would the nurse provide the patient when the patient's health care provider prescribed an iron preparation for anemia?

Iron preparation should be taken with liquids or foods containing vitamin C.

Which rationale supports the purpose of a reviewing a patient's prothrombin time (PT) test?

It detects abnormalities of clotting time.

Which clinical manifestations would the nurse anticipate when providing care for a patient suffering from hemolysis after a blood transfusion reaction?

Jaundice of the skin Yellow discoloration of the sclera

Which clinical manifestations would the nurse anticipate when providing care for a patient suffering from hemolysis after a blood transfusion reaction?

Jaundice of the skin Yellow discoloration of the sclera

Which amount of blood loss average would the nurse explain when discussing menstruation with a young adolescent?

Less than 80 mL

Which patient problem would the nurse review in the plan of care for a patient who is bleeding internally as a result of a blood disorder?

Low platelet count poses potential for patient injury

Which clinical manifestations would the nurse associate with a patient experiencing an actively bleeding ulcer?

Melena stool Coffee-ground emesis

Which condition would the nurse associate with a patient's laboratory report indicating a positive Bence- Jones protein test?

Multiple myeloma

On review of the hematologic system, which common problems would the nurse associate with disorders of this system?

Pain Infection Bone marrow failure

Which disorder would the nurse suspect in a patient who arrives at the emergency department with severe cough and noticeable small, red, pinpoint lesions on the chest, neck, and face and who develops distal arm lesions after obtaining a blood pressure?

Petechiae

Which disorder would the nurse suspect in a patient who arrives at the emergency department with severe cough and noticeable small, red, pinpoint lesions on the chest, neck, and face and who develops distal arm lesions after obtaining blood pressure?

Petechiae

Which process permits a cell to engulf (surround) and proceed to digest any foreign material?

Phagocytosis

Which laboratory result indicates an abnormal value for a female patient?

Platelets: 100,000/mm WBC count: 14,000/mm RBC count: 3.0 million/mm

Which laboratory finding for a patient receiving chemotherapy treatments for colon cancer would the nurse report immediately to the health care provider?

Platelets: 93,000/mm

Which blood condition would the nurse associate with a patient who presents with a very ruddy facial complexion?

Polycythemia

Which suspected conditions warrant the health care provider prescribing a D-dimer blood test?

Pulmonary embolism Disseminated intravascular coagulation

For which disorder would the nurse prepare to teach the patient when the nurse notes a patient's platelet count of 50,000 mm ??

Risk for bleeding

Which locations would be best to visualize the of petechiae presence when providing care for an African- American patient diagnosed with thrombocytopenia purpura?

Soles of the feet Palms of the hands

After receiving instructions regarding foods high in iron to assist with iron deficiency anemia, which food selection by the patient would indicate understanding of instructions?

Spinach

Which cells would the nurse associate with providing cellular immunity for a patient?

T cells

Which changes in the hematologic system would the nurse associate with the aging process?

There is less blood volume. Bone marrow activity decreases. The patient is more prone to hypovolemia and shock.

Which condition would the nurse associate with a complete blood count (CBC) report reflecting a platelet count of l100,000/mm for a patient receiving chemotherapy?

Thrombocytopenia

Which potential blood dyscrasia would the nurse associate with a patient's susceptibility to hemorrhage when treated with antineoplastic medication?

Thrombocytopenia

Which food item would the nurse suggest to reinforce the health care provider's instructions for the patient to increase iron intake?

Whole-grain enriched bread