Drugs Exam

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?

Disconnect the blood tubing, flush with normal saline, and administer morphine. (nver add medications to blood or blood products. The transfusion must be temporarily stopped in order to administer the morphine.)

Which term refers to the percentage of blood volume that consists of erythrocytes?

Hematocrit

Which client is not a candidate for blood donation according to the American Heart Association? 86 year old male with blood pressure 110/70 mmHg 50 year old female with pulse 95 beats/minute 18 year old male weighing 52 kg. 26 year old female with hemoglobin 11.0 g/dL

26 year old female with hemoglobin 11.0 g/dL (Clients must meet the following criteria to be eligible as blood donors: body weight at least 50 kg; pulse rate regular between 50 and 100 bpm; systolic BP 90 to 180 mmHg and diastolic 50 to 100 mmHg; hemoglobin level at least 12.5 g/dL for women. There is no upper age limit to donation.)

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? 6:00 pm 4:00 pm 3:00 pm 2:00 pm

4:00pm

A client with Hodgkin disease had a bone marrow biopsy yesterday and reports aching at the biopsy site, rated a 5 (on a 1-10 scale). After assessing the biopsy site, which nursing intervention is most appropriate? Administer aspirin (ASA) 325 mg po, as ordered Administer acetaminophen 500 mg po, as ordered Notify the physician Reposition the client to a high Fowler position and continue to monitor the pain

Administer acetaminophen 500 mg po, as ordered (After a marrow sample is obtained, pressure is applied to the site for several minutes. The site is then covered with a sterile dressing. Most clients have no discomfort after a bone marrow biopsy, but the site of a biopsy may ache for 1 or 2 days. Warm tub baths and a mild analgesic agent (e.g., acetaminophen) may be useful. Aspirin-containing analgesic agents should be avoided it the immediate post-procedure period because they can aggravate or potentiate bleeding.)

A nurse administers blood products to a client with Hodgkin disease. During the administration, the nurse notes the client has a fever and diffuse reddened skin rash. From what condition does the nurse suspect the client is suffering?

Graft-versus-host disease (Graft-versus-hold disease (GVHD) occurs in only severely immunocompromised recipients (such as those with Hodgkin disease). The transfused lymphocytes attack the host lymphocytes or body tissues; symptoms or signs may include fever, diffuse reddened skin rash, nausea, vomiting, and diarrhea.)

The nurse is providing health education to an older adult client who has low red blood cell levels. To promote red blood cell production, the nurse should encourage intake of what foods? Select all that apply.

Leafy green vegetables Lean meats Nuts and seeds (A healthy diet that includes lean meats, nuts, seeds and green vegetables can promote red cell production. Animal fats are not known to promote red cell production. Organic foods are not necessarily more likely to promote red cell synthesis.)

A nurse cares for several mothers and babies in the postpartum unit. Which mother does the nurse recognize as being most at risk for a febrile nonhemolytic reaction?

Rh negative mother, Rh positive baby

Place the following steps in order when determining the type and severity of a transfusion reaction. Use all options.

Stop the transfusion. Assess the client. Notify the health care provider. Notify the blood bank. Send the tubing and container to the blood bank.

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?

The condition is likely caused by a vitamin B12 deficiency." (Vitamin B12 combines with intrinsic factor produced in the stomach. The vitamin B12 -intrinsic factor complex is absorbed in the distal ileum. Clients who have had a partial or total gastrectomy may have limited amounts of intrinsic factor, and the absorption of vitamin B12 may be diminished. Megaloblastic anemia may be caused by a folate deficiency; however, the client's history of gastrectomy indicates the likely cause is a vitamin B12 deficiency. Megaloblastic anemia causes large erythrocytes (RBCs), not small or rigid.)

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? Anemia Neutropenia Thrombocytopenia myelodysplastic syndrome

anemia