Hematology and immunology

"I understand your concern. The blood is carefully sprained 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?

Erythropoietin (Epogen)

A patient with chronic kidney disease has chronic anemia. What a pharmacologic alternative to blood transfusion maybe use for this patient?

The client has the right to refuse a transfusion

An 18-year-old client presents to the emergency department with a severe open fracture of the lower extremity. The healthcare provider tells the client that the client will need a blood transfusion. The client refuses, despite the advice of the healthcare provider. What does the nurse understand is a legal implication of the scenario?

Discontinue the infusion immediately and maintain the IV line with normal saline solution using new IV tubing

During a blood transfusion with packed red blood cells, a client reports chills, low back pain, and nausea. What PRIORITY action should the nurse take?

Procedural steps for transfusing a unit of packed red blood cells, in order

Start an IV line Obtain the unit of PRBCs from the blood bank. Double check the labels with another nurse to ensure correct ABO group and Rh type. Initiate the blood transfusion within 30 minutes of receipt Monitor closely for signs of a transfusion reaction

Neutrophils

The body response to infection by increasing the production of white blood cells. The nurse nurse to evaluate the differential count for the level of ...............The first white blood cells to respond to an inflammatory event.

Disposing of the blood container and tubing in biohazard waste

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

cultural beliefs

The client is a Jehovah's Witness with severe anemia and is prescribed two units of packed red blood cells. The nurse begins to teach the client about the blood transfusion. The client refuses to sign the consent form for blood administration. The nurse tell to assess the clients

Verify that the client has signed a written consent

The client is to receive a unit of packed red blood cells. The first intervention of the nurse is to

1500

The nurse begins a routine blood transfusion of packed red blood cells at 1100. To ensure client safety, the unit must be completely transfused by what time?

Decreased oxygen level

The nurse expects which assessment finding when caring for a client with a decreased hemoglobin level?

Request that the pastor be present to support the family at the client bedside.

The nurse in an ICU is assigned to 2 clients. One of the clients has just passed away. The deceased clients family members have arrived to be at the clients bedside. Despite wanting to support the clients family, the nurse must assess the other clients vital signs every 15 minutes, because the client is receiving a blood transfusion. In this situation, what is the nurses best action?

Programs T lymphocytes to become regulator or effector T cells

What is the function of the thymus gland?

Erythropoietin

Which substance stimulates the bone marrow to produce red blood cells?

lack of erythropoietin

A client in acute renal failure has been prescribed 2 units of packed red blood cells. The nurse explains to the client that the blood transfusion is most likely needed for what?

Phagocytosis

A client is admitted with cellulitis and experiences a consequent increase in white blood cell count. During what process will pathogens be engulfed by white blood cells that ingest foreign particles?

Bank autologous blood

A client is to have a hip replacement in three months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?

In the bone marrow

A client with a hematologic disorder asks the nurse how the body forms blood cells. The nurse should describe the process that takes place where?

Crackles auscultated bilaterally.

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

I understand your concern. The blood is screen very carefully for different viruses as well as HIV.

The patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions. The patient states the nurse, "I am not going to have a transfusion because I don't want to get aids." What is the best response by the nurse?

Leukopenia

A decrease in circulating white blood cells is

Active acquired immunity

A nurse has given a child's scheduled vaccination for rubella. This vaccine will cause the child to develop which of the following?

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 complains of chills and has a fever of 101F, an increase form a precious temp of 99.2F. What does the nurse recognize is occurring with this patient?

Palpating of the clients lymph nodes

The nurse is completing a focused assessment addressing a clients immune function. What should the nurse prioritize in the physical assessment.

Type O

A client is in the hospital with a bleeding gastric ulcer and requires a blood transfusion. He has been typed and crossmatched for 2 units of packed red blood cells and found to have type o blood. What type of blood will the nurse administer to this client?

Slow the infusion rate and monitor the client closely.

A client is receiving a blood transfusion and reports a new onset of slight dyspnea. The nurses rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurses most appropriate action?

Delayed hypersensitivity response

A client received 2 units of packed red blood cells while in the hospital with recital bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of r act does the nurse understand could be occurring?

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 bpm. What is the best action for the nurse to take after stopping the transfusion and awaiting further instruction from the healthcare provider?

Immediately stop the transfusion, and feels normal Celine solution, call the physician and notify the blood bank.

A client receiving a blood transfusion experiences an acute hemolytic reaction. Which nursing intervention is the most important?

Every unit of donated blood is Typed and tested for antibodies to infections

A client verbalizes fear of infection from a blood transfusion. what is the nurses best response?

artificially acquired active immunity

A client will be receiving a hep B vaccine serious prior to employment in a dialysis center. What type of immunity will this provide?

Ensure that the client has a current crossmatch

A client will be undergoing a total hip arthroplasty later in the day and it is anticipated that the client may require a blood transfusion during surgery. How can the nurse best ensure the client safety if A blood transfusion is required?

Epoetin alpha

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

A hemolytic allergic reaction caused by an antigen reaction.

A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem?

May be developing an infection

A nurse is reviewing a clients morning laboratory Results, and notes a left shift in the band sales. Based on this result, the nurse can interpret that the client

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

Acquired immunity

During a mumps outbreak at a local school, a teacher has been exposed. The client has previously been immunized for mumps, and consequently possesses:

Stop the transfusion immediately

The nurse caring for a client receiving a transfusion notes that 15 minutes after the infusion of packed red blod cells (prbc) has begun, the client is having difficulty breathing and complains of severe chest tightness. What is the most appropriate initial action for the nurse to take?

Place the patient in an upright position Administer diuretics as prescribed Discontinue the transfusion Administer oxygen

The nurse is administering 2 units of packed RBCs to an older adult patient who has a bleeding duodenal ulcer. The patient begins to experience. Difficulty breathing and the nurse assess crackles in the lung bases, jugular distinction, and an increase in blood pressure. What action by the nurse is necessary if the reaction is severe? Select all that apply.

High IgE concentration

The nurse is evaluating a clients complete blood cell count and differential along with the serum immunoglobulin E (IgE) Concentration. Which results might indicate that the client has an allergic disorder?