Management of Patients with non-malignant Hematologic disorders
The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma?
The client with enlarged lymph nodes in the neck
The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has
A general education in all white blood cells
The clinic nurse is caring for client diagnosed with leukopenia. What does the nurse know this client has
A general reduction in all white blood cells
Which of the following is only curative treatment for chronic myeloid leukemia (CML)
Allogeneic steam cell transplant
Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia
Apply prolonged pressure to needle sites or other sources of eternal bleeding
A client is receiving chemotherapy for acute myeloid leukemia and has poor nutritional intake. The first action of the nurse is to
Ask "are you experiencing nausea"
An elderly client is hospitalized for induction of chemotherapy to treat leukemia. The client reports fatigue to the nurse. What nursing intervention would best address the client's fatigue
Assist the client to sit in a chair for meals
The nurse cares for a client with AML with severe bone pain. What pathophysiological concept does the nurse understand is the reason for the client's pain
Bone marrow expans
The nurse practitioner suspects that a patient has MM based on his major presenting symptom and the analysis of his laboratory results. Select the classic symptom for this disease
Bone pain in the back of the ribs
Which of the following are complications related to polycythemia vera? Select all that apply
CVA MI Ulcers Hematuria
A nurse cares for a client with early Hodgkin lymphoma. While assessing the client, the nurse will most likely find painless enlargement of which lymph node
Cervical
A 40 year old client has multiple myeloma. Prior to starting treatment with thalidomide (thalomid) it is most important for the nurse to
Contract with the client regarding birth control methods
A nurse reviews the lab results of a client with PV. Which findings will the nurse find. Select all that apply
Decreased erythropoietin Increased hemoglobin
A client is receiving radiation therapy for lesions in the abdomen from non-Hodgkin;s lymphoma. Because of the effects of the radiation treatments, the nurse now assesses for
Diarrheal stools
A nurse has established for a client the nursing diagnosis of risk for infection. Which of the following interventions would the nurse include in the plan of care for this client? Select all answers that apply.
Encourage the client to take deep breath every 4 hours while awake Assess skin and mucous membrane every shift Auscultate lung sounds every shift and prn
A client with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention
Evaluate the client for potential infection
A patient is schedule for a test to help confirm the diagnosis fo AML. Which of the following is the result that the nurse knows is consistent with the diagnosis
Excess of immature blast cells
A nurse prepares a client for a bone marrow biopsy who is suspected of having acute myeloid leukemia. What results from the bone marrow biopsy does the nurse expect
Excess of immature leukocytes
A patient with acute myeloid leukemia is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host?
Graft versus host disease
When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential
Health history, such as bleeding, fatigue or fainting
A client with leukemia is being discharged from the hospital to hospice care. Which statement by the client indicates the client has not achieved the goal for the nursing diagnosis Spiritual distress
I do not understand why this happened to me
Which statement indicates the client has understands teachings about induction therapy for leukemia
I will be in the hospital for several weeks
Which statement indicates the client understands teaching about induction therapy for leukemia
I will be in the hospital for several weeks
After chemotherapy for AML, what interventions will best to help to prevent renal complications. Select all that apply
Increase hydration Administer allopurinol Administer rasburicase
For a client with Hodgkin lymphoma, who is at a risk for ineffective airway clearance and impaired gas exchange, the nurse places the client in a high Fowler's position to
Increase lung expansion
For a client with Hodgkin lymphoma, who is at risk for ineffective airway clearance and impaired gas exchange, the nurse places the client in a high Fowler's position to
Increase lung expansion
A patient with acute myeloid leukemia (AML) has a neutrophil count that persists at less than 100/mm3. What should the nurse cautiously monitor this patient for
Infection
A patient with acute myeloid leukemia has a neutrophil count that persists at less than 100 mm3. What should the nurse cautiously monitor this patient for
Infection
The nurse is teaching a client with acute lymphocytic leukemia about therapy. What statement should be included in the plan of care
Intrathecal chemotherapy is used primarily as preventive therapy
A nurse is teaching a client with MM about the therapeutic benefits of radiation therapy. Which statements will the nurse include in the teaching. Select all that apply
It helps to strengthen the bone It helps to decrease the bone pain
Which term refers to a form of white blood cell involved in immune response
Lymphocyte
A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?
Maintain nutrition
A client has been diagnosed with polycythemia Vera. It is most important for the nurse to teach the client about
Maintaining adequate blood pressure control
What assessment finding best indicates that the client has recovered from induction therapy?
Neutrophil and platelet counts within normal limits
The hospitalized client is experiencing gastrointestinal bleeding. Laboratory test results show that the client platelets are 9000mm3. The client is prednisone and azathioprine (imuran) the nurse
Performs a neurological assessment with vital signs
The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What lab study should the nurse be concerned about?
Platelet count of 9000mm3
A nurse is caring for an asymptomatic client with acute myelogenous leukemia. The client has a total WBC count of 0, a platelet count of 3,000mm2 and a hemoglobin level of 9mg/dL. He has a single lumen central venous catheter in place and physician has ordered the nurse to administer imipenem cilastatin (Primaxin) 500 mg every 8 hours, transfuse 1 unit packed RBC, give amphotericin B (Fungizone) 40 mg IV over 4 hours and transfuse 2 pheresis units of platelets. In what order should the nurse infuse these medications and blood products?
Platelets, imipenem cilastatin, amphotericin B, packed RBCs
The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristics of erythrocytosis
Polycythemia vera
Which nursing intervention is most appropriate for a client with MM
Preventing bone injury
Which statement best describes the function of stem cells in the bone marrow
Produce all blood cells
The nurse is caring for a patient with hodgkin lymphoma in the hospital and preparing discharge planning education. Knowing that this patient is at risk for the development of a second malignancy, what education would be beneficial to reduce the risk factors. Select al that apply
Reduce exposure to excessive sunlight Smoking cessation Decrease alcohol intake
The nurse is assessing a patient with polycythemia vera. What skin assessment data would the nurse determine is a normal finding for this patient
Ruddy complexion
The nurse is assisting the client with MM to ambulated. What is the most important nursing diagnosis to help prevent fractures in this client
Safety
Clinical assessment of a patient with AML includes observing for signs of infection, the major cause of earth for AML . The nurse should assess for indicators of
Splenomegaly
A client with PV presents to the primary care clinic for an annual physical. Which health care provider prescriptions does the nurse recognize as preventive measures to prevent thrombosis in the client. Select all that apply
Statin therapy Beta blocker therapy
Which term is used to refer to a primitive cell that is capable of self-replication and differentiation
Stem cell
The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma
The client with enlarged lymph nodes in the neck
A nurse is providing teaching to a client who will undergo chemotherapy and radiation prior to hematopoietic stem cell transplantation for AML. What statement will the nurse use to describe the purpose of chemotherapy and radiation
These therapies destroy the ability of your body to produce blood cells inside your bone marrow
The nurse is aware that chronic lymphocytic leukemia, a common malignancy in those older than 60, has an early stage and a late stage. The nurse assesses a patient for late stage CLL by looking for
Thrombocytopenia
The nurse is aware the CLL, a common malignancy in those older than 60, has an early stage and a late stage. The nurse assesses a patient for late stage CLL by looking for
Thrombocytopenia
Which assessment findings support the client's diagnosis of acute myeloid leukemia? Select all that apply
Weakness and fatigue Petechiae Enlarged lymph nodes Bone pain
What is the rationale for the classification of leukemia
Which bone marrow stem cell is dysfunctional
The nurse is caring for a patient with chronic CML who is taking gleevec. In what phase of leukemia does the nurse understand that this medication is most useful to induce remission
Chronic
A 48 year old female recently diagnosed with leukemia presents with increased immature lymphocytes, decreased granulocytes and normal erythrocytes. The client most likely has which type of leukemia
Chronic lymphatic leukemia
A nurse assesses a patient who has been diagnosed with DIC. Which of the following indicators are consistent with this diagnosis? Select all that apply
Cyanosis in the extremities Dyspnea and hypoxia Increased blood area use nitrogen (BUN) and creatinine
A client with MM is complaint about pain. What interventions will the nurse give the client. To help reduce pain during activity
Do not lift more than 10 pounds
The oncology advanced practice nurse is assessing a client with leukemia. How would the oncology APN assess for enlargement and tenderness over the liver and spleen?
By palpating the abdomen
A client presents with peripheral neuropathy and hypothesis of the feet. What is the best nursing intervention
Assess for signs of injury
A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action
Assess renal function
A nurse prepares teaching for a group of clients with chronic myeloid leukemia (CML). When planning the teaching on a medication adherence, which factors associated with lower oral therapy adherence will the nurse keep in mind? Select all that apply
Living alone Low socioeconomic status Not participating in a clinical trial Taking medication independent of meals
A client was admitted to the hospital with a pathological pelvic fracture. The client informs the nurse that he has been having a strange pain in the pelvic area for a couple of weeks that was getting worse with activity prior to the fracture. What does the nurse suspect may be occurring based on these symptoms?
Multiple myeloma