Med Surg II: Ch 16 Care of Pts with Hematologic Disorders EAQs

Which information would the nurse include when teaching a patient with a discharge instruction to take iron supplements? Select all that apply. One, some, or all responses may be correct.

"Antacids interfere with the absorption of iron." "Take iron with orange juice to assist with absorption."

When teaching a patient with thrombocytopenia about medications, which medications would the nurse advise the patient to avoid? Select all that apply. One, some, or all responses may be correct.

Aspirin Contact sports Anticoagulant therapy Nonsteroidal anti-inflammatory drugs (NSAIDs)

Which type of blood transfusion would the patient receive when stating, "I've already donated my own blood in case I need a transfusion during my joint replacement surgery"?

Autologous

Which intervention would the nurse identify as the priority when reviewing the plan of care for a patient hospitalized with sickle cell crisis?

Control pain

Which food selections indicate patient understanding of the need to increase dietary folic acid? Select all that apply. One, some, or all responses may be correct.

Eggs Broccoli Whole-grain products

Which focus of care would the nurse evaluate when providing care for a patient with pernicious anemia?

Ensuring administration of monthly B12 injections for life

After consulting with the patient's dietician regarding an oral iron supplement, which liquid would the nurse request to increase absorption of the medication?

Orange juice

Which clinical manifestation would the nurse report immediately when providing care for a patient with severe anemia who is receiving a blood transfusion?

Pain in the lower back

Which clinical manifestations would the nurse associate with severe anemia? Select all that apply. One, some, or all responses may be correct.

Pallor Tachypnea Smooth tongue

The nurse would anticipate administering epoetin alfa to patients with which diseases? Select all that apply. One, some, or all responses may be correct.

Rheumatoid arthritis, if the patient has anemia from therapy End-stage renal disease Chemotherapy treatment with anemia

Which example would the nurse provide for a patient who is experiencing disseminated intravascular coagulation (DIC) and asks about the pathologic cause of the disorder?

Sepsis

When a middle-aged adult with a history of anemia tells the nurse about "having trouble getting through the day lately," which symptom would the nurse expect the patient to report to the primary health care provider?

Shortness of breath

Which patient statements reflect understanding of content presented by the nurse regarding a new diagnosis of sickle cell anemia? Select all that apply. One, some, or all responses may be correct.

"I will need to stop drinking alcoholic beverages." "I plan on starting a smoking-cessation class next week." "I will make sure I drink at least 4 to 6 L of fluid, daily."

Which content would the nurse include when providing discharge instructions for a patient with multiple myeloma?

"Obtain assistance when moving to prevent fractures."

Which response would the nurse utilize when the patient's spouse states, "The health care provider told me the chemo didn't work and there's nothing left to try. That means my spouse is going to die"?

"That must have been so hard for you."

Which characteristics would the nurse associate with hemophilia? Select all that apply. One, some, or all responses may be correct.

A deficiency of factor IX A deficiency of factor VIII An inherited X-linked disorder

Which pathology would the nurse suspect in a patient with leukemia who complains of a headache?

Abnormal white blood cells have infiltrated the central nervous system

Which intervention would the nurse implement after the charge nurse immediately stops a transfusion for a patient receiving a second unit of blood who becomes short of breath and has distended neck veins?

Administering oxygen and furosemide

Which standards of care would the nurse monitor to ensure a safe and effective transfusion when assisting in administration of a patient's blood transfusion? Select all that apply. One, some, or all responses may be correct.

Blood transfusion tubing includes a special blood filter. Monitor the patient closely after blood transfusion for any changes. Ensure that transfusion of the blood occurs after verifying the patient's identification.

Which type of blood transfusion problem would the nurse associate with a patient experiencing jugular venous distention, cough, dyspnea, and tachycardia?

Circulatory overload

Initially, which diagnostic test would the nurse anticipate scheduling when a middle-aged male patient receives a diagnosis of multiple myeloma?

Complete blood count (CBC) with differential and urinary Bence-Jones protein levels

Which characteristics would the nurse associate with aplastic anemia? Select all that apply. One, some, or all responses may be correct.

Decreased red blood cells Decreased white blood cells

Which responses would the nurse utilize when a patient diagnosed with leukemia asks what could have caused the disease? Select all that apply. One, some, or all responses may be correct.

Exposure to ionizing radiation Human T-lymphotropic virus 1 An abnormal number of chromosomes Chemicals that are toxic to the bone marrow

When a patient with sickle cell anemia complains of experiencing a crisis at least once a week and wants to reduce the frequency, which treatment would the nurse anticipate the primary health care provider prescribing?

Hydroxyurea

Which clinical manifestations would the nurse associate with a patient diagnosed with leukemia? Select all that apply. One, some, or all responses may be correct.

Increased white blood cells Possible link to benzene exposure

Which interventions would the nurse implement when providing care for a newly diagnosed patient with thrombocytopenia who has a risk for injury from bleeding? Select all that apply. One, some, or all responses may be correct.

Increasing the patients dietary fiber Avoiding prolonged tourniquet use Providing the patient a soft-bristled toothbrush

For the patient who reports taking ferrous sulfate tablets daily during an annual physical, the nurse would associate the medication as a treatment for which condition?

Iron deficiency anemia

Which teaching point would the nurse identify in the plan of care for a patient recently diagnosed with thrombocytopenia?

Instruct the patient to use a soft toothbrush.

The nurse understands that the patient with megaloblastic (pernicious) anemia has which deficiencies? Select all that apply. One, some, or all responses may be correct.

Intrinsic factor Cyanocobalamin

Patients with hypochromic, microcytic anemia need to increase their intake of which nutrient?

Iron

Which intervention would the nurse identify in the plan of care when the laboratory report reflects an increase in the uric acid level for a patient receiving chemotherapy for leukemia?

Maintaining adequate hydration

Which type of anemia would the nurse associate with the patient experiencing neurologic clinical manifestations?

Megaloblastic anemia

Which condition would the nurse include in the teaching for a patient diagnosed with an excessive production of red blood cells?

Polycythemia vera

Which clinical manifestations would the nurse anticipate when providing care for a patient with thrombocytopenia? Select all that apply. One, some, or all responses may be correct.

Purpura Ecchymoses Gastrointestinal bleeding

Which clinical manifestation would alert the nurse to a potential problem when the patient begins to hemorrhage from an incision during the immediate postoperative period?

Rapid, weak pulse

Which characteristics would the nurse associate with an assigned patient with sickle cell anemia? Select all that apply. One, some, or all responses may be correct.

The disorder is hereditary. The disease is a result of abnormal hemoglobin.

When participating in a patient care planning conference regarding an autologous bone marrow transplantation, the nurse understands that the plan of care includes preparing the patient for a transplant from which source?

The patient

Which unique characteristics would the nurse link to a patient with sickle cell disease? Select all that apply. One, some, or all responses may be correct.

There is no cure for this disease. Extreme pain occurs during a crisis. Sickle cell patients have abnormally shaped red blood cells.

Which frequently used therapy would the nurse explain when teaching a patient with a hematologic disorder? Select all that apply. One, some, or all responses may be correct.

Transfusions Splenectomy Stem cell transplantation