Ch 33

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?

"I have difficulty breathing when walking 30 feet."

For a client diagnosed with idiopathic thrombocytopenia purpura (ITP), which nursing intervention is appropriate?

Administering stool softeners, as ordered, to prevent straining during defecation

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 external bleeding

A client in end-stage renal disease is prescribed epoetin alfa and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, what is the priority action taken by the nurse?

Assesses the hemoglobin level

Which is a symptom of hemochromatosis?

Bronzing of the skin

The nurse is educating a client about iron supplements. The nurse teaches that what vitamin enhances the absorption of iron?

C

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia?

Erythrocytes that are microcytic and hypochromic

When assessing a 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 receiving a blood transfusion experiences an acute hemolytic reaction. What is the nurse's priority intervention?

Immediately stop the transfusion, infuse normal saline solution, call the health care provider, and notify the blood bank.

The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned the co-worker may have?

Iron deficiency anemia

A client with a diagnosis of pernicious anemia comes to the clinic and reports numbness and tingling in the arms and legs. What do these symptoms indicate?

Neurologic involvement

The nurse is caring for an older adult client who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine where the blood loss is coming from, what intervention can the nurse provide?

Observe stools for blood.

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron?

Orange juice

While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters?

Platelet count, prothrombin time, and partial thromboplastin time

A client awaiting a bone marrow aspiration asks the nurse to explain where on the body the procedure will take place. What body part does the nurse identify for the client?

Posterior iliac crest

A client is treated for anemia. What is the nurse's best understanding about the correlation between anemia and the client's iron stores?

There is a strong correlation between iron stores and hemoglobin levels.

A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse?

To detect the abnormal sounds suggestive of acute chest syndrome and heart failure

A client with sepsis is experiencing disseminated intravascular coagulation (DIC). The client is bleeding from mucous membranes, venipuncture sites, and the rectum. Blood is present in the urine. The nurse establishes the nursing diagnosis of Risk for deficient fluid volume related to bleeding. The most appropriate and measurable outcome for this client is that the client exhibits

Urine output greater than or equal to 30 mL/hour

A nurse is caring for a client with thrombocytopenia. What is the best way to protect this client?

Use the smallest needle possible for injections.

During preparation for bowel surgery, a client receives an antibiotic to reduce intestinal bacteria. The nurse knows that hypoprothrombinemia may occur as a result of antibiotic therapy interfering with synthesis of which vitamin?

Vitamin K

Which medication is the antidote to warfarin?

Vitamin K

A client with sickle cell anemia has a

low hematocrit

A client admitted to the hospital with abdominal pain, anemia, and bloody stools reports feeling weak and dizzy. The client has rectal pressure and needs to urinate and move their bowels. The nurse should help them:

onto the bedpan.

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count?

Thrombocytopenia

A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client?

Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.