Chapter 29- Nonmalignant Hematologic Disorders

The nurse is instructing a client about taking a liquid iron preparation for the treatment of iron-deficiency anemia. What should the nurse include in the instructions? Iron may cause indigestion and should be taken with an antacid such as Mylanta. Discontinue the use of iron if your stool turns black. Dilute the liquid preparation with another liquid such as juice and drink with a straw. Do not take medication with orange juice because it will delay absorption of the iron.

Dilute the liquid preparation with another liquid such as juice and drink with a straw

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 macrocytic and hyperchromic An increased number of erythrocytes Erythrocytes that are microcytic and hypochromic Clustering of platelets with sickled red blood cells

Erythrocytes that are microcytic and hypochromic

A patient with End Stage Kidney Disease is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication? Folate levels Hemoglobin level Creatinine level Potassium level

Hemoglobin level

The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient? It will determine what type of anemia the patient has. It may indicate deficiencies in essential nutrients. It is part of the required assessment information. It is important for the nurse to determine what type of foods the patient will eat.

It may indicate deficiencies in essential nutrients

The nurse is assessing a patient who is a strict vegetarian. What type of anemia is the nurse aware that this patient is at risk for? Aplastic anemia Sickle cell anemia Iron deficiency anemia Megaloblastic anemia

Megaloblastic anemia

A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms? "Eat cold, bland foods with a large amount of water." "Eat small amounts of bland, soft foods frequently." "Eat low-fiber blended foods only." "Eat larger amounts of bland, soft foods less frequently."

"Eat small amounts of bland, soft foods frequently."

A client with sickle cell crisis is admitted to the hospital in severe pain. While caring for the client during the crisis, which is the priority nursing intervention? Limiting the client's intake of oral and IV fluids Administering and evaluating the effectiveness of opioid analgesics Encouraging the client to ambulate immediately Limit foods that contain folic acid

Administering and evaluating the effectiveness of opioid analgesics

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process due to thrombocytopenia in a client with leukemia? Eliminating direct contact with others who are infectious Applying prolonged pressure to needle sites or other sources of external bleeding Monitoring temperature at least once per shift Implementing neutropenic precautions

Applying prolonged pressure to needle sites or other sources of external bleeding

The nurse is planning care for a client with severe fatigue secondary to anemia. What concept will the nurse use as the basis for planning interventions? Determining what days to be active. Keeping long activity periods to build client stamina. Assisting in prioritizing activities. Encouraging early and frequent activities.

Assisting in prioritizing activities

A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia? Calcium level of 9.4 mg/dL Potassium level of 5.2 mEq/L Creatinine level of 6 mg/100 mL Magnesium level of 2.5 mg/dL

Creatinine level of 6 mg/100 mL

A patient with chronic renal failure is examined by the health care provider for anemia. Which laboratory results will the nurse monitor? Increased mean corpuscular volume Decreased level of erythropoietin Decreased total iron-binding capacity Increased reticulocyte count

Decreased level of erythropoietin

The nurse and the client are discussing some strategies for ingesting iron to combat the client's iron-deficiency anemia. Which is among the nurse's strategies? Drink liquid iron preparations with a straw. Taking iron pills with milk aids in absorption. Avoid vitamin C as it prevents absorption. Take iron with an antacid to avoid stomach upset.

Drink liquid iron preparations with a straw

When assessing a client with anemia, which assessment is essential? Age and gender Lifestyle assessments, such as exercise routines Family history Health history, including menstrual history in women

Health history, including menstrual history in women

A nurse provides nutritional information for a patient diagnosed with an iron-deficiency anemia. What education should the nurse provide? Decrease the intake of citrus fruits because they interfere with iron absorption. Take an iron supplement with meals to reduce gastric irritation. Decrease the intake of high-fat red meats, especially organ meats. Increase the intake of green, leafy vegetables.

Increase the intake of green, leafy vegetables

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? Megaloblastic anemia Iron deficiency anemia Sickle cell anemia Aplastic anemia

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? Severity of the disease Loss of vibratory and position senses Insufficient intake of dietary nutrients Neurologic involvement

Neurologic involvement

While assessing a client, the nurse will recognize what as the most obvious sign of anemia? Flow murmurs Tachycardia Jaundice Pallor

Pallor

The nurse's role in the management of polycythemia vera is primarily that of an educator. Choose the best health promotion advice that a nurse could give. Use compression stockings when walking to prevent deep vein thrombosis (DVT). Participate in regular phlebotomy procedures to decrease blood viscosity. Take aspirin daily to prevent clot formation. Take antiplatelets on a regular basis.

Participate in regular phlebotomy procedures to decrease blood viscosity

A nurse is caring for a client with severe anemia. The client is tachycardic and reports dizziness and exertional dyspnea. What signs and symptoms might develop if this client goes into heart failure? Fever Peripheral edema Nausea and vomiting Migraine

Peripheral edema

A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the cause. The patient takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this patient at risk for? Pernicious anemia Sickle cell anemia Aplastic anemia Iron deficiency anemia

Pernicious anemia

While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters? Thrombin time, calcium levels, and potassium levels Platelet count, prothrombin time, and partial thromboplastin time Platelet count, blood glucose levels, and white blood cell (WBC) count Fibrinogen level, WBC, and platelet count

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? Sternum Posterior iliac crest Femur Ankle

Posterior iliac crest

A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for? The onset of a bacterial infection Bleeding Abdominal pain Diarrhea

The onset of a bacterial infection

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 weak correlation between iron stores and hemoglobin levels. There is a strong correlation between iron stores and hemoglobin characteristics. There is an inverse relationship between iron stores and hemoglobin levels. There is a strong correlation between iron stores and hemoglobin levels.

There is a strong correlation between iron stores and hemoglobin levels

A nurse is caring for a client with thrombocytopenia. What is the best way to protect this client? Maintain accurate fluid intake and output records. Limit visits by family members. Encourage the client to use a wheelchair. Use the smallest needle possible for injections.

Use the smallest needle possible for injections

Which medication is the antidote to warfarin? Aspirin Vitamin K Protamine sulfate Clopidogrel

Vitamin K

A client with idiopathic thrombocytopenic purpura (ITP) is admitted to an acute care facility. The nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral hemorrhage when the platelet count falls below what number? 135,000/?l. 20,000/?l. 10,000/?l. 75,000/?l.

10,000/?l.

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 health care provider immediately because the client probably is experiencing which problem? A hemolytic allergic reaction caused by an antigen reaction A hemolytic reaction to mismatched blood A hemolytic reaction to Rh-incompatible blood A hemolytic reaction caused by bacterial contamination of donor blood

A hemolytic allergic reaction caused by an antigen reaction

A complete blood count is commonly performed before a client goes into surgery. What does this test seek to identify? Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels Potential hepatic dysfunction indicated by decreased blood urea nitrogen (BUN) and creatinine levels Electrolyte imbalance that could affect the blood's ability to coagulate properly Low levels of urine constituents normally excreted in the urine

Abnormally low hematocrit (HCT) and hemoglobin (Hb) levels

Which is a symptom of hemochromatosis? Inflammation of the mouth Bronzing of the skin Weight gain Inflammation of the tongue

Bronzing of the skin

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

C

A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order? chest radiograph CBC ECG antibiotic

CBC

A thin client is prescribed iron dextran intramuscularly. What is most important action taken by the nurse when administering this medication? Injects into the deltoid muscle Uses a 23-gauge needle Rubs the site vigorously Employs the Z-track technique

Employs the Z-track technique

The nurse obtains a unit of blood for the client, Donald D. Smith. The name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. What action should the nurse take? Ask the client if he was ever known as Donald A. Smith Check with the blood bank first and then administer the blood with their permission Administer the unit of blood Refuse to administer the blood

Refuse to administer the blood

The nurse is screening donors for blood donation. Which client is an acceptable donor for blood? Received a blood transfusion within 1 year Had a dental extraction 2 days ago for caries in a tooth Has a history of viral hepatitis as a teenager 10 years ago Reports having a cold 1 month ago that resolved quickly

Reports having a cold 1 month ago that resolved quickly

The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for? Bone marrow biopsy Magnetic resonance imaging (MRI) study Schilling test Bone marrow aspiration

Schilling test

A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching? Decrease intake of dietary fiber Take with dairy products Decrease intake of fruits and juices Take 1 hour before breakfast

Take 1 hour before breakfast

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 E Vitamin K Vitamin A Vitamin D

Vitamin K

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. to the bedside commode. to a standing position so he can urinate. to the bathroom.

onto the bedpan

The nurse is caring for a client with type 2 diabetes who take metformin to manage glucose levels. The nurse recognizes the client may be most at risk for which vitamin deficiency? B12 A Folate C

B12

During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding? Low ferritin level concentration Enlarged mean corpuscular volume (MCV) Elevated red blood cell (RBC) count Elevated hematocrit concentration

Low ferritin level concentration

A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention? Monitoring the client's breathing and reviewing the client's arterial blood gases Monitoring the client's blood pressure and reviewing the client's hematocrit Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential Monitoring the client's heart rate and reviewing the client's hemoglobin

Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential

Which of the following is accurate regarding the use of corticosteroids for immune hemolytic anemia? Select all that apply. If the hemoglobin returns to normal, the corticosteroid dose can be lowered. Corticosteroids are not effective in the treatment of immune hemolytic anemia. They decrease the macrophages ability to clear the antibody-coated RBCs. They produce lasting effects. The treatment consists of low doses of corticosteroids.

They decrease the macrophages ability to clear the antibody-coated RBCs. If the hemoglobin returns to normal, the corticosteroid dose can be lowered.

Parents arrive to the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse? "The trait is passed down through the mother." "It is an acquired, not a hereditary disorder." "The child must inherit two defective genes, one from each parent." "Most likely, the father is the carrier of the gene."

"The child must inherit two defective genes, one from each parent."

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption? Eating leafy green vegetables with a glass of water Eating apple slices with carrots Eating calf's liver with a glass of orange juice Eating a steak with mushrooms

Eating calf's liver with a glass of orange juice

A client with sickle cell disease is treated for a thrombotic event. Which organs or body systems does the nurse recognize as being at greatest risk for thrombosis in a client with sickle cell disease? Select all that apply. Cardiac system Liver Spleen Lungs Central nervous system

Spleen Lungs Central nervous system

The most common cause of iron deficiency anemia in men and postmenopausal women is menorrhagia. bleeding. chronic alcoholism. iron malabsorption.

bleeding