Hematology
Folate deficiency
A Hypoproliferative type of anemia that is common in Alcoholics, pregnant women, patients with celiac disease
Hemostasis
A balance between 2 systems: thrombus formation and fibrinolysis
Decrease cardiac demands by promoting rest
A client from a Mediterranean country is admitted with thalassemia, jaundice, splenomegaly, and hepatomegaly. Which should be the primary focus of nursing care for this client?
Left Shift
An increase of band cells; more immature cells than normal cells present in the blood
Glucose-6-Phosphate Dehydrogenase Deficiency
Days after exposure to offending agentpallor, jaundice, and hemoglobinuria increase in reticulocyte count occur. What am I ?
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 (RBCs), a patient begins to complain of chills, low back pain, and nausea. What priority action should the nurse take?
Granulocytes
Eosinophils, Basophils, and Neutrophils are the 3 main subgroups
15g/100mL
How much hemoglobin is normally contained in whole blood?
Reticuloendothelial Cells
Located in the liver and the spleen, what removes old erythrocytes; average lifespan is 120 days
Megakaryocytes
Platelets, or thrombocytes located in the bone marrow
Stem Cells
Primitive cells, that are self-replicating, located in the marrow which is highly vascular
Basophils
Produce and store histamines
Stroma
Refers to all tissue within the marrow that is not directly involved in hematopoiesis
Myeloid or Lymphoid
The stem-cells differentiate into 2 different stem cells known as
hematopoietic stem cell transplant - HSCT
Used to treat clients with aplastic anemia
T Lymphocytes
What are responsible for delayed allergic reactions, rejection of foreign tissue (transplants), and destruction of tumor cells? A process known as cellular immunity
Check the client regarding chills, low back pain, dyspnea, and skin itching during the transfusion.
A client with aplastic anemia is going to receive a blood transfusion. In addition to taking vital signs and verifying that the unit of blood cells is matched to the client, what other assessments/actions would you take?
pica
A craving for ice, starch, or dirt with iron deficiency is termed what?
spherocytes
What are small, spherically shaped RBCs called?
Lean meat
What food should the nurse recommend for a client diagnosed with vitamin B12 deficiency?
haptoglobin
What is a blood protein synthesized by the liver; binds free hemoglobin released from RBCs; which is then removed by the reticuloendothelial system?
anemia
What is a condition in which the Hgb concentration is lower than normal, reflecting the presences of fewer than normal number of RBCs in circulation?
hemochromatosis
What is a genetic condition in which excess iron is absorbed from the GI tract
erythropoietin
What is a hormone produced primarily by the kidney? Stimulates the differentiation of the primitive myeloid stem cell into an erythroblast
aplasia
What is a lack of cellular development?
ferritin
What is a protein that stores iron and controls the release?
thrombocytopenia
What is lower than normal platelet count called?
hypochromia
What is pallor within the RBC caused by decreased hemoglobin content?
thrombocytosis
What is higher than normal platelet count called?
Platelet count, prothrombin time, and partial thromboplastin time
While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters?
Exposure to foreign antigens may cause altered immune function.
A nurse is taking health history from a new client, which includes asking about a history of blood transfusions. This is important for which of the following reasons?
Assesses the hemoglobin level
A client in end-stage renal disease is prescribed epoetin alfa (Epogen) and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, the nurse
eat foods with good sources of iron
A client is admitted with fatigue, shortness of breath, pale skin, and dried, cracked lips, tongue, and mouth. The hemoglobin is 9 g/dL (90 g/L), and red blood cell count is 3.5 million cells/mm3 (3.5 × 1012/L). The nurse should instruct the client to:
Disconnect the blood tubing, flush with normal saline, and administer morphine
A client receiving a unit of packed red blood cells (PRBCs) has been prescribed morphine 1 mg intravenously now for pain. What is the best method for the nurse to administer the morphine?
Coagulopathy
A nursing instructor in a BSN program is preparing for a lecture on disorders of the hematopoietic system. Included in the lecture are conditions caused by reduced levels or absence of blood-clotting proteins. Which of the following is the instructor most likely referring to?
Aplastic anemia
A patient is brought to the ER complaining of fatigue, large amounts of bruising on the extremities, and abdominal pain localized in the left upper quadrant. A health history reveals the patient has been treated three times in the past 2 months for a sore throat. Lab tests indicate severe anemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, with what could the patient be diagnosed?
Essential thrombocythemia
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is the most likely clinical disorder the patient is being treated for?
Administer eltrombopag (Promacta
A patient who has idiopathic thrombocytopenia purpura (ITP) has a critically low platelet count. Which nursing intervention will be included in the care plan for a patient with ITP?
Erythropoietin (Epogen)
A patient with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?
Administering and evaluating the effectiveness of opioid analgesics
A patient with sickle cell crisis is admitted to the hospital in severe pain. While caring for the patient during the crisis, which of the following is the priority nursing intervention?
Severe beta thalassemia
If left untreated this disorder can be fatal within the first few years of life
Eosinophils
Important in the phagocytosis of parasites. An increase in these cells indicates a hypersensitivity reaction; they neutralize histamine
5%
In normal blood, monocytes account for approximately what percentage of the total leukocyte count?
Fungi and Viruses
Macrophages are effective against
Extramedullary Hematopoiesis
Production of blood cells in the liver and spleen
Phlebotomy
The client is diagnosed with polycythemia vera. The nurse prepares the client for which procedure?
Pneumococcal vaccine
The client is planned to have a splenectomy. The nurse should prepare which medication to administer to this client?
• Place the patient in an upright position with the feet dependent. • Administer diuretics as prescribed. • Administer oxygen. • Discontinue the transfusion.
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 assesses crackles in the lung bases, jugular vein distention, and an increase in blood pressure. What action by the nurse is necessary if the reaction is severe?
reticulocytes
What are slightly immature RBCs called? Usually only 1% in circulation
microcytosis
What is a smaller than normal RBC called?
D-dimer
What is a test to measure fibrin breakdown?
megaloblastic anemia
What is a type of anemia characterized by the presence of abnormally large, nucleated RBCs?
hemosiderin
What is an iron-containing pigment derived from breakdown of hemoglobin?
polycythemia
What is referred to as an increased volume of RBCs. Used when the Hct level is elevated
mean corpuscular volume
What is the average volume of RBC? Used to diagnose the type of anemia
angular cheilosis
What is the cracking sore at the corners of the mouth?
Bone Marrow
What is the primary sit for hematopoiesis?
Hematopoiesis
What is the process of creating new blood cells?
poikilocytosis
What is variation in shape of RBCs called?
Band Cell
A less mature granulocyte with a single-lobe and elongated nucleus
Sickle Cell anemia
Which hemolytic disorder is characterized by ischemia or infarction results from micro clots , the patient may have pain, swelling , and fever
Phagocytosis
A ingestion and digestion process of bacteria and particles by neutrophils-the major function
Serum ferritin: 15 ng/mL
A nurse practitioner reviewed the blood work of a male patient suspected of having microcytic anemia. The nurse suspected occult bleeding. Identify the laboratory result that would indicate this initial stage of iron deficiency.
Immunoglobulins Igs
B lymphocytes differentiate into plasma cells that produce antibodies called_____________ which are protein molecules that destroy foreign material. This process is known as humoral immunity
Bleeding
The nurse recognizes the most common cause of iron deficiency anemia in an adult is which of the following?
Yellow Marrow
What is the largest component of the stroma?
Lymphoid stem cells
What produces either T or B lymphocytes? T cells derive from the thymus; B cells derive from marrow
Myeloid stem cells
What produces erythrocytes, leukocytes, and platelets
Vit B12 & Folic Acid
What vitamin(s) are essential for DNA synthesis in RBCs
Distal Ileum
Where is B12-intrinsic factor complex absorbed
Proximal Small Intestine
Where is folate absorbed
Vitamin K
Which of the following medications is the antidote to Coumadin?
Protamine sulfate
Which of the following medications is the antidote to Heparin?