Test 3 med surge chapter 32: hematology

A nurse has participated in organizing a blood donation drive at a local community center. Which of the following individuals would most likely be disallowed from donating blood?

A woman whose blood pressure is 88/51 mm Hg

A patient has been scheduled for a bone marrow biopsy and admits to the nurse that she is worried about the pain involved with the procedure. What patient education is most accurate?

"Most people feel some brief, sharp pain when the needle enters the bone."

The nurse is planning the care of a patient with a nutritional deficit and a diagnosis of megaloblastic anemia. The nurse should recognize that this patient's health problem is due to what

Abnormalities in the structure and function RBCs

The nurse is preparing to administer a unit of platelets to an adult patient. When administering this blood product, which of the following actions should the nurse perform?

Administer the platelets as rapidly as the patient can tolerate.

The nurse is describing the role of plasminogen in the clotting cascade. Where in the body is plasminogen present?

All body fluids

A client's health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the patient's increased risk for what hematologic disorder?

Anemia

A nurse is educating a patient about the role of B lymphocytes. The nurse's description will include which of the following physiologic processes?

Antibody production

A patient's low hemoglobin level has necessitated transfusion of PRBCs. Prior to administration, what action should the nurse perform?

Assess the patient's vital signs to establish baselines.

interdisciplinary team has been commissioned to create policies and procedures aimed at preventing acute hemolytic transfusion reactions. What action has the greatest potential to reduce the risk of this transfusion reaction?

Be vigilant in identifying the patient and the blood component.

A patient on the medical unit is receiving a unit of PRBCs. Difficult IV access has necessitated a slow infusion rate and the nurse notes that the infusion began 4 hours ago. What is the nurse's most appropriate action?

Discontinue the remainder of the PRBC transfusion and inform the physician.

A patient is receiving the first of two ordered units of PRBCs. Shortly after the initiation of the transfusion, the patient complains of chills and experiences a sharp increase in temperature. What is the nurse's priority action?

Discontinue the transfusion.

A nurse at a blood donation clinic has completed the collection of blood from a woman. The woman states that she feels "lightheaded" and she appears visibly pale. What is the nurse's most appropriate action?

Help her into a sitting position with her head lowered below her knees.

The nurse is describing normal RBC physiology to a patient who has a diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?

Hemoglobin

A patient's electronic health record states that the patient receives regular transfusions of factor IX. The nurse would be justified in suspecting that this patient has what diagnosis?

Hemophilia

Two units of PRBCs have been ordered for a patient who has experienced a GI bleed. The patient is highly reluctant to receive a transfusion, stating, "I'm terrified of getting AIDS from a blood transfusion."

How can the nurse best address the patient's concerns? "The chances of contracting AIDS from a blood transfusion in the United States are exceedingly low."

A patient with a hematologic disorder asks the nurse how the body forms blood cells. The nurse should describe a process that takes place where?

In the bone marrow

The nurse educating a patient with anemia is describing the process of RBC production. When the patient's kidneys sense a low level of oxygen in circulating blood, what physiologic response is initiated?

Increased production of erythropoietin

A patient lives with a diagnosis of sickle cell anemia and receives frequent blood transfusions. The nurse should recognize the patient's consequent risk of what complication of treatment?

Iron overload

Through the process of hematopoiesis, stem cells differentiate into either myeloid or lymphoid stem cells. Into what do myeloid stem cells further differentiate?

Leukocytes,Platelets,Erythrocytes

nurse is caring for a patient who has developed scar tissue in many of the areas that normally produce blood cells. What organs can become active in blood cell production by the process of extramedullary hematopoiesis?

Liver and spleen

The nurse is providing care for an older adult who has a hematologic disorder. What age-related change in hematologic function should the nurse integrate into care planning?

Older adults are less able to increase blood cell production when demand suddenly increases.

A patient's wound has begun to heal and the blood clot which formed is no longer necessary. When a blood clot is no longer needed, the fibrinogen and fibrin will be digested by which of the following?

Plasmin

An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?

Platelets will aggregate at the injury site.

A patient undergoing a hip replacement has autologous blood on standby if a transfusion is needed. What is the primary advantage of autologous transfusions?

Prevention of viral infections from another person's blood

A patient's diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin (Coumadin), an anticoagulant. When assessing the therapeutic response to this medication, what is the nurse's most appropriate action?

Review the patient's international normalized ratio .The INR and aPTT serve as useful screening tools for evaluating a patient's clotting ability and to monitor the therapeutic effectiveness of anticoagulant medications.

A patient's most recent blood work reveals low levels of albumin. This assessment finding should suggest the possibility of what nursing diagnosis?

Risk for imbalanced fluid volume related to low albumin

A nurse is caring for a patient who undergoing preliminary testing for a hematologic disorder. What sign or symptom most likely suggests a potential hematologic disorder?

Severe fatigue

A man suffers a leg wound which causes minor blood loss. As a result of bleeding, the process of primary hemostasis is activated. What occurs in primary hemostasis?

Severed blood vessels constrict.

Fresh-frozen plasma (FFP) has been ordered for a hospital patient. Prior to administration of this blood product, the nurse should prioritize what patient education?

Signs and symptoms of a transfusion reaction

The nurse's review of a patient's most recent blood work reveals a significant increase in the number of band cells. The nurse's subsequent assessment should focus on which of the following

Signs and symptoms of infection

A patient is receiving a blood transfusion and complains of a new onset of slight dyspnea. The nurse's rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurse's most appropriate action?

Slow the infusion rate and monitor the patient closely.

An older adult client is exhibiting many of the characteristic signs and symptoms of iron deficiency. In addition to a complete blood count, what diagnostic assessment should the nurse anticipate?

Stool for occult blood

A patient is being treated in the ICU after a medical error resulted in an acute hemolytic transfusion reaction. What was the etiology of this patient's adverse reaction?

The donor blood was incompatible with that of the patient.

A patient is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?

The need to report any signs or symptoms of infection promptly

Which of the following circumstances would most clearly warrant autologous blood donation?

The patient has elective surgery pending.

A patient is being treated for the effects of a longstanding vitamin B12 deficiency. What aspect of the patient's health history would most likely predispose her to this deficiency?

The patient is a vegan.

The nurse's brief review of a patient's electronic health record indicates that the patient regularly undergoes therapeutic phlebotomy. Which of the following rationales for this procedure is most plausible?

The patient may chronically produce excess red blood cells.

nurse caring for a patient receiving a transfusion notes that 15 minutes after the infusion of packed red blood cells (PRBCs) has begun, the patient is having difficulty breathing and complains of severe chest tightness.

What is the most appropriate initial action for the nurse to take? Stop the transfusion immediately.Vascular collapse, bronchospasm, laryngeal edema, shock, fever, chills, and jugular vein distension are severe reactions.

A patient has been diagnosed with a lymphoid stem cell defect. This patient has the potential for a problem involving which of the following?Plasma cells

a defect in the lymphoid stem cell can cause problems with T or B lymphocytes, plasma cells (a more differentiated form of B lymphocyte), or natural killer cells.

A patient has come to the OB/GYN clinic due to recent heavy menstrual flow. Because of the patient's consequent increase in RBC production,

the nurse knows that the patient may need to increase her daily intake of what substance? Iron