Ch. 30 Anemia and other RBC disorders EAQ

Which laboratory report findings support the nurse's conclusion that a patient has thalassemia major? Select all that apply.

Increased bilirubin levels Increased serum iron levels Increased reticulocyte level

Which action would the nurse take to safely infuse one unit of fresh frozen plasma (FFP) in a patient?

Infuse the FFP as rapidly as the patient will tolerate

A patient with neutropenia asks how the prescribed protective (reverse) isolation helps prevent the spread of organisms. Which response by the nurse is appropriate?

"It is designed to minimize the spread of germs to you from sources outside your environment."

The nurse is providing discharge instructions to a patient who has anemia secondary to acute blood loss. Which instruction would the nurse include in the discharge teaching?

"Now that the blood loss is controlled and as your blood volume is replaced, the anemia generally corrects itself, so no long-term treatment is needed."

Which instruction would the nurse include when teaching a patient about the administration of an oral iron substitute?

"Take it one hour before breakfast, with orange juice."

While taking undiluted liquid iron that was prescribed, a patient asks the nurse why it must be drunk through a straw. Which response by the nurse is appropriate?

"it prevents staining of teeth."

A patient that is receiving treatment for thalassemia shows evidence of hemolysis. The nurse anticipates a prescription for which supplementation?

folic acid

A patient is to receive cobalamin (vitamin B12) 1,000 mcg by mouth (PO). The pharmacy issues 250-mcg tablets. Which number of tablets would the nurse administer to the patient?

four tablets

The nurse reviews documentation of assessment findings of a patient with severe anemia. Which assessment finding would the nurse question?

hyperpigmentation

The nurse provides discharge teaching to a patient with sickle cell disease (SCD). Which statements made by the patient indicate understanding of the teaching? Select all that apply.

i should avoid high altitudes "I should start screening for retinopathy at age 10."

The nurse recalls that hemolytic anemia can be caused by which extrinsic factors?

infectious agent

which condition may cause a patient to develop anemia due to decreased hemoglobin synthesis?

iron deficiency

The nurse assesses a patient who has severe anemia and expects to find which manifestations? Select all that apply.

jaundice and pruritus vertigo dyspnea at rest Glossitis and smooth tongue

The nurse understands that with repeated episodes of sickling, which organ is most affected?

lungs

A patient has a hemoglobin level of 11 g/dL. The nurse determines that the patient has which level of severity of anemia?

mild anemia

To ensure maximum effectiveness of lifelong iron supplementation therapy, which intervention would the nurse include in the patient's plan of care? Select all that apply.

monitor the patient for liver problems evaluate the patients response to therapy Continue the supplementation for two to three months after hemoglobin levels return to normal

Which assessment finding would the nurse associate with severe anemia?

pallor

Which condition is characterized by the presence of a high percentage of hemoglobin S (Hgb S) in the erythrocytes?

sickle cell disease

A nurse mentor provides teaching to a group of nursing students about the cardiac manifestations of severe anemia. Which compensatory cardiac changes would the nurse include? Select all that apply.

tachycardia heart failure intermittent claudication

Which instruction would the nurse include in the teaching plan for a patient newly diagnosed with microcytic hypochromic anemia?

Take the iron with orange juice one hour before meals.

When a patient is prescribed iron tablets for the treatment of anemia, which measures ensure maximum absorption? Select all that apply.

Taking the tablet with orange juice Taking the tablet an hour before meals

A patient's laboratory reports show a low mean corpuscular volume (MCV) and a high reticulocyte count. The nurse suspects which condition?

Thalassemia

The nurse recalls that the standard of care for pain includes which component?

That competent and compassionate care is provided to all patient

The nurse provides dietary teaching to a patient with anemia and would include which food sources to promote red blood cell (RBC) maturation? Select all that apply.

avocados red meat

Which finding supports the nurse's conclusion that a patient has pernicious anemia?

Smooth, beefy-red tongue

To prepare for a patient's transfusion of packed red blood cells, the nurse would select which IV solution to use for the procedure?

0.9% normal saline

The nurse will begin a patient's transfusion of packed red blood cells at 1030. The nurse would plan to stay in the patient's room until which time?

1045

If a unit of packed red blood cells is picked up from the laboratory at 1015, the nurse would plan to hang the unit to begin infusion no later than which time?

1045

The nurse reviews a patient's assessment findings, which include arthralgia, liver enlargement, and total body iron level of 70 g. The nurse would anticipate providing care related to which condition?

Hemochromatosis

The nurse recalls that heparin should not be given to a patient with a history of which condition?

Heparin-induced thrombocytopenia (HIT)

The nurse expects to observe which manifestations in a patient who experienced an acute blood loss of 2000 mL? Select all that apply.

Air hunger Clammy skin decreased central venous pressure

The nurse would ask which health care team member to assist when checking a unit of packed red blood cells before administration?

Another registered nurse

A patient with anemia experiences fatigue when performing activities of daily living. Which nursing intervention is appropriate to include in the patient's plan of care?

Assist the patient in prioritizing activities.

Which condition results in anemia due to synthesis of defective deoxyribonucleic acid (DNA) in the body?

Folic acid deficiency

The nurse would take which action to ensure patient safety when administering a unit of packed red blood cells (PRBCs)?

Have a second registered nurse check the identifying information on the unit of blood against the identification bracelet and blood-bank identification bracelet.

Which instruction would the nurse include when teaching a patient about the administration of an iron supplement?

Dilute the liquid iron and ingest it through a straw.

Which foods would the nurse encourage the patient to eat in order to provide nutritional support for hemoglobin synthesis? Select all that apply.

Legumes Dried Fruits Dark, green leafy vegetables

Which erythrocyte characteristic would the nurse expect to see in the laboratory findings for a patient who has experienced acute blood loss?

Normocytic

The nurse is caring for a patient with severe anemia. The nurse expects which compensatory respiratory changes? Select all that apply.

Orthopnea Tachypnea dyspnea at rest

Which role does folic acid play in erythropoiesis?

Promotes RBC maturation

Which potential side effect would the nurse include when teaching a patient about the administration of ferrous gluconate?

constipation