Chapter 32

A client with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells. If the nurse hangs the blood at 12PM what time must the infusion be completed

4PM

A client with Hodgkin disease has a bone marrow biopsy yesterday and reports aching at the biopsy site, rated 5/10. After assessing the biopsy site, which nursing intervention is the most appropriate?

Administer acetaminophen 500 mg po as ordered

A client who has idiopathic thrombocytopenia purpura ITP has critically low platelets count. Which nursing intervention will be included in the care plan for this client?

Administer eltrombopag

The physician performs a bone marrow biopsy from the posterior iliac crest on a client with pancytopenia. What intervention should the nurse perform after the procedure?

Apply pressure over the site for 5-7 mins

The nurse recognizes that the most common cause of iron deficiency anemia in an adult is?

Bleeding

A client with severe anemia is admitted to the hospital bc of religious beliefs, the client is refusing blood transfusions. The nurse anticipates pharmacologic therapy with with drug to stimulate the production of rbc?

Epoetin Alfa

Which symptom is the most commonly reported in association with hematologic diseases?

Extreme fatigue

Which term refers to the percentage of blood volume that consists of erythrocytes?

Hematocrit

A nurse is teaching a client with Vitamin b12 deficiency about appropriate food choices to increase the amount of B12 ingested with each meal. Teaching is effective when client says

I will eat a meat source such as chicken or pork with each meal.

A nurse is reviewing a client's morning lab results and notes a left shift in the band cells. Based on this result, the nurse can interpret that the client may be developing an?

Infection

which term refers to a form of white blood cell involved in the immune response?

Lymphocyte

Which cell of hematopoiesis is responsible for the production of red blood cells and platelets?

Myeloid stem cell

The nurse is completing a pretransfusion assessment to determine a female clients history of prev transfusions as well as prev reactions to transfusions. Which is the most important info to obtain from this client before the transfusion.

Number of pregnancies

What is a symptom of severe thrombocytopenia?

Petechiae

Which is the major function of neutrophils?

Phagocytosis

which statement best describes the function of fibrinogen?

Plays a key role in forming blood clots

One hour after a transfusion of packed red blood cells is started, a client develops redness on the truck and reports itching. The nurse stops the RBC infusion and administers diphenhydramine 25 mg po as ordered. Thirty minutes later, the redness and itching are gone. What action should the nurse take next?

Resume the transfusion

Which type of lymphocyte is responsible for cellular immunity?

T lymphocytes

Determine an alternate way in which adults with diseases that destroy marrow can resume production of blood cells. Which explanation by the students is correct?

The liver and spleen can resume production of blood cells through extra medullary hematopoiesis

One hour after completion of fresh frozen plaza transfusion, a client reports SOB and is very anxious. The client's vital are BP 98/60 HR 110 and temp 99.4 and SaO2 88%. Ausculatation of the lungs reveal posterior coarse crackles to the mid and lower lobes bilaterally. Based on the symptoms, the nurse suspects the client is experiencing which problem?

Transfusion- related acute injury

The MD orders a transfusion with packed red blood cells for a client hospitalized with severe iron deficiency anemia. When the blood id administered, what is the most important action the nurse can take to prevent a transfusion reaction?

Verify the client's identity according to hospital policy

A client comes into the emergency department reporting an enlarged tongue. The tongue appears smooth and beefy red in color. The nurse observes a 5-cm incision on the upper left quadrant of the abdomen. When questioned, the client states, "I had a partial gastrostomy 2 years ago" based on this info the nurse attributes these symptoms to which problem?

Vitamin B12 deficiency

During a blood transfusion with packed rbc, a client reports chills, low back pain, and nausea. What priority action should the nurse take?

discontinue the infusion immediately and maintain the iv line with normal saline solution using new iv tubing

Which term describes the percentage of blood volume that consists of erythrocytes?

hematocrit

Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called

megaloblasts

What nursing intervention should be incorporation in the plan for a client with impaired liver function and a low albumin concentration

monitor for edema at least once per shift