Med. Surg. II Exam 1

A female patient has a hemoglobin of 6.4 g/dL and is preparing to have a blood transfusion. Why would it be important for the nurse to obtain information about the patient's history of pregnancy prior to the transfusion?

A higher number of pregnancies can increase the risk of reaction

A patient with chronic kidney disease is being examined by the nurse practitioner for anemia. The nurse has reviewed the laboratory data for hemoglobin and RBC count. What other test results would the nurse anticipate observing?

Decreased level of erythropoietin

A patient with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?

Erythropoietin

A patient is undergoing platelet phrases at the outpatient clinic. What does the nurse recognize is the most likely clinical disorder the patient is being treated for?

Essential thrombocytopenia

A patient with chronic anemia has had many blood transfusions over the last 3 years. What type of transfusion reaction should the nurse monitor for that is commonly found in patients who frequently receive antibodies?

Febrile non hemolytic reactions

Plasma

Fluid portion of blood

A nurse is caring for a patient who has has a bone marrow aspiration with biopsy. What complication should the nurse monitor the patient for?

Hemorrhage

A patient who has long term packed RBC transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that may help prevent organ damage?

Iron chelation therapy

Describe how NK cells serve as an important part of the body's immune defense system

accumulate in the lymphoid tissues to mature, kill virus & cancer cells.

Lymphocytes

The mature from of WBCs

A patient will need a blood transfusion for the replacement of blood loss from the GI tract. The patient states, "That stuff isn't safe!" What is the best response from the nurse?

"I understand your concern. The blood is carefully screened but is not completely risk free."

A patient develops a hemolytic reaction to a blood transfusion. What actions should the nurse take after this occurs? (Select all that apply)

Collect a urine sample to detect hemoglobin Document the reaction according to policy

The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in?

Lateral poison with one leg flexed

The nurse is administering two units of packed RBCs to an older adult patient with a bleeding duodenal ulcer. The patient begins to experience difficulty breathing and the nurse assess crackles in the lung bases, jugular vein distention, and an increase in BP. What action by the nurse is necessary if the reaction is severe? (Select all that apply)

Place the patient in an upright position with the feet dependent, admin. diuretics as prn, discontinue the transfusion , admin O2.

Why is the storm of the bone marrow is important?

Produces colony stimulating factors needed for hematopoiesis

An older adult patient presents to the healthcare provider reporting exhaustion. The nurse, aware of the most common hematologic condition affecting older adults, assess for which laboratory values?

RBC

A patient receiving plasma develops transfusion- related acute lung injury (TRALI) 4 hours after the transfusion. What type of aggressive therapy does the nurse anticipate the patient will receive prevent death from the injury?

Supplemental O2 Provision of intravenous fluid support Intubation & mechanical ventilation

The healthcare provider believes the a patient has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse assess the WBC count for?

T lympocytes

Fibrinogen

clotting factor present in plasma

Shift to the left

increase in number of blood cells more immature cells are present in the blood more than normal

Hemoglobin

makes up 95% of the mass of the RBC

Albumin

plasma protein primarily responsible for the maintenance of fluid balance.

Thrombocytes

platelets

Bone marrow

site of blood cell formation

Site of activity for most macrophages

spleen

phagycytosis

the ingestion of bacteria or other material by phagocytes and ameboid protozoans.

Monocytes

the largest classification of leukocytes

Hematopoiesis

the process of continually replacing blood cells