Nursing Assessment: Hematologic Function

A nurse is discussing the difference between blood and plasma with a client. Which best represents the components of plasma?

90% water, 10% proteins, blood cells, clotting factors, hormones, enzymes

The nurse is assisting the physician to control the bleeding for a client who has had an insertion of a vascular access. What can the nurse obtain for the physician to use to control the bleeding?

A fibrin sponge

A public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population?

Anemia

Which type of leukocyte contains histamine and is an important part of hypersensitivity reactions?

Basophils

Why would it be important for the nurse to obtain information regarding dietary history of a client with a possible abnormality of the hematopoietic or lymphatic system?

Compromised nutrition interferes with production of blood cells and hemoglobin.

The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see which lab result?

Decreased hematocrit

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

The nurse expects which assessment finding when caring for a client with a decreased hemoglobin level?

Decreased oxygen level.

A client informs the nurse that he is having a difficult time coping with seasonal allergies and has taken some over-the-counter medications to assist with control of symptoms. What results would indicate to the nurse that the client does have allergies?

Elevated eosinophils

A nurse is providing care to a cancer client. Which protein in plasma functions primarily as immunologic agents?

Gamma globulins

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

Hematocrit

A nurse cares for a client with iron-deficiency anemia. Which treatment will the nurse anticipate the client receiving?

Oral iron supplementation

Which is the major function of neutrophils?

Phagocytosis

The nurse is caring for a client who is undergoing bone marrow aspiration to determine the blood cell formation status. What nursing intervention should the nurse provide to the client during the test?

Support the client and monitor the status.

A nurse, caring for a client with human immunodeficiency virus (HIV), reviews the client's differential WBC count. What type of WBC will the nurse check the level of?

T lymphocytes

The nurse is caring for a client with hypoxia. What does the nurse understand is true regarding the client's oxygen level and the production of red blood cells?

The kidneys sense low oxygen levels in the blood and stimulate erythropoietin, stimulating the marrow to produce more red blood cells.

A nursing instructor is reviewing the role and function of stem cells in the bone marrow with a group of nursing students. After providing the explanation, the instructor asks the students to use their knowledge of anatomy and physiology to 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 extramedullary hematopoiesis.

A patient with a diagnosis of HIV exhibits a decreased level of T lymphocytes. What consequence does this state present for this patient?

The patient is particularly susceptible to infection.

Both the liver and the spleen have a role in erythrocyte metabolism. How would this role best be described?

The spleen removes erythrocytes after 120 days, and the liver removes severely damaged erythrocytes.

Which cells are white blood cells with immune functions?

lymphocytes

A patient has asked the nurse about the clotting cascade, and the nurse explains that plasminogen is a component necessary in the clotting cascade. Where in the body is plasminogen present?

All body fluids

Your six-year-old son, Austin, was riding his bike outside and fell - resulting in an impressive case of road rash on his left lateral thigh. Since you're studying hematopoiesis in nursing school, you begin to explain the wound-healing process to him to distract him from his painful wound management. Which of the following best describes the function of fibrinogen?

It plays a key role in forming blood clots

A client in acute renal failure has been prescribed 2 units of packed red blood cells (PRBCs). The nurse explains to the client that the blood transfusion is most likely needed for which reason?

Lack of erythropoietin

The nurse is aware that a patient has been diagnosed with thrombocytopenia. Which of the following is the most typical first indicator of the diagnosis that a patient will exhibit?

Petechiae

Which type of lymphocyte is responsible for cellular immunity?

T lymphocyte

When administering a blood transfusion to a client with multiple traumatic injuries, the nurse monitors closely for evidence of a transfusion reaction. Shortly after the transfusion begins, the client complains of chest pain, nausea, and itching. When urticaria, tachycardia, and hypotension develop, the nurse stops the transfusion and notifies the physician. The nurse suspects which type of hypersensitivity reaction?

Type II (cytolytic, cytotoxic) hypersensitivity reaction

A nurse cares for a client with megaloblastic anemia who had a total gastrectomy three years ago. What statement will the nurse include in the client's teaching regarding the condition?

"The condition is likely caused by a vitamin B12 deficiency."

A nurse is assigned to care for a patient with ascites, secondary to cirrhosis. The nurse understands that the fluid accumulation in the peritoneal cavity results from a combination of factors including an alteration in oncotic pressure gradients and increased capillary permeability. Therefore, the nurse monitors the serum level of the plasma protein responsible for maintaining oncotic pressure, which is:

Albumin.

Dennis Morgan, a 49-year-old chef, is a client of the primary care group where you practice nursing. Dennis has been studying up on blood cell production since the development of his blood disorder. At each appointment, he tries to fool you, his nurse, with blood cell trivia. His latest question: "Which of the following cell types are produced from pluripotential stem cells?" Your response is:

All options are correct.

The nurse is obtaining the health history of a client suspected of having a hematological condition. The nurse notes the client has a history of alcohol abuse. Which clinical presentation is related to alcohol consumption?

Anemia

The nurse is caring for a patient with a hematologic disorder. The patient asks the nurse where the body forms blood cells. Where should the nurse tell the patient that blood cells are formed?

In the bone marrow

The nurse is caring for a client with a lymphatic system disorder. What physical assessment is a priority for the nurse to perform?

Inspect the tonsils for size and appearance.

The nurse is providing health education to an older adult client who has low red blood cell levels. To promote red blood cell production, the nurse should encourage intake of what foods? Select all that apply.

Leafy green vegetables Lean meats Nuts and seeds

Which blood cell type is matched correctly with its function?

Leukocyte: Fights infection

The body responds to infection by increasing the production of white blood cells (WBCs). The nurse should evaluate the differential count for what type of WBCs, which are the first WBCs to respond to an inflammatory event?

Neutrophils

In the surgical group where you practice nursing, knowledge regarding hematopoiesis is used frequently in regards to client post-surgical care. Which of the following is true for the variation in the normal number of erythrocytes?

People who engage in strenuous activity have an increased number of erythrocytes

Under normal conditions, the adult bone marrow produces approximately 70 billion neutrophils. What is the major function of neutrophils?

Phagocytosis

An elderly adult trips over her dog and receives an injury to her skin that causes minor blood loss. Primary hemostasis is activated in this patient. What occurs during primary hemostasis?

Severed blood vessels constrict.

You are caring for a client who is undergoing bone marrow aspiration to determine their blood cell formation status. What nursing intervention should you provide to your client after the test?

Support the client during a bone marrow aspiration and monitor the status.

A client will be having a bone marrow aspiration to determine the status of blood cell formation. What role does the nurse have during the test?

The nurse assists the physician and supports the client during the procedure.

A nurse is reviewing a client's morning laboratory 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.

A nurse is reviewing a client's white blood cell count with the client. As part of the discussion, the nurse explains about granulocytes and agranulocytes and their function. Which type of white blood cell would the nurse describe as being most numerous?

neutrophils

Which is a symptom of severe thrombocytopenia?

petechiae

Which cells are also known as thrombocytes?

platelets

A client is scheduled to undergo a bone marrow aspiration and biopsy. The nurse understands that which site would most likely be used?

posterior iliac crest