test 5 chpt. 20 med surge

A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive?

induction therapy

A client with sickle cell anemia has a

low hematocrit

The nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. What disease will the nurse mention with a primary characteristic of erythrocytosis?

polycythemia vera

Pt. diagnosed acute myeloid leukemia- being treated with induction therapy-what nursing action should be prioritized in pts. care plan?

protective isolation and vigilant use of standard precautions

pt. with Von Willebrand-recent bowel changes- need for colonoscopy- intervention in anticipation of this procedure?

pt. should be given necessary clotting factors before the procedure

A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron?

rich sources of vitamin C

pts. PT- prothrombin time- was low- vit K deficiency- treated with vit-K- at home teaching?

the need for adequate nutrition

Pt. admitted with pernicious anemia- what med?

vitamin B12

A 50-year-old woman was recently diagnosed with non-Hodgkin's lymphoma (NHL) and has begun a treatment regimen that includes simultaneous radiation therapy and chemotherapy. The combination of severe symptoms and aggressive therapy has necessitated admission to the hospital. When providing care for this patient, which of the following actions should the nurse implement?

Applying standard precautions conscientiously to reduce the patient's risk of infection

The nurse is instructing the client with polycythemia vera how to perform isometric exercises such as contracting and relaxing the quadriceps and gluteal muscle during periods of inactivity. What does the nurse understand is the rationale for this type of exercise?

Contraction of skeletal muscle compresses the walls of veins and increases the circulation of venous blood as it returns to the heart.

A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia?

Creatinine level of 6 mg/100 mL

A client's family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC?

DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs."

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption?

Eating calf's liver with a glass of orange juice

The nurse is interacting with a family that has been caring for a client with cancer for several months. What are the best interventions to assist in relieving caregiver stress in this family? Select all that apply.

Educate the family about medications and side effects. Allow family members to express feelings. Suggest support for household maintenance.

A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client's fever?

Neutropenia

A patient with a diagnosis of immune thrombocytopenic purpura (ITP) is currently receiving IVIG for the treatment of her health condition. The nurse who is providing this patient's care is aware that ITP is a consequence of:

Platelet destruction and impaired platelet production resulting from an autoimmune process

The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis?

Polycythemia vera

diagnostic workup for Hodgkins lymphoma- presence of what assessment finding is considered diagnostic of the disease?

Reed Sternberg cells

The nurse is screening donors for blood donation. Which client is an acceptable donor for blood?

Reports having a cold 1 month ago that resolved quickly

A nurse cares for several mothers and babies in the postpartum unit. Which mother does the nurse recognize as being most at risk for a febrile nonhemolytic reaction?

Rh-negative mother; Rh-positive child

A patient with sickle cell disease comes to the emergency department and reports severe pain in the back, right hip, and right arm. What intervention is important for the nurse to provide?

Start an intravenous line with dextrose 5% in 0.25 normal saline

Place the following steps in order when determining the type and severity of a transfusion reaction. Use all options.

Stop the transfusion. Assess the client. Notify the health care provider. Notify the blood bank. Send the tubing and container to the blood bank.

Parents arrive to the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse?

The child must inherit two defective genes, one from each parent.

A client is treated for anemia. What is the nurse's best understanding about the correlation between anemia and the client's iron stores?

There is a strong correlation between iron stores and hemoglobin levels.

The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma?

client with enlarged lymph nodes in the neck

A male client has been receiving a continuous infusion of weight-based heparin for more than 4 days. The client's PTT is at a level that requires an increase of heparin by 100 units per hour. The client has the laboratory findings shown above. What is the most important action for the nurse to take?

consult with the physician about discontinuing heparin

multiple myeloma- care plan- risk for injury- what contributes to risk?

decreased bone density

A client with multiple myeloma is complaining about pain. What instructions will the nurse give the client to help to reduce pain during activity?

do not lift more than 10 pounds

preparing health education for myelodysplastic syndrome (MDS) topic should nurse prioritize?

emergency management of bleeding episodes

pt. with poorly controlled diabetes- developed end stage renal failure- anemia- anticipate what drug?

epoetin alfa

iron deficiency anemia- what nursing diagnosis?

fatigue related to decreased oxygen carrying capacity

oncology nurse caring for pt. with multiple myeloma- experiencing bone destruction- blood test- nurse should anticipate what imbalance?

hypercalcemia

diagnostic testing for chronic lymphocytic leukemia- what assessment finding is certain to be present?

increased lymphocyte levels

pts. absolute neutrophil count is 440- no sign of infection- what should nurse prioritize?

meticulous hand hygiene

diagnosed acute leukemia- what assessment addresses most common cause of death among pts. with leukemia?

monitoring for infection

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron?

orange juice

platelet level of 17000- when inspecting integumentary system-what finding most consistent?

petechiae

acute myeloid leukemia- preparing to undergo induction therapy- highest priority to which nursing diagnosis?

risk for infection

The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for?

schilling test

pt. with history of a-fib accidentally overdosed on warfarin- what is the antidote?

vitamin K

A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host?

graft versus host disease

home health nurse- caring for pt. with multiple myeloma- interventions to prioritize for pts. severe bone pain?

helping the pt. manage the opioid analgesic regimen

Hodgkins lymphoma treatment deemed successful- regular health assessments due to risk for what?

hematologic cancers

The nurse is administering packed red blood cell (RBC) transfusions for a patient with myelodysplastic syndrome (MDS). The patient has had several transfusions and is likely to receive several more. What is a priority for the nurse to monitor related to the transfusions?

iron levels

A client with a diagnosis of pernicious anemia comes to the clinic and reports numbness and tingling in the arms and legs. What do these symptoms indicate?

Neurologic involvement

pt. has long standing diagnosis of polycythemia vera- how can nurse gauge course of disease?

follow the trends of the pts. hematocrit

complaining of fatigue- health interview suggestive of pica- lab findings low serum iron- low ferritin- what diagnosis?

iron deficiency anemia

A nurse assesses a client diagnosed with megaloblastic anemia. Which clinical findings will the nurse most likely find? Select all that apply.

jaundice ulcerated corners of mouth concave nails

The client is planned to have a splenectomy. The nurse should prepare which medication to administer to this client?

pneumococcal vaccine

60- chronic myeloid leukemia- will be treated in home setting- nurse preparing appropriate health education- topic to emphasize?

the importance of adhering to the prescribed drug regimen

A critical care nurse is caring for a patient with autoimmune hemolytic anemia. The patient is not responding to conservative treatments, and her condition is now becoming life-threatening. The nurse is aware that a treatment option in this case may include what?

splenectomy

Pt. newly diagnosed with thrombocytopenia- pt. asks nurse to explain disease- what should nurse explain?

there could be decreased production of platelets