ch 20

A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see? A)Hypercalcemia B)Hyperkalemia C)Hypernatremia D)Hypermagnesemia

A) Hypercalcemia Calcium is released when bone is destroyed, causing hypercalcemia. Multiple myeloma doesn't affect potassium, sodium, or magnesium levels.

The nurse cares for a client with acute myeloid leukemia with severe bone pain. What pathophysiological concept does the nurse understand is the reason for the client's pain? A)Abnormal blood cells deposit in small vessels. B)Bone marrow expands. C) Lymph nodes expand. D)Abnormal blood cells crystalize.

B) Bone marrow expands In acute myeloid leukemia, bone pain is caused when the bone marrow expands.

During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding? A)Elevated hematocrit concentration B) Enlarged mean corpuscular volume (MCV) C) Low ferritin level concentration D)Elevated red blood cell (RBC) count

C) Low ferritin level concentration The most consistent indicator of iron deficiency anemia is a low ferritin level, which reflects low iron stores. As the anemia progresses, the MCV, which measures the size of the erythrocytes, also decreases. Hematocrit and RBC levels are also low in relation to the hemoglobin concentration.

A client who is being treated for AML has bruises on both legs. What is the nurse's most appropriate action? A)Ask the client whether they have recently fallen. B)Evaluate the client's INR. C)Keep the client on bed rest. D)Evaluate the client's platelet count.

D) Elevate clients platelet count Complications of AML include bleeding. The risk of bleeding correlates with the level and duration of platelet deficiency. Major hemorrhages may develop when the platelet count drops to less than 10,000/mm3. The bleeding is usually unrelated to falling. Keeping the client on bed rest will not prevent bleeding when the client has a low platelet count. Assessment for other areas of bleeding is also a priority intervention.

While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters? A) Platelet count, prothrombin time, and partial thromboplastin time B)Platelet count, blood glucose levels, and white blood cell (WBC) count C)Thrombin time, calcium levels, and potassium levels D)Fibrinogen level, WBC, and platelet count

A) Platelet count, prothrombin time, and partial thromboplastin time

A nurse cares for a client with myelodysplastic syndrome who requires frequent PRBC transfusions. What blood component does the nurse recognize as being most harmful if accumulated in the tissues due to chronic blood transfusions? A)Iron B) Calcium C) Hemoglobin D) Potassium

A) Iron Iron overload is a complication unique to people who have had long-term PRBC transfusion. Over time, the excess iron deposits in body tissues can cause organ damage, particularly in the liver, heart, testes, and pancreas.