CH 21 BLOOD CELLS AND THE HEMATOPOIETIC

A client comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is the most likely cause of the symptoms?

Allergic reaction

A client is suspected of having acute leukemia. Which diagnostic test does the nurse prepare for to verify that diagnosis?

Bone marrow biopsy

Select the option that best describes the production of T lymphocytes.

Bone marrow → thymus → lymph nodes

A nurse is assessing a client presenting with symptoms of fatigue, fever, severe joint pain, and headache. Laboratory results reveal an erythrocyte sedimentation rate (ESR) rate of 60 mm/hour. The client asks what the blood test results mean. What is the mostappropriate explanation for the nurse to provide?

"The ESR tests for the presence of inflammation in the body."

The nurse is reviewing the results of a client's complete blood count and differential. The results of this test will inform the nurse of what aspects of the client's current status? Select all that apply.

-The proportion of each type of white cell in the client's blood -The number of platelets that are present in each unit of blood

A female client with a diagnosis of psoriatic arthritis is currently taking a course of prednisone for the control of symptoms related to inflammation. Which erythrocyte sedimentation rate (ESR) would indicate that the medication course has decreased the inflammation within normal limits?

10 mm/hr

The nurse is reviewing the client's laboratory report. Select the report that represents a normal value for leukocytes.

6500 cells/mL (6.5 ×109/L)

Which person should the charge nurse assign as a roommate for a client diagnosed with aplastic anemia?

A client in traction with a broken femur

Which plasma protein is considered the most abundant type?

Albumin

The globulins that make up part of the plasma of the blood have three distinct purposes. What are the gamma globulins?

Antibodies of the immune system

The nurse is reviewing the laboratory results of a newborn. The infant has anemia, thrombocytopenia, and granulocytopenia (pancytopenia). Based on these results, the nurse anticipates the diagnosis of which type of anemia?

Aplastic anemia

Which type of lymphocyte is involved with humoral-mediated immunity?

B lymphocytes

A client comes to the clinic following exposure to chicken pox. The client states he had chickenpox as a child but was worried about getting sick again. Which statement best explains humoral-mediated immunity to the client?

B lymphocytes (B cells) in the body produce antibodies to fight infections. Once exposed, the cells retain memory and are able to quickly fight off pathogens during re-exposure and prevent the disease from reoccurring.

Which type of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions?

Basophils

Which is considered a function of plasma?

Carrying nutrients

A nurse working in an emergency department is assigned to triage the following clients. Which client should the nurse evaluate first?

Client who has chemotherapy-induced neutropenia (decrease in neutrophil levels) and a temperature of 101.2°F (38.4°C)

The nurse notes a client with a hemoglobin level of 80 g/L (8.0 g/dL) is tachypneic after activity. The nurse attributes the increased respiratory rate to what cause?

Compensation for decreased oxygen-carrying capacity

The nurse's review of a client's laboratory results indicates that inflammation is absent and platelet levels are low. Which test was performed to provide the platelet count?

Complete blood count

Regulation of blood cells is thought to be controlled in part by which hormone-like growth factor?

Cytokines

Although the usual site for a bone marrow test is the posterior iliac crest, other sites include the anterior iliac crest and the sternum. What are the dangers of using the sternum for a bone marrow test in children?

Danger of perforating the mediastinum and heart

What are the components of blood? Select all that apply

Electrolytes Enzymes

A nurse is evaluating laboratory results of a client diagnosed with a parasitic infection. The tests reveal a large group of cells that are membrane-bound with granules in their cytoplasm that are aiding in the destruction of the parasite. Which cell is the nurse evaluating?

Eosinophil

Which leukocyte is correctly matched with its function within the body?

Eosinophil—allergic reaction

A client with kidney failure has been admitted to the hospital for severe anemia. The client has refused a blood transfusion. The nurse anticipates administering which drug to stimulate the production of red blood cells?

Erythropoietin (EPO)

A client being treated for polymyalgia rheumatica (PMR) comes to the clinic for a follow-up visit. The current erythrocyte sedimentation rate (ESR) rate has decreased from 60 mm/hour to 30 mm/hour and the client is afebrile, denies any headaches, and reports a decrease in joint pain and fatigue. Based on these findings, the nurse anticipates which change to the treatment plan?

Gradually decrease the current dosage of prednisone and repeat ESR in 2 weeks.

A client who has received chemotherapy has a steadily decreasing white blood cell count. To increase the neutrophil count, the nurse anticipates administering:

Granulocyte colony-stimulating factor

Which function is the main job of lymphocytes?

Immune reaction

The nurse is caring for a pediatric client who will be having bone marrow aspiration from the posterior iliac crest. The parent asks why the sternum is not used to obtain the sample as this is the site used for another relative. How does the nurse respond?

In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs.

A client is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which problem?

Increased blood viscosity

A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which health problem?

Infections

Which type of macrophages are found in the liver?

Kupffer cells

An adult female, newly diagnosed with possible leukemia, arrives for a bone marrow biopsy. The admission laboratory work includes: red blood cell count (RBC): 3.4 ×106/µL (3.4 ×1012/L); white blood cell count (WBC): 2,500/µL (2.5 ×109/L); platelet count of 80 ×103/µL (80 ×109/L); all below normal values. What assessment is the highest priority for this client?

Monitoring for any type of bleeding.

A nurse sends a blood sample to the lab for analysis. Assuming the sample is normal, the nurse anticipates which white blood cells (WBCs) will account for the highest percentage?

Neutrophils

Which is the most common leukocyte in normal blood?

Neutrophils

Which type of cell is the most common leukocyte in normal blood?

Neutrophils

A client is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count (CBC), which level is the most important for the nurse to communicate to the health care provider?

Neutrophils 85%

When a white blood cell with differential count reveals an acute infection, which statement is correct regarding the client's neutrophils?

Neutrophils are the first white blood cell to elevate in an acute infection.

A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result, which action should the nurse include in the

Place the client on bleeding precautions.

The nurse is caring for a client with leukemia who is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding?

Platelets

What is the name of the fluid that remains after blood clots in a blood specimen vial?

Serum

A client diagnosed with pancytopenia due to aplastic anemia is scheduled for which treatment that can correct bone marrow deficiencies

Stem cell transplant

The nurse is teaching a client about how a vaccine can help create immunity to a virus. What information does the nurse provide?

The vaccine causes B lymphocytes to create antibodies against the virus.

A 6-year-old child is having a stem cell transplant using umbilical cord blood. What benefit does the nurse understand that this type of transplant will have for the child?

This type of transplant creates less risk of graft versus host disease

Stem cell transplantation has been shown to provide potential cures for diseases such as aplastic anemia and the leukemias. What are the sources of stem cells used for transplant?

Umbilical cord blood and bone marrow

A nurse is reviewing laboratory data for an older adult client. Which laboratory value should the nurse be most concerned about?

White blood cell (WBC) count 3500/mL

A nurse is reviewing the laboratory data for a hospitalized client. The nurse would be most concerned about which finding?

White blood cell (WBC) count of 2800/µL (2.80 x 10^9/L)

The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider?

White blood cells (WBCs) 18,500/µL (18.50 x 10^9/L)

A client asks, "What do these basophils and mast cells do in the body?" The health care provider responds that they:

are involved when you have an allergic reaction.

A nurse on an oncology floor is treating a client who is anemic following chemotherapy. The drugs being administered are designed to increase the number of red blood cells in circulation. These drugs are likely agonists of:

cytokines