Hematologic Function

A client who had a splenectomy a year ago is having a routine examination. Which follow-up question will the nurse ask as a priority?

"Have you gotten a flu shot this year?"

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."

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

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.

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

When conducting a health assessment on a client suspected for having a hematological disorder, the nurse should collect which data? Select all that apply.

Dietary intake Medication use Ethnicity Herbal supplements

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

What factor in plasma can be transformed from a liquid to a solid?

Fibrinogen

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The nurse is caring for a patient whose bone marrow has been replaced by scar tissue in much of the areas that produce blood cells for the body. What organs can become active in blood cell production by the process of extramedullary hematopoiesis?

Liver and spleen

Which term refers to a form of white blood cell involved in immune response?

Lymphocyte

A 44-year-old man with a longstanding diagnosis of AIDS has been admitted to the hospital with an absolute neutrophil count (ANC) of 385/mm3. When planning the patient's care, what action should the nurse prioritize?

Placing the patient on protective isolation precautions

Place the clotting cascade in the correct order.

Prothrombin activator Prothrombin Thrombin Fibrinogen Fibrin

Which of the following in a client's health history would the nurse recognize as potentially compromising the client's blood cell volume?

Splenectomy

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.

Which type of lymphocyte is responsible for cellular immunity?

T lymphocyte

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 health care provider believes that the client has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?

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 produce erythropoietin, stimulating the bone marrow to produce more red blood cells.

A patient with esophageal varices secondary to liver cirrhosis has received a transfusion of frozen plasma. The nurse is aware of the fact that plasma:

Accounts for the majority of the blood's volume in the body

A client with Hodgkin disease had a bone marrow biopsy yesterday and reports aching at the biopsy site, rated a 5 (on a 1-10 scale). After assessing the biopsy site, which nursing intervention is most appropriate?

Administer acetaminophen 500 mg po, as ordered

Plasma proteins play an essential role in maintaining water balance and blood pressure. Select the laboratory analysis that a nurse should review to check the levels of the most abundant plasma protein.

Albumin

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.

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

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

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 physician performs a bone marrow biopsy from the posterior iliac crest on a client with pancytopenia. What intervention should the nurse perform after the procedure?

Apply pressure over the site for 5-7 minutes

A patient with a diagnosis of hepatitis C is being treated in the medical unit of the hospital and has experienced a downward trend in albumin levels. In light of this diagnostic finding, what assessments should the nurse prioritize?

Assessment of the patient's fluid balance and assessment for third-spacing and edema

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

Basophils

A client with myelodysplastic syndromes (MDS) receives routine blood transfusions. Which treatment will the nurse expect to be prescribed to prevent the development of iron overload?

Chelation therapy

A nursing instructor in a BSN program is preparing for a lecture on disorders of the hematopoietic system. Included in the lecture are conditions caused by reduced levels or absence of blood-clotting proteins. Which of the following is the instructor most likely referring to?

Coagulopathy

A nurse is completing a detailed health history and assessment in the electronic medical record (EMR) for a client with a disorder of the hematopoietic system. Which symptom is the most commonly reported in association with hematologic diseases?

Extreme fatigue

Which protein in plasma functions primarily as immunologic agents?

Gamma globulins

Albumin is a protein in the plasma portion of the blood. Under normal conditions, albumin cannot pass through the wall of a capillary. What significance is this for the vascular compartment?

Helps retain fluid in the vascular compartment

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

Hemorrhage

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 client's CBC with differential reveals small-shaped hemoglobin molecules. The nurse expects to administer which medication to this client?

Iron

The nurse is caring for a client who has a unit of whole blood removed every 6 weeks as treatment for polycythemia vera. Which laboratory test will the nurse monitor to determine if the procedure is adversely affecting the client?

Iron

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

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

Oral iron supplementation

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

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

Phagocytosis

A client's family member asks what hematopoiesis is. What should the nurse tell the family member?

The manufacture and development of blood cells

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.

The nursing instructor is teaching their clinical group about laboratory blood tests. What is the major function of erythrocytes?

Transportation of O2 to the tissues and removal of CO2 from the tissues

While caring for a client, the nurse notes petechiae on the client's trunk and lower extremities. What precaution will the nurse take when caring for this client?

Use an electric razor when assisting client with shaving.

A nurse is reading a journal article about white blood cells and how they function. The nurse demonstrates understanding of the article by identifying which white blood cell as a granulocyte? Select all that apply.

eosinophils basophils neutrophils

A nurse is preparing a review class about hematologic problems for a group of nurses working at the clinic. As part of the class, the nurse is describing the process by which the body continuously replenishes the supply of blood cells. The nurse is describing which process?

hematopoiesis

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