Hematologic PLQ

A patient with neutropenia is at an increased risk for __________, which increases proportionately with the decrease in the neutrophil count.

infection

An increase in _______________ may be seen in patients exposed to a bacterial infection.

neutrophils

The average lifespan of a normal circulating erythrocyte is 60 days or about 2 months.

FALSE.

____________ is the primary site for hematopoiesis, a process of continuous blood cell formation.

bone marrow

Delayed hemolytic reactions usually occur within _________ days after transfusion, when the level of antibody has been increased to the extent that a reaction can occur.

14

A client with kidney injury has decreased erythropoietin production. Upon analysis of the client's complete blood count, the nurse will expect which of the following results?

A decreased hemoglobin and hematocrit The decreased production of erythropoietin will result in a decreased hemoglobin and hematocrit. The client will have normal MCV and RDW because the erythrocytes are normal in appearance.

When teaching a client with sickle cell disease about strategies to prevent crises, what measures should the nurse recommend?

Avoiding cold temperatures and ensuring sufficient hydration Keeping warm and providing adequate hydration can be effective in diminishing the occurrence and severity of attacks. Hygiene, antibiotics, and high protein intake do not prevent crises. Maximizing activity may exacerbate pain and be unrealistic.

The average lifespan of a normal circulating erythrocyte is 60 days or about 2 months.

FALSE-120 days!

To be considered a blood donor, a man must have a minimum hemoglobin level of 12 g/dL.

FALSE-at least 12.5 or more!

In hypoproliferative anemias, premature destruction of erythrocytes results in the liberation of hemoglobin from the erythrocytes into the plasma.

False

The most common type of blood transfusion reaction is an allergic reaction that causes urticaria.

False

The nurse is caring for a client who has developed scar tissue in many of the areas that normally produce blood cells. What organs can become active in blood cell production by the process of extramedullary hematopoiesis?

Liver and spleen In adults with disease that causes marrow destruction, fibrosis, or scarring, the liver and spleen can also resume production of blood cells by a process known as extramedullary hematopoiesis. The kidneys and pancreas do not produce blood cells for the body.

A nurse is caring for a client with severe anemia. The client is tachycardic and reports dizziness and exertional dyspnea. What signs and symptoms might develop if this client goes into heart failure?

Peripheral edema Cardiac status should be carefully assessed in clients with anemia. When the hemoglobin level is low, the heart attempts to compensate by pumping faster and harder in an effort to deliver more blood to hypoxic tissue. This increased cardiac workload can result in symptoms such as tachycardia, palpitations, dyspnea, dizziness, orthopnea, and exertional dyspnea. Heart failure may eventually develop, as evidenced by an enlarged heart (cardiomegaly) and liver (hepatomegaly), and by peripheral edema. Nausea, migraine, and fever are not associated with heart failure.

A client undergoing a hip replacement has autologous blood on standby if a transfusion is needed. What is the primary advantage of autologous transfusions?

Prevention of viral infections from another person's blood The primary advantage of autologous transfusions is the prevention of viral infections from another person's blood. Other secondary advantages include safe transfusion for clients with a history of transfusion reactions, prevention of alloimmunization, and avoidance of complications in clients with alloantibodies.

A nurse is caring for a client who is undergoing preliminary testing for a hematologic disorder. What sign or symptom most likely suggests a potential hematologic disorder?

Severe fatigue The most common indicator of hematologic disease is extreme fatigue. This is more common than changes in LOC, infections, or anaphylaxis.

The nurse's review of a client's most recent blood work reveals a significant increase in the number of band cells. The nurse's subsequent assessment should focus on which of the following?

Signs and symptoms of infection Ordinarily, band cells account for only a small percentage of circulating granulocytes, although their percentage can increase greatly under conditions in which neutrophil production increases, such as infection. This finding is not suggestive of problems with oxygenation and subsequent activity intolerance.

A client is receiving a blood transfusion and reports a new onset of slight dyspnea. The nurse's rapid assessment reveals bilateral lung crackles and elevated BP. What is the nurse's most appropriate action?

Slow the infusion rate and monitor the client closely The client is showing early signs of hypervolemia; the nurse should slow the infusion rate and assess the client closely for any signs of exacerbation. At this stage, discontinuing the transfusion is not necessary. A bolus would worsen the client's fluid overload.

Polycythemia vera is a rare form of anemia.

True

Anemia is the most common hematologic condition affecting older adults, particularly those admitted to hospitals or those in long-term care facilities.

TRUE

Iron deficiency anemia, the most common type of anemia in all age groups, also is the most common anemia in the world.

TRUE

Polycythemia vera is a rare form of anemia.

TRUE

The primary function of lymphocytes is to attack foreign material.

TRUE

The patient, who is experiencing severe circulatory overload due to too much blood infusing too quickly, should be placed in an upright position with the feet in a dependent position.

True

Disseminated intravascular coagulation (DIC) is characterized by a process of inflammation and _______________ within the vasculature.

coagulation

The most common symptom and complication of anemia is _________, which has the greatest negative impact on a patient's level of functioning.

fatigue

____________________ is a genetic condition in which excess iron, absorbed from the GI tract, is deposited in various body organs.

hemochroatosis

Patients with __________ anemia develop a smooth sore red tongue.

pernicious