Practice Questions Saunders 7th edition

Apheresis/ Leukopharesis (procedure during the Harvest process)

Blood removed from donor, machine filters out the stems cells. Returns the left over blood to donor.

Aplastic Crisis

Decreased production and increased destruction of RBC's. caused by viral infection or depletion of folic acid manifestations: profound anemia and pallor

Conditioning refers to

Immunosuppression therapy regime: use to get rid of all cancer cells, create space in bone marrow for engraftment of new bone marrow

Bone marrow/ stem cell transplantation, are the most common treatments for?

Leukemia

Without the replacement of blood-forming stem cell function through transplantation, the client would ______?

Patients would die of infection or hemorrhage. Because chemo is so damaging to bone marrow cells,

The nurse observes a mother giving an oral iron supplement to her 6-year-old with iron deficiency anemia. Which action by the mother indicates the "need for further teaching" a) The mom gave the supplement with a glass of milk b) The mom gave the supplement with a glass of water c) The mom gave the supplement with a glass of OJ d) The mom gave the supplement with a glass of apple juice

a)Milk may affect the absorption of the iron. Vitamin C increases the absorption of iron in the body. The mom should be instructed to give iron supplement with citrus fruit or juice high in vitamin C. Water does not help absorb the iron

Hyperhemolytic Crisis

an accelerated rate of RBC destruction manifestations: anemia, jaundice and reticulocytosis

A child with leukemia is experiencing nausea related to medication therapy. The nurse, concerned about the child's nutritional status, should offer which items during an episode of nausea? a) low- calorie foods b) cool, clear liquids c) low-protein foods d) the child's favorite foods

b) when child is nauseated, it is best to offer frequent intake of cool, clear liquids in small amounts it is better tolerated. do not give child favorite foods, then favorite food will be associated with nausea

The nurse reinforces home care instructions to the parents of a child with leukemia regarding measures related to monitoring for infection. Which statement by a parent indicates the "need for further teaching" a) I will use proper hand-washing techniques b) I need to take my child's rectal temp daily c) I need to inspect my child's skin daily for redness d) I need to inspect my child's mouth daily for lesions

b) The risk of injury to fragile mucous membranes is so great in the child with leukemia rectal temperatures can easily cause damaged rectal tissues, no rectal temps should be taken

The nurse is explaining causes and reasons of hemophilia A to the parents of a child with the disease. The nurse should make which statement about hemophilia A? a) Hemophilia A is a Y-linked hereditary disorder b) Hemophilia A results from a deficiency of factor IX c) Hemophilia A results from a deficiency of factor VIII d) Hemophilia A is always inherited in a recessive manner

c) Hemophilia A results from a deficiency of factor VIII Hemaphilia A may also occur from a gene mutation Hemophilia B (Christmas disease) results from a deficiency of factor IX Hemophilia is a X-linked hereditary disorder NOT Y-linked

A 4-year-old child is admitted to the hospital with suspected acute lymphocytic leukemia (ALL). The nurse should prepare for which diagnostic study that can confirm this diagnosis? a) Platelet count b) lumbar puncture c) A bone marrow biopsy d) WBC count

c) Microscopic view of bone marrow obtained by aspirate and biopsy is the confirmatory test for leukemia WBC count may be low or high in Leukemia lumbar puncture is related to CNS disroders altered platelet count is a result of chemo

The nurse is caring for a child with aplastic anemia is reviewing the laboratory results and notes a WBC count of 6000mm3 and a platelet count of 20,000mm3. Which nursing intervention should be incorporated into plan of care? a) encourage naps b) encourage a diet high in iron c) encourage quiet play activities d) maintain strict isolation precautions

c) encourage quiet play activities Precautionary measures to prevent bleeding should be taken with a child with a low platelet count. This includes: no injections, rectal temps, use a soft toothbrush, quiet activities and no contact sports Strict isolation would be required if WBC count was low Naps/ diet unrelated to risk of bleeding

Splenic Sequestration

caused by pooling/ clumping of blood in the spleen manifestations: profound anemia, hypovolemia, and shock

Vaso-occulsive Crisis

caused by stasis of blood with clumping of cells in micro-circulation, ischemia and infarction manifestations: fever, painful swelling of hands, feet, and joints, and abdominal pain

The nurse reinforces home care instructions to the parents of a 3-year-old who has been hospitalized with hemophilia. Which statement by a parent indicates the "need for further teaching" a) I will supervise my child closely b) I will pad the furniture c) I will remove household items that can easily fall over d) I will avoid immunizations and dental hygiene treatments for my child

d) The nurse needs to stress the importance of immunizations, dental care, and routine well-child care. Options a,b, and c are appropriate statements. Parent also instructed measures to take in the event of blunt trauma

The nurse reinforces instructions to the parents of a child with sickle cell anemia regarding the precipitating factors related to pain crisis. Which if identified by a parent as a precipitating factor, indicates the "need for further teaching" a) Stress b) Trauma c) Infection d) Fluid overload

d) should encourage fluid intake of 1.5 to 2 times the daily requirement to prevent dehydration.

Bone marrow transplantation (BMT) and stem cell transplantation (PBSCT) replace stem cells that have be destroyed by _________?

high doses of chemotherapy and/ or radiation therapy

posttransplantation period

infection, bleeding, neutropenia, thrombocytopenia major concerns, untill engraftment occurs

Side effects of liquid iron preparation

stains teeth, teach parents that liquid iron should be taken through a straw, and brush teeth afterwards.

Engraftment

transfused stem cells move into marrow-forming sites of persons bones. takes 2 to 5 weeks