Prep U/ Med Surge Ch. 30
A patient will need a blood transfusion for the replacement of blood loss from the gastrointestinal tract. The patient states, "That stuff isn't safe!" What is the best response from the nurse?
"I understand your concern. The blood is carefully screened but is not completely risk free."
A nurse is teaching a client with a vitamin B12 deficiency about appropriate food choices to increase the amount of B12 ingested with each meal. The nurse knows the teaching is effective based on which statement by the client?
"I will eat a meat source such as chicken or pork with each meal."
A nurse is educating a client about the role of B lymphocytes. The nurse's description will include which of the following physiologic processes?
Antibody production
A client's low hemoglobin level has necessitated transfusion of PRBCs. Prior to administration, what action should the nurse perform?
Assess the client's vital signs to establish baselines.
A volunteer wanting to donate blood for the first time wishes to know more about the various blood groups. The nurse educating the volunteer regarding the blood groups should mention which of the following as the determining factor that classifies blood into groups A, B, AB, and O?
Combinations of antigens and antibodies
A 75-year-old woman visited her health care provider for an annual check-up. She told the doctor that she feels exhausted all the time and barely has the energy to go out of her home, run errands, and visit friends. The nurse expects that the health care provider will order which of the following lab studies based on the most common hematologic condition affecting the elderly?
Complete blood count
The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see which lab result?
Decreased hematocrit
The nurse expects which assessment finding when caring for a client with a decreased hemoglobin level?
Decreased oxygen level.
The nurse expects which assessment finding when caring for a client with a decreased hemoglobin level?
Decreased oxygen level. Hemoglobin carries oxygen.
Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?
Myeloid stem cell
Which type of white blood cell (WBC) is the most numerous?
Neutrophil
A nurse is transfusing whole blood to a client with impaired renal function. During the transfusion, the client tells the nurse, "I feel very short of breath all of a sudden." What is the nurse's primary action?
Stop the infusion.
A client is visiting the physician and has signs and symptoms consistent with anemia. Why would the nurse ask the client about recent travel to foreign countries.
The agent that causes malaria following the bite of an infected mosquito invades erythrocytes and causes anemia.
A client is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?
The need to report any signs or symptoms of infection promptly
T lymphocytes function
are integral in cell-mediated immunity
A nurse educator is lecturing a group of students on caring for patients with a hematopoietic disorder. The nurse begins the lecture by providing a definition of hematopoiesis. This term is best defined as the normal:
formation and development of blood cells.
B lymphocytes function
integral in humoral immunity
Which is a symptom of severe thrombocytopenia?
petechiae
Which cells are also known as thrombocytes?
platelets
Which cells have the lifespan of approximately 7.5 days, and one-third of their population remains in the spleen (unless needed to fight significant bleeding)?
platelets
The nurse is explaining the wound-healing process to a patient. Which best describes the function of fibrinogen?
plays a key role in forming blood clots
plasma cell function
secrete immunoglobulin
A nurse in the ED is caring for a trauma client following a motor vehicle accident. The client's blood donor card indicates type AB blood. People with type AB blood are:
universal recipients
Using a penlight and tongue blade, the nurse inspects the client's tonsils for size and appearance. Tonsils are present and touch the uvula. How should the nurse grade these findings?
3
A client with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells (RBCs). If the nurse hangs the blood at 12:00 pm, by what time must the infusion be completed?
4:00 pm
An instructor asks students approximately how long platelets last? What would the students correctly identify?
7.5 days
A nurse is reviewing blood count values for a female client. Which value would necessitate notifying the client's health care provider?
70,000/mm3 platelets The normal range for platelet count is 150,000 to 350,000/mm3.
A client who has idiopathic thrombocytopenia purpura (ITP) has a critically low platelet count. Which nursing intervention will be included in the care plan for this client?
Administer eltrombopag
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 client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have?
Allergy
A client's health history reveals daily consumption of two to three bottles of wine. The nurse should plan assessments and interventions in light of the client's increased risk for what hematologic disorder?
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
A client with a history of sickle cell anemia has developed iron overload from repeated blood transfusions. What treatment does the nurse anticipate will be prescribed?
Chelation therapy
A 66-year-old man underwent a successful partial gastrectomy for the treatment of stomach cancer 3 years ago. The man had a scheduled follow-up appointment with his primary caregiver and had blood work completed. The results of the man's blood work indicated anemia. The nurse who is contributing to the patient's care should recognize that this patient's anemia may be attributable to what factor?
Decreased vitamin B12 absorption patients who have had a partial or total gastrectomy may have limited amounts of intrinsic factor, and therefore the absorption of vitamin B12 may be diminished,
A client on the medical unit is receiving a unit of PRBCs. Difficult IV access has necessitated a slow infusion rate and the nurse notes that the infusion began 4 hours ago. What is the nurse's most appropriate action?
Discontinue the remainder of the PRBC transfusion and inform the health care provider.
The charge nurse should intervene when observing a new nurse perform which action after a client has suffered a possible hemolytic blood transfusion reaction?
Disposing of the blood container and tubing in biohazard waste.
The nurse is reviewing a client's laboratory results and notes that her hemoglobin level is 15 g/dL. What action should the nurse take next?
Document the finding as normal.
The nurse is reviewing a client's laboratory results and notes that her hemoglobin level is 15 g/dL. What action should the nurse take next?
Document the finding as normal. In adults, the normal amount of hemoglobin is 12 to 17.4 g/dL.
A client needs increased production of red blood cells. Which of the following drugs would the nurse expect to be prescribed for the client?
Epoetin alfa
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is the most likely clinical disorder the patient is being treated for?
Essential thrombocythemia
Which of the following reports from the client during the health history would lead the nurse to suspect that the client has a disorder of the hematopoietic or lymphatic system? Select all that apply.
Experiences prolonged bleeding from an obvious injury. Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. Feels fatigued with normal activities.
Leukocytes function
Fights infection
A client undergoing a complete blood cell (CBC) count for the detection of anemia wants to know more about hemoglobin. Which should the nurse explain to the client as being the main function of hemoglobin?
Gives its oxygen to cells of the body and picks up carbon dioxide
A client complains of extreme fatigue. Which system should the nurse suspect is most likely affected?
Hematological
The nurse is describing normal RBC physiology to a client who has a diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?
Hemoglobin
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 patient with a hematologic disorder. The patient asks the nurse where the body forms blood cells. Where should the nurse tell the patient that blood cells are formed?
In the bone marrow
A patient who has long-term packed RBC (PRBC) transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that can help prevent organ damage?
Iron chelation therapy
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 of the following reasons?
Lack of erythropoietin
Which blood cell type is matched correctly with its function?
Leukocyte: Fights infection
A client has a leukocyte count of 13,000/mm3. How would the nurse document the client's condition?
Leukocytosis
A client has a leukocyte count of 3,000/mm3. How would the nurse document the client's condition?
Leukopenia Normal leukocyte count is between 5,000 and 10,000/mm3.
Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?
Liver
A nurse cares for a client with iron-deficiency anemia. Which treatment will the nurse anticipate the client receiving?
Oral iron supplementation
Knowledge regarding hematopoiesis is essential in postsurgical client care. Which statement about the variation in the normal number of erythrocytes is true?
People who engage in strenuous activity have an increased number of erythrocytes.
An individual has accidentally cut his hand, immediately initiating the process of hemostasis. Following vasoconstriction, what event in the process of hemostasis will take place?
Platelets will aggregate at the injury site
The client is planned to have a splenectomy. The nurse should prepare which medication to administer to this client?
Pneumococcal vaccine
The nurse is assisting with preparation for a client about to undergo a Schilling test. Which of the following actions by the nurse is correct?
Prepare to collect urine from the client for 24 to 48 hours.
An older adult patient presents to the physician's office with a complaint of exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows that which laboratory values should be assessed?
RBC count
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
The nurse expects which assessment finding of the oral cavity when the client is diagnosed with pernicious anemia?
Smooth tongue
Which term is used to refer to a primitive cell that is capable of self-replication and differentiation?
Stem cell
Which type of lymphocyte is responsible for cellular immunity?
T lymphocyte
The physician believes that the patient has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?
T lymphocytes
A client comes into the emergency department reporting an enlarged tongue. The tongue appears smooth and beefy red in color. The nurse also observes a 5-cm incision on the upper left quadrant of the abdomen. When questioned, the client states, "I had a partial gastrostomy 2 years ago." Based on this information, the nurse attributes these symptoms to which problem?
Vitamin B12 deficiency
