349 ch 32 assessment of hematologic function & treatment modalities

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 agree that you should be concerned with the safety of the blood, but it is important that you have this transfusion." "The blood is carefully screened, so there is no possibility of you contracting any illness or disease from the blood." "I understand your concern. The blood is carefully screened but is not completely risk free." "You will have to decide if refusing the blood transfusion is worth the risk to your health."

"I understand your concern. The blood is carefully screened but is not completely risk free."

Which client is not a candidate to be a blood donor according to the American Red Cross? 50-year-old female with pulse 95 beats/minute 18-year-old male weighing 52 kg 26-year-old female with hemoglobin 11.0 g/dL 86-year-old male with blood pressure 110/70 mm Hg

26-year-old female with hemoglobin 11.0 g/dL

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? 2:00 pm 4:00 pm 3:00 pm 6:00 pm

4:00 pm

After withdrawing the needle from blood donor's arm, the site begins to bleed excessively. What is the nurse's first action? Lower the arm below the level of the heart. Assist the client into an erect position. Hold firm pressure on the venipuncture site. Apply a tourniquet above the antecubital fossa.

Hold firm pressure on the venipuncture site.

Which is a symptom of severe thrombocytopenia? Petechiae Inflammation of the mouth Inflammation of the tongue Dyspnea

Petechiae

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? Where a mask when entering the client's room. Elevate the client's head of the bed. Use an electric razor when assisting client with shaving. Apply supplemental oxygen to maintain the client's oxygenation.

Use an electric razor when assisting client with shaving.

The nurse is administering 2 units of packed RBCs to an older adult patient who has a bleeding duodenal ulcer. The patient begins to experience difficulty breathing and the nurse assesses crackles in the lung bases, jugular vein distention, and an increase in blood pressure. What action by the nurse is necessary if the reaction is severe? (Select all that apply.) Administer diuretics as prescribed. Continue the infusion but slow the rate down. Place the patient in an upright position with the feet dependent. Administer oxygen. Discontinue the transfusion.

administer diuretics as prescribed place the patient in an upright position with the feet dependent administer oxygen discontinue the transfusion

The nurse should be alert to which adverse assessment finding when transfusing a unit of packed red blood cells (PRBCs) too rapidly? Oral temperature of 97°F Pain and tenderness in calf area Crackles auscultated bilaterally Respiratory rate of 10 breaths/minute

crackles auscultated bilaterally

A client receiving a blood transfusion reports shortness of breath, appears anxious, and has a pulse of 125 beats/minute. What is the best action for the nurse to take after stopping the transfusion and awaiting further instruction from the health care provider? Ensure there is an oxygen delivery device at the bedside. Administer prescribed PRN anti-anxiety agent. Place the client in a recumbent position with legs elevated. Remove the intravenous line.

ensure there is an oxygen delivery device at the bedside

A nurse administers blood products to a client with Hodgkin disease. During the administration, the nurse notes the client has a fever and diffuse reddened skin rash. From what condition does the nurse suspect the client is suffering? Creutzfeldt-Jakob disease Bacterial contamination Graft-versus-host disease Delayed hemolytic reaction

graft- versus host disease

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? Splintering of bone fragments Blood transfusion reaction Shock Hemorrhage

hemorrhage

The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in? Jackknife position Supine with head of the bed elevated 30 degrees Lithotomy position Lateral position with one leg flexed

lateral position with one leg flexed

Which blood cell type is matched correctly with its function? B lymphocyte: Secretes immunoglobulin T lymphocyte: Humoral immunity Plasma cell: Cell-mediated immunity Leukocyte: Fights infection

leukocyte: fights infection

Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following? Pancreas Large intestine Liver Kidney

liver

Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets? Neutrophil Lymphoid stem cell Myeloid stem cell Monocyte

myeloid stem cell

The client is to receive a unit of packed red blood cells. What is the nurse's first action? Observe for gas bubbles in the unit of packed red blood cells. Verify that the client has signed a written consent form. Check the label on the unit of blood with another registered nurse. Ensure that the intravenous site has a 20-gauge or larger needle.

verify that the client has signed a written consent form

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 brain senses low oxygen levels in the blood and produces hemoglobin, which binds to more red blood cells. The bone marrow is stimulated by low oxygen levels in the blood to produce erythropoietin, maturing the 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. The kidneys sense low oxygen levels in the blood and produce hemoglobin, stimulating the marrow to produce more 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.