Active Learning - Hematologic Disorders

Most common causes of anemia in the elderly are ____ and ____ . Vitamin B12 deficiency, folate deficiency, gastrointestinal bleeding and myelodysplastic syndrome are some other causes of anemia in the aging population.​

chronic disease and iron deficiency

Results from mutations at the factor VIII or IX loci on the X chromosome​

hemophilia

is an X-linked, recessive disorder caused by the deficiency of functional plasma clotting factor VIII (FVIII), which may be inherited or arise from spontaneous mutation.​

hemophilia A

s an inherited, X-linked, recessive disorder that results in the deficiency of functional plasma coagulation factor IX.​

hemophilia B (christmas disease)

which anemia: Condition lacking adequate healthy red blood cells​ Insufficient iron levels​ Iron required for body to produce enough red blood cells to oxygenate the body​

iron deficiency anemia

Tired, increased fatigue, no source of iron (no red meat), bounding pulses 3+ Cause is not eating and poor dietary intake → give ferrous sulfate and needs diet change, give iron pills with vitamin C for absorption, liquid iron through a straw so no staining teeth

iron deficient anemia

Overproduction of WBCs​

leukocytosis

which anemia is also known as addisons disease; A decrease in red blood cells when the body can't absorb enough vitamin B-12.​

pernicious anemia (b12 deficiency)

Blood is THICK, rosey because of thick blood → occlusions and splenomegaly, retinopathy, vision changes, acute chest syndrome Treat by donating blood

polycytehmia vera

Mutation in gene responsible for hemoglobin production;​ Hereditary hemoglobinopathy characterized by abnormal hemoglobin cells. These sickle cells cause occlusion of small blood vessels, ischemia, severe pain episodes, delayed growth and development, and damage to many organs. ​ ​

sickle cell disease

this is a greater risk for iron overload, require frequent chelatin therapy

thalassemia majo

Severe anemia, profound hemolysis, ineffective erythropoiesis.​ May require numerous blood transfusions.

thalassemia major

Congenital bleeding disorder is characterized by low or ineffective von Willebrand factor, which is essential for platelet adhesion and helps to transport factor VIII in the blood.​ Not curable.​

von willebrand disease

The nurse is caring for a patient who is receiving antiretroviral therapy (ART) for treatment of HIV infection. Which assessment best indicates that the patient's condition is improving? A. Decreased viral load B. Increased drug resistance C. Decreased CD4+ T-cell count D. Increased aminotransferase levels

A

Which best describes the purpose of a bone marrow biopsy? A. To determine the cause of severe anemia B. To detect the risk of blood clots C. To test for the procedure of allergens in the blood D. To determine the density of bone

A

A nurse is completing the admission history for a client who has human immunodeficiency virus (HIV). Which risk factors does the nurse identify as being associated with this virus? SELECT ALL A. Prenatal exposure B. Pregnancy C. Monogamous sex partner D. Menopause E. Occupational exposure

A D E

Below 200 cd4 count, HIV diagnosis, opportunistic infection Sulfamethoxazole → treat infection Bactrim on discharge and less risk for infection Neutropenic precautions Take antiretrovirals at same time everyday

AIDS

A nurse is preparing to transfuse a unit of packed RBCs for a client who has severe anemia. The nurse should identify which of the following interventions will help prevent an acute hemolytic reaction? A. Ensures that the client has a patent IV line before obtaining blood product from the refrigerator B. Verifies with another nurse that the client and blood product match the client's ID band for blood component as well as the blood ID information in their chart. C. Takes a complete set of vital signs before beginning transfusion and periodically during the transfusion D. Stays with the client for the first 15 to 30 mins of the transfusion

B

A nurse is reviewing laboratory results for a client who has a WBC count of 20,000/mm3. The nurse should identify that the client has which of the following conditions? A. Neutropenia B. Leukocytosis C. Thrombocytosis D. Leukopenia

B

Nurse is preparing to administer one unit of packed red cells into a client in need of a transfusion. The client currently has a bag of lactated ringer's infusing into his IV. Which is the most appropriate action for the nurse to take? A. Discontinue the LR solution and start an infusion of D5W to run with the packed cells B. Discontinue the LR solution and start an infusion of 0.9% NaCl run with the packet cells C. Start the unit of packed red blood cells and use with the LR solution D. Wait to administer the packed red blood cells until the current IV bag of LR is complete

B

The nurse informs the patient with a bacterial pneumonia that the most important factor in antibiotics treatment is: A. Antibiotics should have been used to prevent pneumonia B. All of the supplied antibiotics should be taken even when symptoms have resolved C. Enough antibiotics for 2 days treatment should be reserved in case symptoms reoccur D. Patient should get antibiotics for any infection to prevent development of streptococcal-related diseases

B

Which of the following should be an indicator for a blood product transfusion in an adult client ? SELECT ALL A. Hemoglobin 12 g per deciliter B. Hemorrhage that causes 30% total volume blood loss C. Platelet count of 100,000 micrograms per liter D. International normalized ratio level greater than 2.0 E. sickle cell disease that causes anemia

B E

A nurse is planning an educational session about HIV for newly licensed nurses. Which of the following information should the nurse include about HIV transmission? A. Primarily transmitted through casual contact B. Primarily transmitted through a wound caused by an accident C. Primarily transmitted through direct contact with infected bodily fluids D. Primarily transmitted through eating raw meat

C

Nurse is caring for a client who takes large doses of ibuprofen daily for joint pain. The nurse knows that it is important to monitor for which of the following adverse effects? SELECT ALL A. Bradycardia B. Hypertension C. Black tarry stools D. Bruising E. Constipation

C D

A nurse is caring for a client who has increased white blood cell count. Which of the following medications can result in an increased WBC count? A. Diuretics B. Antibiotics C. Histamine-2 blockers D. Corotiodereods

D

A nurse is caring for a client who has leukemia and thrombocytopenia (body producing too many platelets). Which of the following actions is the nurse's priority? A. Allow the client to take frequent rest periods throughout the day B. Encourage the client to cough, turn and deep breathe every 2 hours C. Obtain the client's temperature every 4 hours D. Monitor clients platelet counts

D

A nurse is teaching an adolescent about HIV. Which of the following statements by the adolescent indicates an understanding of the teaching> A. "You can get HIV by kissing your partner" B. "HIV can be caught by inhaling illegal drugs" C. "There is a cure for HIV now" D. "A pregnant woman can pass HIV to her unborn baby"

D

Diagnosis of AIDS can be made for a patient with HIV with A. A WBC count less than 3000/mL B. A CD4+ T-cell count less than 500/mL C. Development of oral candidiasis (Thrush) D. Onset of Pneumocystis Jiroveci pneumonia

D

The nurse is teaching a newly diagnosed 34 year old male about his HIV infection. Which statement A. "I will need to take my HIV medication daily for the rest of my life" B. "Although I only take one pill, it has multiple medication combined into a single tablet" C. "I should notify my HIV provider if I get fevers that do not go away with tylenol or aspirin" D. "Once my viral load is undetectable I don't have to worry about taking my medication every day"

D

A pediatric nurse is giving instructions to a 12 year old client with sickle cell disease and his parents. To prevent a crisis the nurse explains that the child should do which of the following? A. Stay away from sick children B. Increase fluids C. Restrict fluids D. Avoid exercise E. Be aware that high altitudes may lead to a crisis

E

which anemia: Body produces excessive RBCs (erythropoietin);​ Increased hemoglobin above normal values;​

Polycythemia vera