CH 30 med surge nurs 3
lymphocyte
A type of white blood cell that make antibodies to fight off infections
When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential?
Health history, such as bleeding, fatigue, or fainting
Multiple myeloma
Malignant proliferation of plasma cells Infiltrate bone marrow and aggregate into tumor masses in skeletal system S/S back bone pains pelvis, spine and ribs pain as well
The nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. What disease will the nurse mention with a primary characteristic of erythrocytosis?
polycythemia vera- same as erythrocytosis- high RBC-thick blood
The nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. What disease will the nurse mention with a primary characteristic of erythrocytosis?
polycythemia vera-rapid proliferation of blood cells-increased hct and hgb, thickened blood
A nurse is caring for a client with multiple myeloma. Which nursing intervention is most appropriate for this client?
preventing bone injury and infractions, pain management
The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client?
promote safety
The nurse recognizes the clinical assessment of a patient with acute myeloid leukemia (AML) includes observing for signs of infection early. What nursing action will most likely help prevent infection?
vigilant hand washing
A nurse prepares a client for a bone marrow biopsy who is suspected of having acute myeloid leukemia. What results from the bone marrow biopsy does the nurse expect?
excess of immature leukocytes
A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host?
graft versus host disease the donor's lymphocytes [graft] recognizes the Pt body as FOREIGN
A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see?
hypercalcemia- calcium is released when bone is destroyed(osteoblast of bone-lysis) causing hypercalcemia
The nurse is teaching the client about consolidation. What statement should be included in the teaching plan?
"Consolidation therapy is administered to reduce the chance of leukemia recurrence."
The nurse is teaching a client with acute lymphocytic leukemia (ALL) about therapy. What statement should be included in the plan of care?
"Intrathecal chemotherapy is used primarily as preventive therapy."
A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention?
Assess the client's hemoglobin and platelets.
Acute Myeloid Leukemia AML
hemorrhage thrombocytopenia (low blood cells)
A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive?
induction therapy
The nurse is administering packed red blood cell (RBC) transfusions for a patient with myelodysplastic syndrome (MDS). The patient has had several transfusions and is likely to receive several more. What is a priority for the nurse to monitor related to the transfusions?
iron levels
A nurse prepares teaching for a group of clients with chronic myeloid leukemia (CML). When planning the teaching on medication adherence, which factors associated with lower oral therapy adherence will the nurse keep in mind? Select all that apply.
living alone low socioeconomic status not participating in clinal trials
The nurse is teaching a clieThe nurse is teaching a client diagnosed with Hodgkin's lymphoma about metastasis. What type of cancer is the most likely to appear as a secondary malignancy in clients with Hodgkin's lymphoma disease?
lung cancer likely secondary to PTs with Hodgkins lymphoma particularly following chemo and radiation combo therapy
A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?
maintain nutrition is the most important goal after induction therapy
The nurse cares for an older adult client with unprovoked back pain and increased serum protein. Which hematologic neoplasm does the nurse suspect the client has?
multiple myeloma
A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client's fever?
neutropenia fever and infection results from decrease in neutropenia Anemia- causes weakness, fatigue, dyspnea on exertion and pallor Pancytopenia_ decrease in leukocytes ,RBC and platelets Thrombocytopenia- decreased platelet count- causes petechiae and bruising in AML
The nurse is reviewing the health history of a client with essential thrombocythemia. Which findings increase the client's risk of developing a complication? Select all that apply.
obesity smoking diabetes hypertension
A nurse is assessing a client with multiple myeloma. Due to this condition, what will this client be at risk for?
pathologic bone fractures and secondary to osteoporosis and osteolytic lesions Multiple myeloma
A client presents with peripheral neuropathy and hypoesthesia of the feet. What is the best nursing intervention?
Assess for signs of injury.
A client who is being treated for AML has bruises on both legs. What is the nurse's most appropriate action?
Evaluate the client's platelet count.
A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see?
Hypercalcemia
The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about?
Platelet count of 9,000/mm3 thrombocytopenia(low blood cell count)
A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive?
Induction therapy
What assessment finding best indicates that the client has recovered from induction therapy?
Neutrophil
What assessment finding best indicates that the client has recovered from induction therapy?
Neutrophil and platelet counts within normal limits
The nurse is caring for a client with multiple myeloma. Why would it be important to assess this client for fractures?
Osteoclasts break down bone cells so pathologic fractures occur. this process increases blood calcium and can result in hypercalcemia- high calcium
Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets?
PancytopeniaPancytopeniaPancytopenia
The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma?
The client with enlarged lymph nodes in the neck-painless
A nurse cares for a client with early Hodgkin lymphoma. While assessing the client, the nurse will most likely find painless enlargement of which lymph node?
cervical- neck lymph nodes non painful swelling of the cervical lymph nodes are the earliest S/S of hodgkin lymphoma
Pancytopenia definition
anemia, thrombocytopenia, and leukopenia a decrease in red blood cells, platelets, white blood cells anemia- decrease in RBC Thrombocytopenia-Decrease in platelets Leukopenia- decrease in leukocytes
A client with chronic lymphocytic leukemia (CLL) experiences frequent bacterial infections. Which medication will the nurse anticipate being prescribed for this client?
asceniv Intravenous treatment with immunoglobulin (IVIG), such as ascenivc, may be given to clients with recurrent infection.
A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention?
asses the client hemoglobin and platelets
A client presents with peripheral neuropathy and hypoesthesia of the feet. What is the best nursing intervention?
assess for sings of injury hypothesis of feet - decreased sensation and numbness