Chapter 31: Caring for Clients with Disorders of the Hematopoietic System - PN 190 Med-Surg -

A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply. Inadequate formed white blood cells Infection Abnormal erythrocyte production Blood loss Destruction of normally formed red blood cells

Blood loss Abnormal erythrocyte production Destruction of normally formed red blood cells

A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem? A hemolytic reaction to mismatched blood A hemolytic reaction to Rh-incompatible blood A hemolytic reaction caused by bacterial contamination of donor blood A hemolytic allergic reaction caused by an antigen reaction

A hemolytic allergic reaction caused by an antigen reaction

Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets? Leukopenia Anemia Pancytopenia Thrombocytopenia

Pancytopenia

A client with sickle cell anemia has a normal hematocrit. high hematocrit. normal blood smear. low hematocrit.

low hematocrit.

Which medication is the antidote to warfarin? Clopidogrel Aspirin Vitamin K Protamine sulfate

Vitamin K

A health care provider prescribes one tablet of ferrous sulfate daily for a 15-year-old girl who experiences heavy blood flow during her menstrual cycle. The nurse advises the patient and her mother that this over-the-counter preparation must be taken for how many months before stored iron replenishment can occur? 1 to 2 months 3 to 5 months 6 to 12 months Longer than 12 months

6 to 12 months

A patient with chronic renal failure is examined by the nurse practitioner for anemia. The nurse knows to review the laboratory data for a decreased hemoglobin level, red blood cell count, and which of the following? Increased reticulocyte count Decreased total iron-binding capacity Decreased level of erythropoietin Increased mean corpuscular volume

Decreased level of erythropoietin

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count? Anemia Neutropenia Leukopenia Thrombocytopenia

Thrombocytopenia

A client's family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC? "DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs." "DIC occurs when the immune system attacks platelets and causes massive bleeding." "DIC is caused when hemolytic processes destroy erythrocytes." "DIC is a complication of an autoimmune disease that attacks the body's own cells."

"DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs."

A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms? "Eat larger amounts of bland, soft foods less frequently." "Eat small amounts of bland, soft foods frequently." "Eat low-fiber blended foods only." "Eat cold, bland foods with a large amount of water."

"Eat small amounts of bland, soft foods frequently."

For a client diagnosed with idiopathic thrombocytopenia purpura (ITP), which nursing intervention is appropriate? Administering stool softeners, as ordered, to prevent straining during defecation Giving aspirin, as ordered, to control body temperature Teaching coughing and deep-breathing techniques to help prevent infection Administering platelets, as ordered, to maintain an adequate platelet count

Administering stool softeners, as ordered, to prevent straining during defecation

Which of the following is the most common hematologic condition affecting elderly patients Bandemia Leukopenia Thrombocytopenia Anemia

Anemia

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia? Eliminate direct contact with others who are infectious Implement neutropenic precautions Monitor temperature at least once per shift Apply prolonged pressure to needle sites or other sources of external bleeding

Apply prolonged pressure to needle sites or other sources of external bleeding

A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure? Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints. Ask if taking a blood pressure has ever produced pain in the upper arm. Ask if taking a blood pressure has ever caused bruising in the hand and wrist. Ask if taking a blood pressure has ever produced the need for medication.

Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints.

The nurse is caring for a client with type 2 diabetes who take metformin to manage glucose levels. The nurse recognizes the client may be most at risk for which vitamin deficiency? Folate A B12 C

B12

A client reports feeling tired, cold, and short of breath at times. Assessment reveals tachycardia and reduced energy. What would the nurse expect the physician to order? antibiotic chest radiograph CBC ECG

CBC

A male client has been receiving a continuous infusion of weight-based heparin for more than 4 days. The client's PTT is at a level that requires an increase of heparin by 100 units per hour. The client has the laboratory findings shown above. The most important action of the nurse is to Begin treatment with the prescribed warfarin (Coumadin). Increase the heparin infusion by 100 units per hour. Continue with the present infusion rate of heparin. Consult with the physician about discontinuing heparin.

Consult with the physician about discontinuing heparin.

A nurse cares for several clients with anemia and notes that all the clients have different types of anemia. What is the nurse's best understanding of how anemias are classified, based on the deficiency of erythrocytes? Select all that apply. Shape of erythrocytes Loss of erythrocytes Destruction of erythrocytes Defective production of erythrocytes Quantity of erythrocytes

Defective production of erythrocytes Destruction of erythrocytes Loss of erythrocytes

The nurse and the client are discussing some strategies for ingesting iron to combat the client's iron-deficiency anemia. Which is among the nurse's strategies? Avoid vitamin C as it prevents absorption. Take iron with an antacid to avoid stomach upset. Taking iron pills with milk aids in absorption. Drink liquid iron preparations with a straw.

Drink liquid iron preparations with a straw.

A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia? Nausea, vomiting, and anorexia Nights sweats, weight loss, and diarrhea Dyspnea, tachycardia, and pallor Itching, rash, and jaundice

Dyspnea, tachycardia, and pallor

When assessing a client with anemia, which assessment is essential? Lifestyle assessments, such as exercise routines Age and gender Health history, including menstrual history in women Family history

Health history, including menstrual history in women

A patient with ESRD is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication? Hemoglobin level Folate levels Creatinine level Potassium level

Hemoglobin level

The thalassemias are a group of hereditary anemias characterized by which of the following? Select all that apply. Hemolysis Thrombocytopenia Extreme microcytosis Hypochromia Anemia

Hypochromia Extreme microcytosis Hemolysis Anemia

The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the physician. What type of anemia is the nurse concerned the co-worker may have? Iron deficiency anemia Megaloblastic anemia Sickle cell anemia Aplastic anemia

Iron deficiency anemia

The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient? It may indicate deficiencies in essential nutrients. It is important for the nurse to determine what type of foods the patient will eat. It will determine what type of anemia the patient has. It is part of the required assessment information.

It may indicate deficiencies in essential nutrients.

A client admitted to the hospital in preparation for a splenectomy to treat autoimmune hemolytic anemia asks the nurse about the benefits of splenectomy. Which statement best explains the expected effect of splenectomy? It will reduce the destruction of platelets by macrophages. It will increase production of platelets by the bone marrow. It will remove the major site of red blood cell (RBC) destruction. It will increase red blood cell (RBC) production to compensate for blood loss.

It will remove the major site of red blood cell (RBC) destruction.

Which iron-rich foods should a nurse encourage an anemic client requiring iron therapy to eat? Shrimp and tomatoes Lamb and peaches Cheese and bananas Lobster and squash

Lamb and peaches

A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention? Monitoring the client's blood pressure and reviewing the client's hematocrit Monitoring the client's breathing and reviewing the client's arterial blood gases Monitoring the client's heart rate and reviewing the client's hemoglobin Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential

Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential

A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in his arms and legs. What do these symptoms indicate? Severity of the disease Neurologic involvement Insufficient intake of dietary nutrients Loss of vibratory and position senses

Neurologic involvement

The nurse is caring for an older adult client who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine where the blood loss is coming from, what intervention can the nurse provide? Observe the gums for bleeding after the client brushes teeth. Observe client for facial droop. Observe the sputum for signs of blood. Observe stools for blood.

Observe stools for blood.

A client with multiple myeloma is complaining of severe pain when the nurse comes in to give a bath and change position. What is the priority intervention by the nurse? Inform the client that she will feel better after receiving a bath and clean sheets. Inform the client that the position must be changed, and then you will give her pain medication and omit the bath. Inform the client that the bath and positioning is an important part of client care and will be done right after pain medication administration. Obtain the pain medication and delay the bath and position change until the medication reaches its peak.

Obtain the pain medication and delay the bath and position change until the medication reaches its peak.

A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. She reports that she first felt pain after manually opening her garage door and that she is taking prednisone daily. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain? Truncal obesity Muscle wasting Hypertension Osteoporosis

Osteoporosis

Which is the following is the most obvious sign of anemia? Tachycardia Jaundice Pallor Flow murmurs

Pallor

The nurse obtains a unit of blood for the client, Donald D. Smith. The name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. The nurse Administers the unit of blood Checks with Blood Bank first and then administers the blood with their permission Asks the client if he was ever known as Donald A. Smith Refuses to administer the blood

Refuses to administer the blood

A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for? Bleeding Diarrhea The onset of a bacterial infection Abdominal pain

The onset of a bacterial infection

A client is being admitted to the hospital with abdominal pain, anemia, and bloody stools. He complains of feeling weak and dizzy. He has rectal pressure and needs to urinate and move his bowels. The nurse should help him: to the bathroom. to the bedside commode. onto the bedpan. to a standing position so he can urinate.

onto the bedpan

A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client? Overhydration enlarges the red blood cells. Bone marrow decreases the erythrocyte production causing decrease in hypoxia. Vascular occlusion in small vessels decreasing blood and oxygen to the tissues. The client has a decreased tolerance of pain related to the chronic nature of the illness.

Vascular occlusion in small vessels decreasing blood and oxygen to the tissues.

A client with severe anemia reports symptoms of tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Laboratory test results reveal low hemoglobin and hematocrit levels. Based on the assessment data, which nursing diagnoses is most appropriate for this client? Fatigue related to decreased hemoglobin and hematocrit Imbalanced nutrition, less than body requirements, related to inadequate intake of essential nutrients Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit Risk for falls related to complaints of dizziness

Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit

While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of which assessment parameters? Platelet count, prothrombin time, and partial thromboplastin time Fibrinogen level, WBC, and platelet count Thrombin time, calcium levels, and potassium levels Platelet count, blood glucose levels, and white blood cell (WBC) count

Platelet count, prothrombin time, and partial thromboplastin time