Chapter: Chapter 19: Nursing Assessment: Hematologic Function

An adult client reports that it is taking longer than usual for minor cuts and injuries to clot. Which of the following questions would the nurse most likely ask the client?

"Are you regularly taking aspirin?"

An instructor asks students approximately how long platelets last? What would the students correctly identify?

7.5 days

When assessing for signs and symptoms related to hematopoietic and lymphatic systems, what details should the nurse ask about further?

A client undergoing cancer treatment

The instructor in the anatomy and physiology class is discussing the components of the blood. What would the instructor cite as the most abundant protein in plasma?

Albumin

Dennis Morgan, a 49-year-old chef, is a client of the primary care group where you practice nursing. Dennis has been studying up on blood cell production since the development of his blood disorder. At each appointment, he tries to fool you, his nurse, with blood cell trivia. His latest question: "Which of the following cell types are produced from pluripotential stem cells?" Your response is:

All options are correct.

A client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have?

Allergy

A client in end-stage renal disease is prescribed epoetin alfa (Epogen) and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, the nurse

Assesses the hemoglobin level

Which of the following cells are capable of differentiating into plasma cells?

B lymphocytes

Which type of leukocyte contains histamine and is an important part of hypersensitivity reactions?

Basophils

You are caring for three clients who have the following blood count values: Client A has 24,500 white blood cells (WBCs), client B has 13.4 g/dL hemoglobin, and client C has a 250,000/mm3 platelet count. Which statement correctly describes the condition of each client?

Client A has a higher WBC count than normal, client B has a normal hemoglobin count, and client C has a normal platelet count.

A nurse is caring for a client with a low platelet count. The nurse understands that a low platelet count affects which of the following?

Clotting of blood

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.

A client is prescribed an intravenous dose of iron dextran. The nurse

Ensures that epinephrine is available

A physician has arrived on the floor to perform a bone marrow aspiration. The nurse first

Ensures that the client has signed the informed consent form

Which cells have the major function of transporting O2 to and removing CO2 from tissues?

Erythrocytes

What factor in plasma can be transformed from a liquid to a solid?

Fibrinogen

A client undergoing a complete blood cell (CBC) count for the detection of anemia wants to know more about hemoglobin. Which of the following 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

Albumin is a protein in the plasma portion of the blood. Under normal conditions albumin cannot pass through the wall of a capillary. What significance is this for the vascular compartment?

Helps retain fluid in the vascular compartment.

Globulins are proteins contained in plasma. What is their primary function?

Immunologic agents

Macrophages attack and destroy foreign substances to the body. Where does this action occur?

In the lymph node

Your six-year-old son, Austin, was riding his bike outside and fell - resulting in an impressive case of road rash on his left lateral thigh. Since you're studying hematopoiesis in nursing school, you begin to explain the wound-healing process to him to distract him from his painful wound management. Which of the following best describes the function of fibrinogen?

It plays a key role in forming blood clots

A client has a leukocyte count of 3,000/mm3. How would the nurse document the client's condition?

Leukopenia

Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?

Liver

Which cells are white blood cells with immune functions?

Lymphocytes

Which cells are converted to red blood cells, white blood cells, and platelets?

Myeloid stem cells

Which type of white blood cell (WBC) is the most numerous?

Neutrophil

You are presenting an educational workshop for a local community group. You have been asked to speak about older adults and their health. What is the most important piece of information to include in this presentation?

Older adults are more susceptible to infections and malignancies.

Which of the following is a term used to describe the process of ingestion and digestion of bacteria by cells?

Phagocytosis

Which finding should a nurse identify as requiring further investigation?

Platelet count of 115,000/mm3

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

While hospitalized, a client accidentally injures his finger and begins to bleed. What substance does the nurse recognize as naturally rushing to the site of injury before any other action takes place?

Platelets

A client is admitted to a healthcare facility with minor lacerations on the leg. The nurse caring for this client observes swelling in the tissues surrounding the affected area. A blood clot is suspected. The nurse should know that which of the following is the first step when the formation of a blood clot begins?

Platelets break down and migrate to the injured area

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

Refuses to administer the blood

The nurse is screening donors for blood donation. The client who is an acceptable donor for blood is the client who

Reports having a cold 1 month ago that resolved quickly

Your client is taking medications that depress the hematopoietic system. What signs should you closely monitor in this client?

Signs of leukopenia and thrombocytopenia

Which of the following in a client's health history would the nurse recognize as potentially compromising the client's blood cell volume?

Splenoectomy

Which of the following terms refers to a primitive cell, capable of self-replication and differentiation?

Stem Cell

You are caring for a client who is undergoing bone marrow aspiration to determine their blood cell formation status. What nursing intervention should you provide to your client after the test?

Support the client during a bone marrow aspiration and monitor the status.

Undifferentiated cells that migrate to the thymus gland develop into which of the following?

T lymphocytes

What is hematopoiesis?

The manufacture and development of blood cells

Both the liver and the spleen have a role in erythrocyte metabolism. How would this role best be described?

The spleen removes erythrocytes after 120 days, and the liver removes severely damaged erythrocytes.

A client with a disorder of the erythrocytes asks the nurse to explain what role these cells play. What would the nurse accurately explain to the client?

Transport O2 to and remove CO2 from the tissues

The nursing instructor is teaching their clinical group about laboratory blood tests. What is the major function of erythrocytes?

Transportation of O2 to the tissues and removal of CO2 from the tissues

The client is to receive a unit of packed red blood cells. The first intervention of the nurse is to

Verify that the client has signed a written consent form.

Bone marrow is soft tissue within specific bones which manufactures blood cells; that is, maintains a role in hematopoiesis. There are several structures in the hematopoietic and lymphatic systems that contribute to the manufacture of blood cells. Which of the following structures does not participate in blood cell production?

Yellow Bone Marrow

An 84-year-old woman is to receive 2 units of packed red blood cells. During the transfusion of the first unit at 125 mL/hour, the client reports shortness of breath 30 minutes into the process. The client exhibits the vital signs shown in the accompanying table. The best nursing intervention is to:

slow the rate of the transfusion and obtain an order for furosemide (Lasix)

A client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have? Select all that apply.

• Allergy • Parasitic infection

Which of the following signs would the nurse recognize as signs of thrombocytopenia? Select all that apply.

• Dark, tarry stools • Bleeding of the gums • Oozing from injection sites

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.