Prepu Chpt 23 Disorders of Red Blood Cells
The nursing is reviewing assessment data of four clients. Which client is at greatest risk for developing pernicious anemia?
A client who has undergone partial gastrectomy
A person with type A blood who exhibits the D antigen would be considered to have which blood type?
A+ Explanation: Persons who express the D antigen are designated Rh positive.
A nurse is preparing her client for a blood transfusion. She knows that a client with type A blood is said to have which type of antibodies?
B
The nurse is assessing an 83-year-old adult client for signs and symptoms of anemia. What normal, age-related change increases this client's risk for anemia?
Blood cells are not replaced as quickly as they are in younger clients.
A client with iron-deficiency anemia reports feeling "tired all of the time." What does the nurse understand may be the cause of the fatigue that the client is experiencing?
Chronic blood loss with inadequate iron available for recycling
Clients with lung disease can develop polycythemia as a result of which condition?
Chronic hypoxia
An older adult with an 80 pack/year history of smoking is diagnosed with emphysema. Recent blood work shows excessive production of red blood cells (erythrocytes), a problem that suggests the need for which intervention?
Continuous supplementary oxygen therapy
Which conditions predispose a person with sickle cell anemia to develop sickling of hemoglobin?
Decreased oxygen saturation
The nurse is assessing a female client with a hemoglobin of 6.8 g/dL (68 g/L). Which symptoms would the nurse expect to find? Select all that apply.
Dyspnea Headache Faintness
Which trend in the hematologic status of a 6-week-old infant (born at 32 weeks' gestation) most clearly warrants medical intervention?
Extremely low hematocrit
The surgical nurse is administering a unit of packed red blood cells to the postoperative client. Which of the following is the most common transfusion reaction?
Febrile reaction
The provider notes that the client's hemoglobin is 8.2 g/dL (82 g/L). Which supplement will the provider recommend to the client?
Ferrous sulfate
The client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which complete blood count (CBC) result is characteristic of this type of anemia?
Hemoglobin 7.8 g/dL (78 g/L)
A nurse is assessing a client who displays pale skin and nail beds. Which laboratory data should the nurse evaluate?
Hemoglobin level
When an Rh-negative mother gives birth to an Rh-positive infant, the mother usually produces antibodies that will attack any subsequent pregnancies in which the fetus is Rh positive. When subsequent babies are Rh positive, erythroblastosis fetalis occurs. What is another name for erythroblastosis fetalis?
Hemolytic disease of the newborn
The client presents with a reduction in red blood cells, white blood cells, and platelets. The practitioner is unable to determine the cause of the client's condition. Which type of anemia does the client have?
Idiopathic aplastic
The pathologic effects of the thalassemias are primarily due to which pathophysiologic process?
Impaired hemoglobin synthesis
Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory increase in which physiologic process?
Increased erythropoiesis
A client undergoing emergent open heart surgery receives an autologous transfusion that has been collected from the operative site. This type of collection is known as which of the following?
Intraoperative salvage
The rate at which hemoglobin is synthesized depends on availability of which substance?
Iron
A nurse is teaching parents of an infant diagnosed with β-thalassemia about major complications of the disease. The nurse determines that the parents understand when they correctly identify which as a major complication of β-thalassemia?
Iron overload
A pediatric nurse is treating a 2-day-old infant for jaundice. The treatment involves exposing the infant's skin to fluorescent light at 420-470 nm wavelengths. What does the light do to the bilirubin?
It converts the bilirubin into a soluble form that is easily excreted in the stool and urine.
A nursing instructor questions students on the removal of erythrocytes from the body. The instructor knows the students understand when they correctly identify which anatomic locations are the site of removal of aged RBCs by phagocytosis? Select all that apply.
Liver Spleen Bone marrow
A client is experiencing fatigue and laboratory results reveal: Hct 40% (0.40); Hgb 8 g/dL (80 g/L); WBC 8000 (8 x 109/L); and platelets 175,000/ µL (175 ×109/L). The nurse would interpret these results as indicative of which diagnosis?
Low hemoglobin/anemia
A 40-year-old client is admitted to the hospital after experiencing 3 days of extreme vomiting. The doctor reviews the lab results and notes that the hemoglobin and hematocrit are elevated. What is the likely cause of these abnormal lab findings?
Manifestation of dehydration
When a 3-day-old full-term infant has an elevated bilirubin level of 18 mg/dL (307.87 μmol/L), the nurse will expect to support which intervention?
Phototherapy
A client presents to his physician with a red face, hands, feet, and ears; a headache; and drowsiness. A blood smear reveals an increased number of erythrocytes. Based on the laboratory results, the nurse prepares teaching material for which disease process?
Polycythemia
A client presents to the clinic with symptoms of elevated blood pressure, dizziness, red face, pain in fingers and toes, headache, and difficulty concentrating. A blood smear reveals an increased number of erythrocytes. Based on these findings, the nurse anticipates which diagnosis?
Polycythemia vera
A client tells the nurse that the doctor told her she has too many red blood cells accompanied by elevated white cells and platelet counts. The nurse recognizes this as:
Polycythemia vera
The client explains to her new provider that she receives periodic phlebotomies to decrease her red blood cell mass. The provider believes the client may have:
Polycythemia vera
The nurse is preparing a client with suspected leukemia for a bone marrow and biopsy. What preferred site will the nurse be sure is accessible for the physician?
Posterior iliac crest
Which anatomical site would the nurse expect to monitor when caring for an adult client who has just had a bone marrow aspiration performed?
Posterior iliac crest
The nurse teaching a client with a deficiency of glucose-6-phosphate-dehydrogenase (G6PD) should instruct the client to avoid taking which medications?
Primaquine
The nurse is caring for a client diagnosed with sickle cell disease. For which factor should the nurse assess to prevent the cells from sickling?
Reduced oxygen tension while the client sleeps
The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which organ?
Spleen
When red blood cells age, which organ is responsible for their destruction?
Spleen
The dietary student is studying folic acid deficiency. The faculty member knows the student is ready to teach clients about this topic when the student makes which statement?
The 30-year-old client who is trying to become pregnant should evaluate her folic acid intake.
A client with iron-deficiency anemia asks, "What does this low mean corpuscular volume (MCV) level mean?" Which response by the nurse is most accurate?
The MCV is one red blood cell (RBC) index that indicates your RBCs are small cells.
A hospital laboratory technologist is analyzing the complete blood count (CBC) of a hospital client. Which statement best reflects an aspect of the platelets that would constitute part of the CBC?
The half-life of a platelet is typically around 8 to 12 days.
The nurse is caring for a 2-day-old newborn infant who appears lethargic and has a yellowish tint to the skin. Select the most likely cause of this newborn's signs and symptoms.
The inability of the immature liver to conjugate bilirubin
When it is determined that a client's red blood cells (RBCs) have a biconcave shape, what will be the nurse's reaction
The nurse will be pleased, as that shape allows for increased oxygen diffusion.
An infant from parents of Mediterranean decent has been diagnosed with a severe form of β-thalassemia anemia. The nurse caring for this infant knows that the infant will most likely receive which medical treatment?
Transfusion therapy
A nurse is teaching parents expecting their first child about the benefits of umbilical cord blood donation. The nurse determines teaching was effective based on which statement?
Umbilical cord blood can provide stem cells for transplantation.
The nurse is teaching a 65-year-old client who is anemic. The client has a history of gastric bypass surgery and his lab work shows a cobalamin deficiency. Which recommendation will help the client maintain an adequate level of cobalamin?
You will need lifelong treatment consisting of intramuscular vitamin B12 injections.
A 6-month-old infant was born with a heart murmur. The pediatrician is recommending valve replacement/repair surgery, based on which laboratory result indicating intravascular hemolysis?
excess of hemoglobin in the blood plasma (hemoglobinemia)
A female client comes to the clinic with symptoms of fatigue and heavy menses over the past 6 months. Laboratory tests reveal a microcytic hypochromic anemia. Based on these results, the nurse anticipates teaching the client about which type of anemia?
iron-deficiency anemia
Megaloblastic anemias caused by folic acid or vitamin B12 deficiencies can seriously affect red blood cell (RBC) production. Which laboratory result correlates with this diagnosis?
mean corpuscular volume (MCV) 120 fl (high) Megaloblastic anemias are caused by impaired DNA synthesis that results in enlarged red cells (MCV >100 fl) due to impaired maturation and division.
All cells of the body age and are replaced in a natural order. When RBCs age, they are destroyed in the spleen. During this process, the iron from their hemoglobin is released into the circulation and returned
to the bone marrow for incorporation into new RBCs.
All cells of the body age and are replaced in a natural order. When RBCs age, they are destroyed in the spleen. During this process, the iron from their hemoglobin is released into the circulation and returned:
to the bone marrow for incorporation into new RBCs.
