Term 3 Unit 2 Hematology CH 30
Which client is not a candidate to be a blood donor according to the American Red Cross?
26-year-old female with hemoglobin 11.0 g/dL
Using a penlight and tongue blade, the nurse inspects the client's tonsils for size and appearance. Tonsils are present and touch the uvula. How should the nurse grade these findings?
3
A client with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells (RBCs). If the nurse hangs the blood at 12:00 pm, by what time must the infusion be completed?
4:00 pm
An instructor asks students approximately how long platelets last? What would the students correctly identify?
7.5 days
A client with Hodgkin disease had a bone marrow biopsy yesterday and reports aching at the biopsy site, rated a 5 (on a 1-10 scale). After assessing the biopsy site, which nursing intervention is most appropriate?
Administer acetaminophen 500 mg po, as ordered
Plasma proteins play an essential role in maintaining water balance and blood pressure. Select the laboratory analysis that a nurse should review to check the levels of the most abundant plasma protein.
Albumin
A nurse is assigned to care for a patient with ascites, secondary to cirrhosis. The nurse understands that the fluid accumulation in the peritoneal cavity results from a combination of factors including an alteration in oncotic pressure gradients and increased capillary permeability. Therefore, the nurse monitors the serum level of the plasma protein responsible for maintaining oncotic pressure, which is:
Albumin.
A client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have?
Allergy
A client with myelodysplastic syndromes (MDS) receives routine blood transfusions. Which treatment will the nurse expect to be prescribed to prevent the development of iron overload?
Chelation therapy
A volunteer wanting to donate blood for the first time wishes to know more about the various blood groups. The nurse educating the volunteer regarding the blood groups should mention which of the following as the determining factor that classifies blood into groups A, B, AB, and O?
Combinations of antigens and antibodies
A 66-year-old man underwent a successful partial gastrectomy for the treatment of stomach cancer 3 years ago. The man had a scheduled follow-up appointment with his primary caregiver and had blood work completed. The results of the man's blood work indicated anemia. The nurse who is contributing to the patient's care should recognize that this patient's anemia may be attributable to what factor?
Decreased vitamin B12 absorption
A client needs increased production of red blood cells. Which of the following drugs would the nurse expect to be prescribed for the client?
Epoetin alfa
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is the most likely clinical disorder the patient is being treated for?
Essential thrombocythemia
Iron toxicity
Hemochromatosis
A nurse is caring for a patient who has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the patient for?
Hemorrhage
A client is scheduled for surgery to remove an abdominal mass. The nurse knows that which reason hemodilution would be contraindicated as a method to provide blood to the client during the surgery?
History of renal disease
The nurse educating a client with anemia is describing the process of red blood cell production. When the client's kidneys sense a low level of oxygen in circulating blood, which physiologic response is initiated?
Increased levels of erythropoietin
A patient who has long-term packed RBC (PRBC) transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that can help prevent organ damage?
Iron chelation therapy
The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in?
Lateral position with one leg flexed
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
Neutrophils
Most abundant white blood cell., The most abundant type of white blood cell. Phagocytic and tend to self-destruct as they destroy foreign invaders, limiting their life span to a few days.
febrile nonhemolytic reaction
Most common blood transfusion reaction; sudden chills and fever, headaches, flushing, anxiety, and muscle pain
Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?
Myeloid stem cell
Which type of white blood cell (WBC) is the most numerous?
Neutrophil
A nurse cares for a client with iron-deficiency anemia. Which treatment will the nurse anticipate the client receiving?
Oral iron supplementation
Transfusion Related Acute Lung Injury (TRALI)
Resp distress and signs of noncardiogenic pulmonary edema Within 6 hours of transfusion Caused by donor anti-leukocyte antibodies
A client's diagnosis of atrial fibrillation has prompted the primary care provider to prescribe warfarin. When assessing the therapeutic response to this medication, which action by the nurse is the most appropriate?
Review the client's international normalized ratio (INR).
The nurse's review of a client's most recent blood work reveals a significant increase in the number of band cells. The nurse's subsequent assessment should focus on which of the following?
Signs and symptoms of infection
Which type of lymphocyte is responsible for cellular immunity?
T lymphocyte
The health care provider believes that the client has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?
T lymphocytes
A client who received 2 units of packed red blood cells 3 hours ago reports a new onset of dyspnea. Which additional assessment findings indicate to the nurse that the client is developing transfusion-related acute lung injury (TRALI)? Select all that apply.
Temperature 102oF (38.8oC) Blood pressure 78/50 mm Hg Oxygen saturation 88% on room air
A client is visiting the physician and has signs and symptoms consistent with anemia. Why would the nurse ask the client about recent travel to foreign countries.
The agent that causes malaria following the bite of an infected mosquito invades erythrocytes and causes anemia.
The nurse is administering a blood transfusion to a client over 4 hours. After 2 hours, the client reports chills and has a fever of 101°F, an increase from a previous temperature of 99.2°F. What does the nurse recognize is occurring with this client?
The client is having a febrile nonhemolytic reaction.
While caring for a client, the nurse notes petechiae on the client's trunk and lower extremities. What precaution will the nurse take when caring for this client?
Use an electric razor when assisting client with shaving.
A client with myelodysplastic syndromes (MDS) routinely takes oral chelation therapy. Which assessment findings indicate to the nurse that the client is experiencing side effects from this treatment? Select all that apply.
Vomiting Skin rash Diarrhea
he nurse recognizes that the most common cause of iron deficiency anemia in an adult is
bleeding.
Which cells have the major function of transporting O2 to and removing CO2 from tissues?
erythrocytes
Hemochromatosis
excess iron deposits throughout the body
Which cells are called white blood cells?
leukocytes
Fibrinogen
plasma protein that is converted to fibrin in the clotting process
The nurse is explaining the wound-healing process to a patient. Which best describes the function of fibrinogen?
plays a key role in forming blood clots
A nurse has participated in organizing a blood donation drive at a local community center. Which client would most likely be disallowed from donating blood?
A client whose blood pressure is 78/49 mm Hg
A client is experiencing symptoms of myelodysplastic syndrome (MDS). The nurse prepare the client for which type of test to aid in diagnosing this condition?
Bone marrow aspiration and biopsy
An 8-year-old client is scheduled to undergo a tonsillectomy for chronic tonsillitis. The symptoms given below are related to tonsil disorders. The nurse caring for this client should know that which of the following symptoms is specifically related to tonsillitis?
Difficulty swallowing
A nurse is performing an initial assessment and notes the client's skin is a gray-tan color, especially on the scars of the client's arms. Which hematological condition does the nurse suspect?
Hemochromatosis
When reviewing a client's chart, the nurse notes that the client's tonsils are listed as grade 3. How does the nurse interpret this finding?
The client's tonsils are touching the uvula.
The nurse is caring for a client with hypoxia. What does the nurse understand is true regarding the client's oxygen level and the production of red blood cells?
The kidneys sense low oxygen levels in the blood and stimulate erythropoietin, stimulating the marrow to produce more red blood cells.
A client will be having a bone marrow aspiration to determine the status of blood cell formation. What role does the nurse have during the test?
The nurse assists the physician and supports the client during the procedure.
