Blueprint Exam Essay Example

normal finding.

And opposite is abnormal. Tender nodes may be due to inflammation, whereas, hard or fixed nodes suggest malignancy.

If a lymph node is palpated, which of the following is a normal finding? . Hard, fixed nodes b. Firm, mobile nodes c. Enlarged, tender nodes d. Hard, non-tender nodes Answer is B While examining the lymph nodes during physical assessment, the nurse would be most concerned about.. . A. Firm inguinal nodes in a patient with an infected foot. B. Inability to palpate any superficial lymph nodes. C. I-CM mobile and entendre auxiliary node. D. 2-CM nonpareil supercritical node.

Feedback: Correct Answer: D Rationale: Enlarged and entendre nodes are most suggestive of malignancy such as lymphoma.

Firm nodes are an expected finding in an area of infection. The superficial lymph nodes are usually not palpable in adults, but if they are palpable, they are normally 0. 5 to 1 CM and entendre. 3) Describe the age-related change in the hematologic system and differences in hematologic parameters. Cell loss and organ atrophy Decreased number of stem cells More vulnerable to possible problems Diminished ability to compensate Iron deficiency decreased Hem levels Iron absorption not impaired but decreased intake.

Due to intake! Fragile Orbs WEB count not changed -? except minimal elevation with infections can't rely on this Platelets unaffected by aging - vascular integrity leads to easy bruising. Hemoglobin levels begin to decrease in both men and women after middle age. The osmotic fragility of Orbs is increased in the older person. The total WEB count and differential are generally not affected by aging.

However, a decrease in humeral antibody response and decrease in T-cell function may occur.

4) Describe the purpose, the significance Of results, and the nursing responsibilities related to diagnostic studies of the hematologic system.

Assessing lymph node is part of assessing homological system The most direct means of evaluating the hematologic system is through laboratory analysis and other diagnostic studies. Complete Blood Cell Count (CB - pig 655) Red Blood cells (4-6 x 10, women < Men) Red cell indices- MCV, MCH, MCHC RBC morphology-size and shape Hmg 12-18 Hmt = 3x that! (3:1) White Blood cells (4000-11 ,000) WBC diff-determine if each wbc is present Neutrophils, eosinophils, basophils, lymphocytes, monocytes.

Platelet Count (1 50,000 - 400,000) . Pancytopenia when the entire CBC is suppressed or marked decrease in the number of RBCs, WBCs and platelets.

In such cases the patient needs care directed toward the management of anemia, infection, and hemorrhage. Erythrocyte Sedimentation Rate (1-20-Women T)- settling of Orb's in 1 hour.

Alteration of plasma proteins, result in aggregation of Orbs and make them heavier the then result with faster sedimentation rate the higher the USER. Used as a nonspecific measure of many diseases, especially inflammatory conditions. Blood typing and Re Factor- found on ORB membranes and form basis for ABA typing. Blood reactions based on ABA incompatibilities result from intramuscular hemolytic.

The agglutinate Iron Metabolism (Serum Iron 50-150 meg/del- measurement of amount Of protein bound iron circulating in the serum) normal levels indicate good storage and use. The laboratory tests seed in evaluating iron metabolism and differentiating enemies include measuring serum levels of iron, total iron-binding capacity (TIBET), serum ferreting, and transferring saturation. Radiological Studies (x-ray- nothing specific, MR.- Metal, or CT- iodine allergy) Radiological studies for the homology

system involve primarily the use of computed tomography (CT) or magnetic resonance imaging (M RI) for evaluating the spleen, liver, and lymph nodes.

Biopsies- Lymph node biopsy and bone marrow- done when peripheral blood smear is nonspecific What are the nursing responsibilities when assisting with bone marrow aspiration? Would you do anything special with this procedure if the patient had pentatonic? Where is the most common site for withdrawal of bone marrow? Bone Marrow Aspiration- Preferred site Posterior Iliac Crest (hip) Done by physician/diagnostic Conscious sedation & Local anesthetic agent Painful! -? prep pit! Post TX pressure to risk of hemorrhage. With bleeding risk as long as 5-10 minutes! Place on affected side for 30-60 minutes.

Apply sterile dregs. Risk/Complications: hemorrhage and infection! Damaging underlying structures-sternum Alternative sites = anterior iliac crest and the sternum.

Monitor the patient's vital signs until stable and assess the site for excess drainage or bleeding. If bleeding is preen, advise the patient to lie on side for 30-60 min to maintain pressure on the site. If bed is too soft, have pit lie on a rolled towel to provide additional pressure. Analgesics for post procedure pain may be administered. Soreness over the puncture site for 3-4 days after the procedure is normal.

Administer an analgesic to control pain at the site. C. Apply pressure over the site for 5 to 10 minutes. D. Elevate the head of the bed to 30 degrees. Feedback: Correct Answer: C Rationale: Because the patient has pentatonic and is at increased risk for bleeding, pressure should be applied for at least 5 to 10 minutes at the site Of the aspiration.

A Band-Aid is used to cover

the aspiration site. The patient will have pain during the aspiration, but not after the procedure is completed. There is no indication that the head needs to be elevated for this patient. A confused patient with pentatonic of unknown origin is scheduled for the following diagnostic tests.

ABA blood typing. D. Bone marrow contact the patient's family member to sign a consent form before biopsy. (correct answer) Feedback: Correct Answer: D Rationale: Bone marrow biopsy is a minor racial procedure that requires the patient or guardian to sign a surgical consent form. The other procedures do not require a signed consent by the patient or family.

Lymph Node Biopsy involves obtaining lymph tissue for histologist examination to determine the diagnosis, and to help for planning therapy.

What does a "shift to the left" mean? How would this affect the interruption counts? An increase in percent of bands is called a shift to the left, meaning the bone marrow is releasing less-mature cells into circulation in response to a site of injury (increased in acute infection and inflammation) The history and hysterical for a newly admitted patient states that the CB shows a "shift to the left. " The nurse will plan to monitor the patient for..

Feedback: Correct Answer: A Rationale: The term shift to the left indicates that the number of immature polyurethane's interruptions, or bands, is elevated and is a sign of severe infection.

There is no indication in the stem that the patient is at risk for hyperemia, pallor/weakness, or cool extremities. What changes can you expect in these tests in the aging adult? CB Hob- normal- possible decrease in men MAC- slight increased MUCH-

slight decrease WEB count platelets-unchanged USER- Increased significantly Serum iron decreased MIST know normal CB ranges - at least three questions related to this!

Recognize both normal and abnormal. INNER - expected range for therapeutic management? 2-3 5) Describe the general clinical manifestations, management and complications of anemia. Anemia deficiency in the number of erythrocytes, quantity of hemoglobin and volume of packed Orbs (homoerotic).

Hypoxia accounts for s/s of anemia. Anemia is not a specific disease, it is a manifestation of a pathologic process. Grouped according to either morphologic or etiologic. Manifestation palpitations, dyspepsia and fatigue. Moderate anemia will experience them while resting.

Fatigue is a prominent symptom in hematologic disorder ask about feelings of tiredness and any change In pit ODL should be noted BC patients safety or risk for fall. Expected lab changes with iron deficiency anemia? H, iron, I TIBET, 1 MUCH and MAC 6) Describe the etiologies, specific clinical manifestations, diagnostic findings, and nursing and collaborative management of anemia studies. TX: iron supplements- causes constipation. Interventions- increase fluids, ambulation, fiber What are normal lab results related to homology? Hem, Hem, ORB, WEB, platelets, ART, INNER, etc.

Pentatonic is decrease of all blood cell types orb, web, and platelets. Commonly seen with plastic anemia. Nursing actions are directed at preventing complications from infection and hemorrhage. Removing the causative agent.

Transfusion, apogee, unpaged What is the treatment for plastic anemia? For best or most successful outcomes? Treatment of plastic anemia is based on identifying and removing the causative agent and providing supportive care until the encyclopedia reverses. Nursing interventions include Energy management, nutrition management, nutritional counseling and teaching prescribed medication.

Rare but one of the most

severe. Supportive Care- platelets TX= include homeopathic stem cell transplant and Mispronunciation with the drugs TAG and kaleidoscopically.

Tx of choice for adults less than 45 is HOST for older adult mispronunciation. Bone marrow replacement- watch for other blood disorders after transplant. (Reverse isolation). Stool softener, limit injection, Plastic anemia is a disease in which the patient has peripheral load pentatonic (decrease of all blood cell types) and hypothetical bone marrow.

Management of plastic anemia is based on identifying and removing the causative agent (when possible) and providing supportive care until the pentatonic reverses What dietary recommendations would help meet the needs of a patient with iron deficiency anemia? And for folic acid deficiency anemia? Provide information about medications that may inhibit iron absorption like antacids, tetracycline's, soft drinks, tea, coffee, calcium, phosphorus and magnesium salts. Teach patient how to keep a food diary to help evaluate nutritional intake. Knowledge of diet.

Iron rich foods include liver muscle meats, eggs, dried fruits, legumes dark green leafy vegetables, whole grain and enriched bread and cereals, potatoes. Folic acid rich food include green leafy vegetables, liver, meat, fish, legumes, whole grains What is and causes pernicious anemia? How will it be diagnosed? What med/ meds are given for pernicious anemia? Pernicious Anemia= Cause GIG diseases such as Croons, gastronomy, resections and runs in families.

Signs: anemia, ore tongue (glottis) , anorexia, WV, bad pain, weakness, ataxia (abnormal movements), decreased senses, parenthesis (numbness and tingling)of the hands/feet. DXL: low ORB count, low Hem but Hem WIN_ due to large size Of ORB. Low Bal 2. Schillings Test (come back abnormal can be a diagnostic.

Radioactive dye and see how much you

excrete, if not excreted then being in absorbed). T x: Vitamin BIB injections. (deep IM, dark in color, give Struck) Patient Education: Altered safety r/t decreased sensations Risk of GIG cancer Interruption - what would be signs/symptoms of infection?

Interruptions play major role in phagocytes microbes Defined as less than 1 000 cells/LU Most common cause insuppressible therapy. Classic signs of inflammation may not occur as well as pus formation. Fever greater than 100.

Monitor absolute granulocytic count, WEB count, and WEB dif to identify signs of and potential for infection Hand washing is the single most important preventive measure n minimizing the risk Of infection in the entropic patient. When a febrile episode occurs fax must be initiated immediately even before the determination of a specific causative organism by culture Polytheism - nursing care and assessment? Treatment? Increased production in numbers of Orbs. Causes blood circulation to be impaired as a result from increased blood viscosity and volume.

The need for 02 may be due to high altitude, pulmonary disease, cardiovascular disease, alveolar hyperventilation, defective 02 transport, or tissue hypoxia. Treatment- phlebotomy to reduce homoerotic.

Iron supplementation should be avoided ND hydration therapy used to reduce the blood viscosity. Low dose aspirin is used a primary prophylaxis vascular evens. Pulmonary' disorders that lead to hyperemia may cause chronic stimulation Of erythrocytes and result in polytheism. ) Describe the pathophysiology, clinical manifestations, and nursing care for the different types of thermodynamic and interruption. Immune Thermodynamic Purport Most common.

Immune system destruction of platelets. Thrombosis Trigonometric Purport (HTTP)=bedding and clotting at the same time Heparin Induced Thermodynamic increase clotting with heparin Tx- protect patient room bleeding, Lower the

platelet count the stricter those precautions In general, skin and mucosa bleeding indicates a platelet disorder.

Spontaneous bleeding into joints or muscles indicates a coagulation factor problem or trauma. Patchier, cosmoses and spider nevus indicate bleeding disorders. Notify health care provider Of any manifestations of bleeding, ask health car provider regarding restrictions in your normal activities, like vigorous exercise.

Don not blow nose forcefully. Do not bend down with your head lower than your waist. Prevent constipation and do not strain when having a Lowell movement use electric razor, avoid using Nasals Use soft bristle toothbrush to prevent -?gum injuries.

Ask your health care provider if you have any invasive procedures done What causes heparin-induced thermodynamic (HITS? Etiology behind the trouble with clotting? How is it TX's? Heparin One of the risks associated with the broad and increasing use of heparin is the development of the life-threatening condition called heparin-induced thermodynamic (HIT). Heparin must be discontinued when HIT is first recognized, which is usually if the patient's platelet count has fallen 50% or ore from its baseline or if a thrombus forms while the patient is on heparin therapy.

Clinical manifestations- clot formation pathophysiology- gig binds with platelet factor and heparin What is the treatment for idiopathic thermodynamic purport (IT P)? The most Common acquired thermodynamic is a syndrome Of abnormal destruction of circulating platelets termed immune trigonometric purport (TIP). Multiple therapies are used to manage the patient with TIP, such as corticosteroids or supplements. Clinical manifestations pathophysiology Do you know the difference between thermodynamic, hemophilia A, atropines, and sickle cell anemia?

Thermodynamic is a reduction of platelets below 150,000/Pl (150 x 109/1_). Replacement of deficient

clotting factors is the primary means of supporting a patient with hemophilia. In addition to treating acute crises, replacement therapy may be given before surgery and dental care provided as a prophylactic measure. Hemophilia is a sex-linked recessive genetic disorder caused by defective or deficient coagulation factor.