Chap 28 Nursing Care of Patients with Hematologic and Lymphatic Disorders – Flashcards
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The nurse is caring for a patient with anemia. Which blood component is deficient in this patient?
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RBCs
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A patient is diagnosed with anemia and asks the nurse what nutrients are important for RBC formation. The nurse bases an answer on the understanding that which nutrients are essential for production of healthy red cells?
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Iron, folic acid, and vitamin B12
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A patient with iron-deficiency anemia has been taking oral iron supplements. Which test should the nurse review to determine the effectiveness of this intervention?
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Hemoglobin and Hct
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The nurse is assisting in the development of a care plan for a patient with anemia. Which nursing diagnosis is most common in a patient with anemia?
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Activity intolerance related to tissue hypoxia
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The nurse is providing dietary teaching to an individual with iron-deficiency anemia. Which patient statement indicates that teaching has been effective?
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Orange juice and red meats
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The nurse is preparing to give an injection of iron (Imferon) to a patient with anemia. What is the rationale for using the Z-track method for injection?
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Prevent discoloration of tissue at the site
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A patient with thrombocytopenia is having pain. What kind of pain medication should have been prescribed? IV? PO?
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Acetaminophen with codeine, PO
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The nurse is caring for a patient with thrombocytopenia. What kind of activity should be avoided?
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Sports, any injection
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A patient with aplastic anemia is to receive an injection of erythropoietin (Epogen). The patient asks what the injection is intended to do. How should the nurse respond to the patient?
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Epogen stimulates the body to produce more RBCs.
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A patient is admitted in sickle cell crisis with symptoms of dyspnea and leg pain. The patient's significant other asks, " I don't know understand why he is hurting so badly". What should the nurse respond?
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Clumping of abnormal RBCs blocks the flow of blood through the blood vessels
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The nurse is reviewing the current patient census on a care area. Who is most likely to present with s/s of sickle cell anemia?
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African American who is older than the age of 6 months
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The nurse is caring for a patient in sickle cell crisis. What is the rationale for providing warm compresses and blankets for this patient?
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Heat prevents vasoconstriction and impaired circulation
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The nurse is teaching a patient with sickle cell anemia how to prevent crises. What kind of foods should the nurse teach the patient to avoid?
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Alcoholic beverages
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A patient is admitted to the hospital with hypertension and vertigo related to polycythemia vera (PV). For which treatment should the nurse prepare the patient?
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Therapeutic phlebotomy
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The nurse is caring for a patient with PV. Which laboratory study should the nurse monitor to help evaluate the effectiveness of treatment for this patient?
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Hematocrit
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The nurse is planning discharge teaching for a patient with polycythemia. Which nursing intervention should the nurse consider to help prevent complications in this patient?
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Encourage 3 L of water intake daily
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The nurse is caring for a patient with a bleeding disorder. Which manifestation might first alert the nurse to the possibility of DIC?
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Petechiae
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The nurse is caring for a patient with a bleeding disorder. Which medication order should the nurse question?
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Aspirin
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The nurse is caring for a patient with a clotting disorder. which blood product should the nurse anticipate being prescribed?
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Cryoprecipitates
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The nurse is reviewing the care plan for a patient with disseminated intravascular coagulation. Which nursing intervention is most likely to cause an acute complication in this patient?
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Administering IM meperidine for pain
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The nurse is assessing a patient with a bleeding disorder and finds large purplish areas in the skin and oral mucosa. Which term should the nurse use to document this finding?
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Purpura
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A comatose patient is admitted to the emergency department after an automobile accident. The nurse notes a Medic Alert identification bracelet that states the patient has hemophilia. What should the nurse do first?
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Notify the physician of the bracelet
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A nurse is assisting with data collection on a newly admitted patient with a history of hemophilia. Which assessment finding indicates that the patient has experienced some severe episodes of bleeding in the past?
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Join deformities
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A patient walks into the urgent care clinic, stating that he has hemophilia and that he is bleeding. The triage nurse does a quick assessment and sees no signs of active bleeding. Several patients are already in the waiting area. Which action by the nurse is most appropriate?
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Place the patient in an examination room and tell the physician that the patient may be bleeding
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A patient with hemophilia A is bleeding. Which treatment should the nurse anticipate being prescribed for this patient?
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IV infusion of factor VIII
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A 54-year-old patient is admitted to the hospital in the final stage of chronic lymphocytic leukemia (CLL). Which manifestation of CLL should the nurse expect to find while collecting admission data?
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Fever and abnormal bleeding
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The nurse is identifying approaches to reduce the risk of infection in a patient with leukemia. Why is it important for the nurse to institute infection control measures for this patient?
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Impaired immune system of the patient due to leukemia
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A patient is being tested for possible leukemia. With which diagnostic test should the nurse anticipate assisting?
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Bone marrow biopsy
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The nurse is emptying the bedside commode of a patient with chronic leukemia and notes that the stool is very dark. Which assumption should guide the nurse's action?
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The patient may be bleeding
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A patient receiving chemotherapy for chronic myelocytic leukemia has irritated mucous membranes. Which mouth care intervention should the nurse include in the plan of care?
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Use sponge toothettes to clean teeth after meals
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A patient with multiple myeloma is being cared for at home. Which nursing diagnosis should guide the nurse when teaching the family how to provide care for the patient?
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Risk for injury related to compromised bone integrity
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A patient with multiple myeloma is at risk for hypercalcemia. Which nursing intervention is most important for this patient?
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Encourage fluids
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The nurse is determining the effectiveness of treatment prescribed for a patient with anemia. Which question should the nurse use to make this evaluation?
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Are you keeping up with your work schedule?
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A patient with Hodgkin's disease has cervical lymph node enlargement. Which symptom should the nurse attend to first?
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Stridor
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The nurse is preparing teaching for a patient with Hodgkins disease Which beverage should the nurse instruct this patient to avoid?
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Alcohol
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The nurse is assessing a patient with stage III Hodgkin's disease. Where should the nurse expect to find enlarged lymph nodes?
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Throughout the body
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A patient with lymphoma wants to attend a family member's wedding but is extremely fatigued. The nurse develops a plan for activity intolerance related to symptoms of lymphoma. How will the nurse know if the plan has been effective?
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The patient attends the wedding
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A patient is being prepared for splenectomy. what is the purpose of the order for a vitamin K injection?
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It corrects clotting factor deficiencies
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The nurse is providing care for a patient who has had a splenectomy. Which nursing action has the highest priority?
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Teach the patient to cough and deep breathe every hour
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A patient who has had a splenectomy complains of malaise. The nurse checks the patient's temperature and finds it is 102F. Which action by the nurse should take priority?
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Notify the physician
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The nurse is collaborating on discharge teaching needed for a patient recovering from a splenectomy. What follow-up care is most important for the nurse to emphasize with this patient?
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Vaccination
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The nurse is preparing to provide care to a patient recovering from surgery. What nursing action is the best way to prevent infection in a postoperative patient?
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Hand hygiene
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The nurse is reviewing laboratory results for a patient with a blood disorder. Reduced fibrinogen and platelet levels, increased thrombin time, and reduced factor assays are laboratory results associated with which hematological disorder?
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DIC
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A patient with anemia and a nursing diagnosis of activity intolerance due to tissue hypoxia and dyspnea is attempting to increase activity tolerance. What percentage of increase in pulse and resp rate should the nurse use to determine if the activity is too strenuous for the patient?
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20%
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A patient has a platelet count of 20,000/mm3. What action should the nurse take?
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Place on bleeding precautions
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The nurse suspects a patient has polycythemia. Which hematocrit value is causing the nurse to have this concern?
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58%
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The nurse is preparing teaching materials for a patient with PV. How many liters of fluid should the nurse instruct the patient to consume each day?
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3
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The daughter of a male patient with hemophilia is concerned about transmitting the genetic disorder to any future children. What percentage of chance of transmitting the gene to future children should the nurse instruct the daughter?
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50%
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The nurse is providing education to an individual with sickle cell anemia. Which activities should the nurse instruct the patient to avoid?
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Scuba diving, skiing in the mountains
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The nurse is collecting information about the sickle cell disease for an upcoming seminar. What should the nurse include as common triggers for a sickle cell crisis?
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Anesthesia, infection, exercise, blood loss
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The nurse suspects a patient is experiencing manifestation of Hodgkin's disease. Which are characteristics of this disease?
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The most curable of all lymphomas, Reed-Stenburg cells, Painless swelling
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During a home visit, the nurse becomes concerned that a child is developing ITP. Which health problems could have precipitated the development of this disorder in the child?
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HIV, Rubella, Hep C, Chickenpox
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A patient is planning to have an allogeneic bone marrow transplant. What will the patient most likely have complete before this transplant occurs?
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Total body irradiation, High-dose chemo
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During a home visit, the nurse becomes concerned that a patient recovering from a splenectomy is at risk for infection. What did the nurse observe to come to this conclusion?
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Received a manicure and pedicure, pored a cup of coffee without washing hands, Had a hot tub, planting flowers in the garden
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A patient is diagnosed with a folic acid deficiency. On what dietary changes should the nurse instruct this patient?
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Peanuts, bread fortified with folic acid, green leafy vegetables, beans
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The nurse is caring for a PT scheduled for tests to confirm the diagnosis of lymphoma. What kind of diagnostic tests should the nurse prepare for this patient?
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CT, lymph node biopsy, lymphangiography, CBC
