chapter 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? a. plasma b. platelets c. red blood cells d. white blood cells
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C red blood cells
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A patient is diagnosed with anemia and ask the nurse what nutrients are important for RBC formation. The nurse bases in the answer on the understanding that which nutrients are essential for production of healthy red cells? A. iron, folic acid, and vitamin b12 B. vitamin C, vitamin D, and selenium C. vitamin A, calcium, and phosphorus D. aluminum, vitamin E, and beta carotene
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A 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? A. hemoglobin and hematocrit B. WBC and platelet counts C. electrolytes, blood urea nitrogen, and creatinine D. thrombin clotting time and pro thrombin time
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A. Hemoglobin and hematocrit
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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? A. Activity intolerance related to tissue hypoxia B. ineffective airway clearance related to dyspnea C. chronic pain related to bone marrow dysfunction D. risk for infection related to reduction in circulating WBC's
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A 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? A. I know I need to eat more green vegetables and dairy products. B. berries and natural cereals are good for me because of my low iron levels. c. I'm going to drink orange juice for breakfast and increase red meat in my diet. D. yellow vegetables and green tea will be important to help build up my blood levels.
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C I'm going to drink orange juice for breakfast and increase red meats in my diet
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The nurse is preparing to give an injection of iron to a patient with anemia. What is the rationale for using the Z track method for injection? A. prevent pain at the site B. prevent tissue damage at the site C. promote absorption of the medication D. prevent discoloration of tissue at the site
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D prevent discoloration of tissue at the site
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A patient with thrombocytopenia is having pain. If each of the following medications as ordered, which should the nurse choose to administer? a. morphine SQ B. meperidine IM C. Oxycodone with aspirin PO D. Acetaminophen with codeine p0
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D acetaminophen with codeine PO
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The nurse is caring for a patient with thrombocytopenia. which activity should be avoided? A. ambulation V. intramuscular injections B. visits from family members D. eating fresh fruits and vegetables
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B intramuscular injections
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A patient with aplastic anemia is to receive an injection of erythropoietin. The patient asks what the injection is intended to do. Which should the nurse respond to the patient? 8. It will inhibit the protein that is attacking your blood cells. Bee. It works like a blood transfusion to give you extra red blood cells C. it will stimulate your body to produce more of its own red blood cells D. it will increase your energy while your body is recovering from the anemia
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C it will stimulate your body to produce more of its own red blood cells
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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 really understand why he is hurting so badly. Which response by the nurse is best? A. The pain is due to a disturbance in cellular metabolism B. the bone marrow is expanding with the sickle cells and that causes pain B. clumping of abnormal red blood cells blocks the flow of blood through the capillaries D. bleeding in the joints occurs because red blood cells are being rapidly destroyed by the bone marrow
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C clumping of abnormal red blood cells blocks the flow of blood through the capillaries
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The nurse is reviewing the current patient census on it care area. Which individual is most likely to present with signs or symptoms of sickle cell anemia? A. a one month old boy who is Hispanic B. a 5 year old girl of Hispanic origin C. 1 year old boy who is African American D. A 3 month old girl who is African American
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C a 1 year old boy who is African American
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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? A. sickle cell crisis causes shivering and discomfort B. helps prevent the cells from becoming sick old C. heat speeds production of new healthy RBCs D. heat prevents vasoconstriction and impaired circulation
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D heat prevents vasoconstriction and impaired circulation
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The nurse is teaching a patient with sickle cell anemia how to prevent crises. Which foods should the nurse teach the patient to avoid? A citrus fruits B alcoholic beverages C. Chocolates and colas D. whole grain products
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B alcoholic beverages
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A patient is admitted to the hospital with hypertension and vertigo related to polycythemia vera. for which treatment should the nurse prepare the patient? A. myelogram B. Splenectomy C. therapeutic phlebotomy D. injection of colony stimulating factors
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C 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? A hematocrit B total protein C. blood urea nitrogen D WBC differential
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A hematocrit
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The nurse is planning discharge teaching for a patient with polycythemia. Which nursing intervention she's a nurse consider to help prevent complications in this patient? A monitor intake and output B. Avoid use of injections for pain C. Maintain bed rest during treatment D encourage 3 liters of water intake daily
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D encourage 3 liters 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 disseminated intravascular coagulation? A petechiae B. Absence of pulses in extremities C. Weakness or paralysis on one side D. Increasing blood pressure and pulse
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A petechiae
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The nurse is caring for a patient with a bleeding disorder. Which medication order should the nurse question? A aspirin B morphine C dioxin D. Thyroid hormone
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A 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? A albumin B normal saline C cryroprecipitates D. Packed WBC's
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C cryroprecipitates
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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? A placing the patient on strict bed rest B providing a diet that is high in fat and sodium C administering intramuscular Demerol for pain D allowing a family member with a respiratory infection to visit
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C administering intramuscular Demerol 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? A purpura B bleeding C petechiae D. Hemorrhage
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A 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? A notify the physician of the bracelets B tape the bracelet to the patient's arm C call the phone number on the bracelet D remove the bracelet and give it to the patient's family member
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A notify the position of the bracelets
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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? A joint deformities B distended abdomen C ecchymosis on the extremities D elevated WBC count
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A joint 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? A palpate the suspected area for tenderness and edema B ask the patient to sit in the waiting room until his name is called C place the patient in an examination room and tell the physician that the patient may be bleeding D send the patient for routine x-rays according to clinic protocol to look for source of bleeding, and then placed him in an examination room
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C 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? A. IV infusion of factor IX B im injection of factor IX C IV infusion of factor VIII D im injection of factor VIII
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D 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. which manifestations of CLL should the nurse expect to find while collecting admission data? A nausea and vomiting Be hypotension and alopecia C fever and abnormal bleeding D cervical lymphadenopathy and chest pain
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C 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? A infection can precipitate hemorrhage in the patient with leukemia Be the drugs needed to fight infection have life-threatening side effects C infection in the patient with leukemia can lead to permanent neurological damage D leukemia seriously and paris the leukocytes in the body's ability to fight infection
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D leukemia seriously impairs the leukocytes in the body's ability to fight infection
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A patient is being tested for possible leukemia. With which diagnostic test should the nurse anticipate assisting? A liver biopsy B thoracentesis C bone marrow biopsy D arterial blood gas analysis
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C 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? A the patient may be bleeding Be the patient may be dehydrated C the patient is most likely on iron supplements D the patient ate something that turned the stool dark color
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A 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? A brush teeth twice a day with a firm toothbrush B used waxed floss between meals and at bedtime C use sponge toothettes to clean teeth after meals D Swamp teeth and mucous membranes 4 times daily with lemon glycerin swabs
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C 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? A risk for injury related to compromised bone integrity B ineffective tissue perfusion related to vascular occlusion C risk for deficient fluid volume related to bleeding disorder D ineffective airway clearance related to cervical lymphadenopathy
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A 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 the patient with hypercalcemia? A encourage fluids B offer citrus juices and fruits C place the patient on a low sodium diet D discourage intake of alcoholic beverages
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A 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? A is your appetite improving B are you sleeping all night? C are you requiring many analgesics? D are you keeping up with your work schedule?
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D 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? A pain B fever C stridor D. Fatigue
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C stridor
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The nurse is preparing teaching for patient with Hodgkin's disease. Which beverage should the nurse instruct this patient to avoid? A wine B coffee C ginger ale D orange juice
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A wine
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The nurse is assessing a patient with stage 3 Hodgkin's disease. Where should the nurse expect to find enlarged lymph nodes? A in the neck only B above the diaphragm only C below the diaphragm only D. Generalized throughout the body
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D generalized throughout the body
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A patient with lymphoma wants to attend a family members wedding but it 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? A the patient is able to sleep 8 hours at night Be the patient can list three ways to combat fatigue See the patient attends the family members wedding D the patient verbalize is understanding of the importance of gradually increasing activity
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C. The patient attend the family members wedding
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A patient with terminal lymphoma says to the nurse, I'm tired of being so fatigued all the time. Can't you just give me a big shot of morphine and help me to end the suffering? Which response by the nurse is most appropriate? A you sound frustrated. It must be difficult to feel so tired all the time. B are you sure that is what you want me to do? Maybe you should think about it first. C that is really not appropriate to ask. Would you like a shot just to take away the pain? D you have orders for morphine 10 to 15 mg. I don't think that's enough to end your suffering.
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A you sound frustrated. It must be difficult to feel so tired all the time
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A patient is being prepared for splenic to me. What is the purpose of the order for a vitamin K injection? Eh it corrects a dietary deficiency B it helps correct underlying anemia C it corrects clotting factor deficiencies D it replaces vitamin K lost during night sweats
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C 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? A assess pain every shift B provide a diet rich in fruits and vegetables C teach the patient to cough and deep breathe every hour D encourage the patient to look at the incision during dressing changes
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C 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 a hundred and two degrees Fahrenheit. Which action by the nurse should take priority? A notify the physician B encourage fluids to reduce fever and prevent dehydration C administer acetaminophen to reduce fever and relieve discomfort D explain to the patient the low grade fevers are common after splenectomy because the spleen is part of the immune system
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A 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? A monthly coagulation studies B nearly influenza vaccination C. Oral analgesics for pain control D routine transfusion of packed RBCs to prevent anemia
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B yearly influenza 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 post operative patient? A practice good hand washing B encouraged two liters of fluid daily C. Change wound dressing daily D. Assess vital signs every 4 hours
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A practice good hand washing
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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 our laboratory results associated with which hematological disorder? A a plastic anemia B sickle cell anemia C pv D disseminated intravascular coagulation
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D disseminated intravascular coagulation
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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 respiratory rate should the nurse use to determine if the activity is too strenuous for the patient? A 5% B 10% C 20% D 30%
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C 20 percent
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A patient has a platelet count of 20,000 / mm 3. What action should the nurse take? A assist out of bed to a chair B draw another blood sample C measure a rectal temperature D place on bleeding precautions
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D placed on bleeding precautions
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The nurse's packs a patient has polycythemia. Which hematocrit value is causing the nurse to have this concern? A 38% B 45% C 47 % D 55%
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D 55%
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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? A 1 B 2 C. 3 D. 4
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C 3
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The daughter of a male patient with haemophilia 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? A 10% B 25% C 50% D 100%
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C. 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? Select all that apply. A scuba diving B contact sports C sexual activity D long distance driving E. Skiing in the mountains F standing for long periods
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A scuba diving E skiing in the mountains
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The nurse is collecting information about sickle cell disease for an upcoming seminar. What should the nurse include as common triggers for a sickle cell crisis? Select all that apply. a anesthesia B chemotherapy C severe infection D strenuous exercise E use of nasal oxygen F blood loss during surgery
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A anesthesia C severe infection D strenuous exercise F blood loss during surgery
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The nurse respects a patient is experiencing manifestations of Hodgkin's disease. Which are characteristics of this health disorder? Select all that apply. A visual changes occur B it is the most curable of all lymphomas C skeletal pain is a common symptom D it is distinguished by the presence of Reed Sternberg cells E painless swelling of cervical, axillary, or inguinal nodes occurs F it is distinguished by the presence of Philadelphia chromosome
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B it is the most curable of all lymphomas D it is distinguished by the presence of Reed Sternberg cells E painless swelling of cervical, axillary, or inguinal nodes occurs
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During a home visit , the nurse becomes concerned that a child is developing idiopathic thrombocytopenic purpura. which health problems could have precipitated the development of this disorder in the child? Select all that apply. A HIV B rubella C hepatitis C D chickenpox E cystic fibrosis
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A HIV B rubella C hepatitis C D chickenpox
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A patient is planning to have in allogeneic bone marrow transplant. what will the patient most likely have completed before the transplant occurs? Select all that apply. A electrophoresis B peritoneal dialysis C total body irradiation D high-dose chemotherapy E massive blood transfusions
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C total body irradiation D high-dose chemotherapy
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During a home visit, the nurse becomes concerned that a patient recovering from us play next to me is at risk for infection. What did the nurse observe to come to this conclusion? Select all that apply. A received a manicure and pedicure B wash hands before preparing lunch C poured a cup of tea after petting the cat D had a hot tub installed on the back patio E planting tomato plants in an outside garden
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A received a manicure and pedicure C poured a cup of tea after petting the cat D had a hot tub installed on the back patio E planting planting tomato plants in an outside garden
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A patient is diagnosed with a folic acid deficiency. On what dietary changes should the nurse instructed the patient? Select all that apply. A snack on peanuts B eat breads fortified with folic acid C add green leafy vegetables to meals D increase the intake of milk each day E prepare soups with a dried peas and beans
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A snack on peanuts B eat bread fortified with folic acid Tea and green leafy vegetables to meals E prepare soups with dried peas and beans
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The nurse is caring for a patient scheduled for tests to confirm the diagnosis of lymphoma. For which diagnostic test should the nurse prepare the patient? Select all that apply. A CT scan B cerebral angiogram C lymph node biopsy D lymph angiography E complete blood count
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A CT scan C lymph node biopsy D lymphangiography E complete blood count
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The recommended dose of filgrastim is 10 mcg / kg / Day. It is supplied at 300 mcg / ml. A patient who weighs 132 LB should receive how many ml?
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2 ml nursing care of patients with hematologic and lymphatic disorders
