Chapter 32 Stem
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| The nurse assesses the abnormal blood value for a young women as: | Normal platelet 140-440, Hct is 3 x's highter than Hgb value
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| The nurse explains that a normal Hct is approximately: | 3 x's the Hgb. Women 37-47/Men 40-54
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| The nurse calls to the attention of the charge nurse the PT/INR of a patient on Coumadin. The value that needs attention is: | Normal: INR 2-3, PT 12-14 sec
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| The nurse caring for a patient receiving a transfusion assesses that the patient is wheezing and is complaining of back pain. After the nurse stops the transfusion, the nurse should: | Change tube, run NS, notify dr/charge nurse, prepare to administer 02/epinephrine/solu-cortef/lasix/antipyretics as prescribed. Notify blood bank
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| The patient receiving Epogen asks how soon there will be an increase in his red blood cell count. The nurse’s best reply is that the initial increase in red cells should be seen in: | Several days
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| The nurse explains that sickle cell crisis occurs when the sickle-shaped red blood cells: | Change shape and get stuck in red capillaries/arteries and veins
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| The information that the nurse recognizes as pertinent patient self-care for a patient with sickle cell anemia is: | Maintain good hydration (4-6 L), avoid smoking/caffeine/alcohol, avoid high altitudes/stress/cold weather. Take hydroxyurea
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| In preparing discharge plans for a patient recently diagnosed with pernicious anemia, it is most important for the nurse to include information regarding: | Monthly injections of b12 for rest of life. Might have symptoms of tired/fatigue so plan activities accordingly. Precaution of easy bruising
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| The rationale for administering injections of vitamin B12 to patients with pernicious anemia is that: | Vitamin replacement b/c body cannot absorb into stomach (missing factor)
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| The foods that the nurse would include in a nutrition teaching plan for an iron-deficiency anemia patient are: | Liver, oyster, red meats, fish, dried fruits, legumes (dried beans/peas), dark green veges, whole grains, cereals that are fortified
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| Based on the nursing assessment, an appropriate nursing diagnosis for a patient with hemophilia would be: | Risk for injury related to bleeding. Acute pain related to bleeding
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| A child with sickle cell anemia is placed on the drug hydroxyurea. The nurse explains that this drug will: | Prevent sickle cell crisis by producing a certain type of Hgb that is resistent to sickling
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| A newborn infant has developed marked jaundice and has a positive Coombs’ test result from high levels of bilirubin. The nurse has assessed the symptoms as being indicative of: | Hemolytic anemia
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| A 3-year-old African-American child is diagnosed with sickle cell anemia. The parents know that sickle cell anemia is hereditary but do not understand why their child has the disease, because neither of them has it. The nurse explains that: | 8% of African americans carry the gene, so one of the parents must be a carrier
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| When the patient with a platelet count of 20,000/mm3 receives 1 unit of platelets, the platelet count should rise to: | Will raise 5,000-10,000. New count would be 25,000-30,000
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| When the nurse prepares to give ferrous sulfate (Feosol) to a home health patient, the nurse will: | Take with food, but no with milk/eggs/caffeine
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| A 35-year-old man is seen in an urgent care clinic. He presents with symptoms of polycythemia vera. The laboratory value that would confirm the possible diagnosis is an extremely: | An extremely high amount of RBCs, increased Hgb and Hct
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| A 52-year-old man has a diagnosis of aplastic anemia. The information that the nurse recognizes as being pertinent to this diagnosis is that the man: | Exposed to chemicals or radiation for long periods of time
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| A nurse is completing an initial assessment on a new patient being seen in the hospital clinic. The female patient presents with vague symptoms of tiredness and large areas of ecchymosis. The question that would be most important to ask is: | Have you been diagnosed with a blood disorder? Do you haev blood in stool/urine? Do your gums bleed when you brush? etc....
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| At the end of a shift, a nurse documents the effectiveness of parent teaching concerning the transmission of hemophilia. Which of the following statements by the mother would best indicate an accurate parental perception? | She can give it to her son, b/c it is on the x chromosome (male chromosome)
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| When assessing the patient with thrombocytopenia, the nurse observes for: | Petichiae, purpura, epitaxis, gingival bleeding, decrease in platelets
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| The nurse uses a common nursing diagnosis for patients with disorders of the hematologic system, which is: | Risk for injury related to bleeding
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| The nurse assessing a patient 20 minutes after a bone marrow biopsy is concerned when the patient says: | Am I supposed to be bleeding this much?
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| The nurse caring for a patient with crushing injuries from an auto accident is horrified to find the patient bleeding profusely from the nose, mouth, and rectum, as well as from the injuries. The nurse assesses this emergency situation as: | DIC
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| At 10:00 AM, the nurse receives 2 units of blood for a patient to be transfused. The nurse should: | Take the 2nd unit of blood back to bank, only 1 unit can run at a time.
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| The nurse notes the past medical history information that is significant to potential bleeding problems as (select all that apply): | Cancer or prior tx, HV, liver disease (Hepatitis), malabsorption, prolonged bleeding/delayed healing, hx. of blood transfusion, placement of prosthetic heart valves, placement of indwelling venous access device
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| The nurse giving iron dextran IM will use the Z-track method because this method (select all that apply): | Locks in to prevent it from leaving the tissue
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| The nurse explains that the major difference between fresh frozen plasma (FFP) and cryoprecipitate (CPP) is that FFP (select all that apply): | No plasma in fresh frozen plasma
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