BN Ch. 82 Blood and Lymph Disorders

Question 1

The _____ sedimentation rate measures the
speed at which RBCs settle in 1 hour at the
bottom of a tube of unclotted blood.

Answer 1

erythrocyte

Question 2

Hemolytic anemia is characterized by the
presence of immature RBCs called _____

Answer 2

reticulocytes

Question 3

Removal of blood and simultaneous infusion
of other solutions to maintain intravascular
volume is known as acute normovolemic ______.

Answer 3

hemodilution

Question 4

If the donor in bone marrow transplantation
is the recipient’s identical twin, it is known as
_____ bone marrow transplantation.

Answer 4

syngeneic

Question 5

Pernicious anemia is caused by a lack of
_____ factor.

Answer 5

intrinsic

Question 6

To identify the percentage of RBC’s in the blood.

Answer 6

Hematocrit

Question 7

To screen for circulating Rh antibodies

Answer 7

Indirect Coombs Test

Question 8

To monitor the clot formation pathway

Answer 8

Partial thromboplastin time

Question 9

To detect antibodies already attched to RBC

Answer 9

Direct Coombs test

Question 10

Write the correct sequence of the various stages
of Hodgkin disease.
1. The disease is present both above and below
the diaphragm.
2. The disease is limited to a single node or a
single extralymphatic site.
3. The disease is spread to one or more
extralymphatic organs or tissues.
4. The disease is present on one side of the
diaphragm and involves more than one
lymph node.

Answer 10

2 The disease is limited to a single node or a
single extralymphatic site.
4 The disease is present on one side of the
diaphragm and involves more than one
lymph node.
1 The disease is present both above and below the diaphragm.
3 The disease is spread to one or more
extralymphatic organs or tissues.

Question 11

Why is a blood type and crossmatch test
done?

Answer 11

• A blood type and crossmatch test is done before a blood transfusion procedure to check the matching of blood group and Rh factor of the recipient’s blood with the donor’s blood.
• An indirect Coombs test is done first on both the donor’s and the recipi- ent’s blood.
• Additional antibody testing is also carried out to identify unusual antibodies.
• Finally, both the donor’s and the potential recipient’s blood are checked for compatibility.
• A blood type and crossmatch test takes up to 1 hour for completion.

Question 12

What is meant by a differential WBC count?

Answer 12

• The differential WBC count includes the counting of granulocytes (neutrophils, basophils, and eosino- phils) and agranulocytes (lymphocytes and mono- cytes).
• In a differential count, the technician compares the number of granular leukocytes to the number of nongranular leukocytes.
• This helps to identify various disease conditions, because the number of different components of WBCs varies with different types of infection.

Question 13

What is meant by the term plasmapheresis?

Answer 13

• Plasmapheresis or apheresis is the procedure used for the separation and removal of specific blood components.
• The remainder of the blood is returned to the client at the time of separation.
• The plasmapheresis procedure is often used for collecting platelets, because it helps to collect a large amount of the platelets from a single donor.

Question 14

What are the signs and symptoms of Cooley anemia?

Answer 14

• Signs and symptoms of Cooley anemia include fever, failure to thrive, and an enlarged spleen.
• Rapid destruction of RBCs causes the release of large amounts of iron, which can be deposited in the skin, heart, liver, and pancreas.
• Growth and sexual development are usually impaired. The heart, liver, and pancreas become fibrotic.
• This reduces their capability to function properly.
• Cooley anemia also increases the risk of heart failure in affected clients.

Question 15

What is the major cause of pernicious
anemia?

Answer 15

• The major cause of pernicious anemia is lack of a gastric substance called intrinsic factor, which is produced in the stomach.
• Intrinsic factor helps to absorb vitamin B12 from food in the small intestine.
• Vitamin B12 is necessary for the proper absorption and use of iron and for the protection of nerve fibers.
• Deficiency of iron in the body causes pernicious anemia in the client.

Question 16

What are the two types of acute leukemia?

Answer 16

• The two types of acute leukemia are:
  Acute lymphoid (lymphocytic or lymphoblastic) leukemia (ALL)
  Acute myeloid (monoblastic or myelogenous) leukemia (AML)

ALL is commonly seen in children, whereas AML is more common in adults.

Question 17

What are petechiae?

Answer 17

Petechiae are small, hemorrhagic spots in the skin that are seen in clients with idiopathic thrombocytopenia purpura.

Question 18

A nurse’s role in managing blood and lymph
disorders involves monitoring the symptoms of the disorder and providing proper nursing care. The nurse also helps the clients with activities of daily living (ADLs).

A nurse is caring for a client with late-stage
pernicious anemia.

a. What symptoms should the nurse monitor
in the client?

Answer 18

If the client is in a late stage of anemia, the nurse should monitor for symptoms such as weakness, fatigue, tingling and numbness of the fingers and feet, sore tongue, walking difficulty, abdominal pain, and loss of appetite and weight.

Question 19

A nurse’s role in managing blood and lymph
disorders involves monitoring the symptoms of the disorder and providing proper nursing care. The nurse also helps the clients with activities of daily living (ADLs).

A nurse is caring for a client with late-stage
pernicious anemia

What nursing care measures should be
employed when caring for the client?

Answer 19

The nurse should employ the following nursing care measures when caring for the client:
* Plan and implement proper dietary modification.
* Administer prescribed vitamin B12 injections.
* Administer prescribed doses of iron supplements, folic acid, and digestants to enhance the client’s vitamin metabolism

Question 20

A nurse is assessing a client who has been
admitted to the healthcare facility for bone
marrow transplantation.

What data should the nurse collect from
the client?

Answer 20

The nurse should collect the following data from the client before bone marrow transplantation:
* Carefully observe and monitor the client with a blood or lymph disorder and document the signs and symptoms.
* Examine the client’s skin for petechiae, bruises, or other evidence of abnormal bleeding.
* Measure and record the client’s blood pressure and pulse.
* Obtain a thorough nursing history about the client’s nutritional status, dyspnea, elimina- tion difficulties, walking or moving difficulties, and pain.
* Monitor and document abnormal lab values.
* Observe and document the client’s emotional
response to the disorder or the disease.
* Observe and document whether the client
requires any type of assistance to perform ADL.

Question 21

A nurse is assessing a client who has been
admitted to the healthcare facility for bone
marrow transplantation.

What are the various nursing diagnoses
that can be established based on the data
collection?

Answer 21

Based on data collection, the following are some of the nursing diagnoses that can be established for clients with a disorder of the blood or lymphatic system:
* Risk for any type of infection due to impaired immune system
* Deficient fluid volume related to hemorrhage
* Diarrhea related to side effects of medication
* Impaired physical mobility related to injuries,
bruising, bleeding into the tissues, fatigue
* Intolerance of activity related to leukemia,
anemia, fatigue
* Disturbed body image related to visible bleeding disorders
* Chronic pain related to sickle cell anemia or
bone marrow aspiration
* Anticipatory grieving related to chronic or
fatal condition or due to genetic nature of disorder