ch 29 hemo disorders

Question 1

a client with sickle cell disease is taking narcotic analgesics for pain control. which intervention by the nurse would decrease the risk for narcotic substance abuse

Answer 1

encourage the client to seek care from a single provider for pain relief

Question 2

a client newly diagnosed with thrombocytopenia is admitted to the medical unit. after the admission assessment, the client asks the nurse to explain the condition. the nurse explains to this client that this condition occurs due to which factor

Answer 2

decreased production of platelets

Question 3

a critical care nurse is caring for a client with immune hemolytic anemia. the client is not responding to conservative treatments, and the client’s condition is now becoming life threatening. the nurse is aware that a treatment option in this case may include which intervention

Answer 3

splenectomy

Question 4

a nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. what should the nurse include in health education

Answer 4

iron will cause the stools to darken in color

Question 5

the nurse is assessing a new client with reports of acute fatigue and a sore tongue that is visibly smooth and beefy red. this client is demonstrating signs and symptoms associated with what form of hematologic disorder

Answer 5

megaloblastic anemia

Question 6

a client with acute kidney injury has decreased erythropoietin production. upon analysis of the client’s complete blood count, the nurse will expect which of the following results?

Answer 6

decreased hemoglobin and hematocrit

Question 7

a client comes to the clinic reporting fatigue and the health interview is suggestive of pica. lab findings reveal a low serum iron level and a low ferritin level. with what would the nurse suspect that the client will be diagnosed?

Answer 7

iron deficiency anemia

Question 8

a client comes to the clinic reporting fatigue. blood work shows increased bilirubin concentration and a increased reticulocyte count. which condition should the nurse most suspect the client has?

Answer 8

a hemolytic anemia

Question 9

a client is admitted to the hospital with pernicious anemia. the nurse should prepare to administer which of the following medications?

Answer 9

vitamin b 12

Question 10

a client’s blood work reveals a platelet level for 17,000. when inspecting the client’s integumentary system, what finding would be most consistent with this platelet level

Answer 10

petechiae

Question 11

a nurse is admitting a client with immune thrombocytopenic purpura to the unit. in completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function? select all that apply

Answer 11

-sulfa

-aspirin

-NSAIDs

Question 12

blood work shows prolonged prothrombin time, but a vitamin k deficiency is ruled out. when assessing the client, areas of ecchymosis are noted. which of the following is a likely cause?

Answer 12

hepatic dysfunction

Question 13

a client with a history of cirrhosis is diagnosed with bleeding esophageal varices. what would the nurse expect to be prescribed

Answer 13

packed red blood cells (PRBCs)

Question 14

nursing diagnosis for hemophilia

Answer 14

ineffective coping

Question 15

which individual is most likely to have anemia

Answer 15

an 81 year old with chronic heart failure

Question 16

nursing diagnosis for iron deficiency anemia

Answer 16

fatigue related to decreased oxygen carrying capacity

Question 17

which assessment finding would signal complication of anemia

Answer 17

shortness of breath and peripheral edema

Question 18

a woman who is in her third trimester of pregnancy has iron deficiency anemia. what food would likely increase her iron stores

Answer 18

beef liver with orange juice

Question 19

nursing diagnosis for sickle cell

Answer 19

ineffective tissue perfusion related to thrombosis

Question 20

what action is most appropriate when hearing lung crackles in a sickle cell patient

Answer 20

inform the health care provider that they may have an infection

Question 21

teaching for a sickle cell client relating to prevention

Answer 21

avoiding cold temperatures and ensuring sufficient hydration

Question 22

a client with history of glucose-6-phosphate dehydrogenase deficiency has pallor, jaundice, and malaise. which assessment question relates to this disorder

Answer 22

what medications have you taken recently?

Question 23

a clients electronic health record notes that the client has previously undergone treatment for secondary polycythemia. the nurse would assess for which factor

Answer 23

evidence of lung disease

Question 24

a client absolute neutrophil count (ANC) is 440 but show no s/s. what action should be priority

Answer 24

meticulous hand hygiene

Question 25

client education for bleeding disorder

Answer 25

avoiding activities that carry a risk for injury

Question 26

priority care for long term care patient with bleeding disorder

Answer 26

fall prevention

Question 27

potential causes for immune thrombocytopenic purpura (ITP). select all that apply

Answer 27

-hepatitis -hiv

Question 28

a client with ITP asks the nurse why they have not chosen to administer platelets. how would the nurse respond

Answer 28

transfused platelets usually aren’t beneficial because they are rapidly destroyed in the body

Question 29

what medication can cause qualitative platelet defect

Answer 29

aspirin

Question 30

nursing priority for hemophiliac with injury

Answer 30

prepare for administration of factor VIII

Question 31

when addressing nursing diagnosis of acute pain related to joint hemorrhage, what principle should guide intervention

Answer 31

NSAIDs are contraindicated due to risk for bleeding

Question 32

the nurse notes that the MAR specifies both oral and subcutaneous option for administration for a prn antiemetic. what is the best action

Answer 32

contact prescriber to have subcutaneous option discontinued

Question 33

a client with von willebrand disease has experienced recent changes in bowel function that suggest need for colonoscopy. what intervention is done in anticipation of this procedure

Answer 33

the client should be given necessary clotting factors before the procedure

Question 34

a client with a history of atrial fibrillation has overdosed on warfarin. what is the antidote

Answer 34

vitamin k

Question 35

which client is most likely at risk for disseminated intravascular coagulation (DIC)

Answer 35

client who is being treated for septic shock