MS CH 28 Nursing Care of Patients With Hematologic and Lymphatic Disorders Flashcards
(163 cards)
A client with iron-deficiency anemia is prescribed oral iron. What should the nurse instruct the client to take it with?
Vitamin C or orange juice to enhance absorption. (Vitamin C aids iron absorption.)
A nurse notes a new onset of glossitis and spoon-shaped nails. What is the priority action?
Notify HCP—likely iron-deficiency anemia needing workup.
A client with sickle cell disease reports joint pain, fatigue, and shortness of breath. What should the nurse do first?
Administer oxygen and assess pain level. (ABC priorities: oxygenation and pain control.)
A client receiving a blood transfusion develops chills, back pain, and hypotension. What is the nurse’s first action?
Stop the transfusion immediately and notify the provider. (Suspected hemolytic reaction.)
What assessment is most important prior to administering packed RBCs?
Verify patient identity with another nurse and match blood to wristband. (Patient safety priority.)
A patient with thrombocytopenia is admitted. Which activity is unsafe?
Flossing teeth daily. (Increased bleeding risk—use soft toothbrush instead.)
A patient on warfarin has an INR of 5.8 and minor gum bleeding. What is the anticipated order?
Administer vitamin K as ordered.
Which client should be assigned to an experienced RN?
Client with disseminated intravascular coagulation (DIC) and active bleeding. (High acuity.)
What is the nurse’s priority in a sickle cell crisis?
Provide pain relief and hydration to improve perfusion.
A client with DIC is bleeding from IV and catheter sites. What lab is most important to check?
Platelet count, PT/PTT, and fibrin degradation products.
A client with sickle cell anemia asks about hydroxyurea. What is the best response?
“It reduces the frequency of pain crises, but may take weeks to show effect.”
What is an appropriate goal for a patient with aplastic anemia and low neutrophils?
Remain free from infection during hospitalization.
A nurse notes petechiae and a platelet count of 18,000/mm³. What is the best intervention?
Initiate bleeding precautions and avoid invasive procedures.
Which assessment finding is consistent with pernicious anemia?
Paresthesia of the hands and feet. (Neurological signs from B12 deficiency.)
Which intervention supports safe mobility in a patient with anemia?
Assist with ambulation and teach to rise slowly from bed.
The nurse is teaching about dietary iron. Which meal has the highest iron content?
Grilled chicken, spinach salad with orange slices, and fortified cereal.
What is the correct nursing action after IM iron administration?
Use the Z-track method to avoid staining tissue.
A client with polycythemia vera has hematocrit of 59%. What is the most likely intervention?
Therapeutic phlebotomy to reduce RBC mass.
A patient with sickle cell crisis has cap refill >4 seconds and cold extremities. What’s the priority?
Administer IV fluids to improve circulation.
Which finding requires immediate intervention in a patient with leukemia?
Oral temp of 100.9°F (38.3°C). (Early sign of infection.)
What is the expected outcome after erythropoietin administration?
Increased hemoglobin and improved energy.
What is a critical safety teaching point for a client post-splenectomy?
Report fever immediately—risk for infection is lifelong.
Which finding indicates DIC improvement?
Platelet count increasing and bleeding stopped.
Which lab confirms hemophilia A?
Low factor VIII level and prolonged PTT.
