Common: Heme/Onc & Blood

Question 1

Onc: Describe why neutropenia is a priority for a nurse to communicate to a provider.

Answer 1

Neutropenia indicates that the patient is at high risk for infection and needs immediate actions to diagnose and treat the cause of the leukopenia

Question 2

Blood: What are 3 ways the nurse monitors the patient for transfusion reaction after the blood is started?

Answer 2

Monitor vital signs every 15 minutes for the first hour

Stay with the patient for the first 15 minutes

Complete transfusion within 4 hours

Question 3

Blood: A nurse preparing to deliver blood to a patient will note and verify what critical information?

Answer 3

Full vital signs including Temp.

Signed informed consent for blood transfusion

Pt and blood ABO & Rh compatibility

Question 4

Blood: What is the primary role of platelets in the blood?

Answer 4

Blood clot formation used to stop or prevent bleeding

Question 5

Blood: Verifying patient and blood compatibility and monitoring pt response to blood transfusion can only be done by whom?

Answer 5

Licensed practitioner such as RN or NP.

Question 6

Heme: Promoting & maintaining oxygenation, keeping RBCs hydrated, managing pain, and promoting neurological function are all goals of nursing interventions for what disease process?

Answer 6

Sickle cell anemia/sickle cell crisis

Question 7

Heme: Pernicious anemia prevents the absorption of what?

Answer 7

Vitamin B12 or Cobalamin

Question 8

Heme/Onc: Describe thrombocytopenia and risks associated with it

Answer 8

The reduction of platelets below 150,000 can cause an increased risk of bleeding.

Question 9

Blood: The most appropriate nursing action when a blood transfusion reaction is suspected

Answer 9

Stop the transfusion

Question 10

Blood: What is unique about blood type AB

Answer 10

Type AB blood is considered a universal recipient, as it contains no antibodies to react to transfused blood.

Question 11

Blood: Describe the difference between heme-iron and nonheme-iron

Answer 11

Food sources of iron fall into two categories – heme iron (from lean red meat, poultry, and fish) and nonheme iron (from fruit, vegetables, grains, and dried peas and beans). The body more easily absorbs heme iron.

Question 12

Blood: B12 injections are commonly given to treat which type of anemia?

Answer 12

Pernicious

Question 13

Blood: Women who have unusually heavy menstrual cycles may be at risk for which type of anemia?

Answer 13

Iron-deficiency anemia results from poor gastrointestinal absorption of iron, a diet that is deficient in iron, or blood loss. The nurse should expect a client who has iron-deficiency anemia to have weakness, pallor, fatigue, reduced tolerance for activity, and cheilosis (ulcerations of the corners of the mouth).

Question 14

Onc: Describe why fresh flowers and other organic plants may be restricted for patients undergoing treatment for cancer

Answer 14

Clients who are receiving chemotherapy and radiation therapy are likely to become immunocompromised as a result of neutropenia, a decreased white blood cell (WBC) count. Because micro-organisms are likely to be present on fresh flowers and plants, immunocompromised clients are instructed not to accept such gifts into the room. In addition, the client is instructed to eat only thoroughly cooked meats and thoroughly washed fruits and vegetables. Immunocompromised clients are more susceptible to infection and illness from food-borne bacteria than other clients.

Question 15

<p>Onc: Antiemetics are often used to help patients who experience which side effect to chemotherapy?</p>

Answer 15

<p>Nausea and vomiting</p>

Question 16

<p>Onc: What is the rationale for teaching a patient receiving radiation therapy for bladder cancer, to clean the perineal area well after each bathroom use?</p>

Answer 16

<p>Radiation to the abdomen will affect organs in the radiation path, such as the bowel, and cause frequent diarrhea. Careful cleaning of this area will help decrease the risk for skin breakdown and infection.</p>

Question 17

<p>Onc: In staging cancer, what does "T", "N", and "M" represent?</p>

Answer 17

<p>T- primary tumor<br></br>N- regional lymph nodes<br></br>M- distant metastases</p>

Question 18

<p>Onc: Most breast cancers are found in the location of most glandular tissue. Where on the breast is that located?</p>

Answer 18

<p>The upper outer quadrant</p>

Question 19

<p>Hem: Describe pancytopenia and which disease process it is often associated with.</p>

Answer 19

<p>Pancytopenia describes the marked decrease in RBCs, WBCs, and Platelets. Someone with aplastic anemia has pancytopenia, the they are at risk for infection and bleeding</p>

Question 20

<p>Blood: At what point is it most appropriate to verify patient identification for a blood transfusion?</p>

Answer 20

<p>Prior to starting the blood transfusion</p>

Question 21

<p>Blood: 0.9% Sodium Chloride is run as a carrier fluid during a blood transfusion. Any other solution is likely what complication?</p>

Answer 21

<p>RBC hemolysis of donor blood</p>

Question 22

<p>Blood: Hemoglobin & Hematocrit (H&H) are common and important lab values used to measure what?</p>

Answer 22

<p>Hgb- amount of protein in the blood</p>

<p>Hct- amount of RBC compared to total blood cell count</p>

Question 23

<p>Blood: What symptoms does the nurse watch for when monitoring for transfusion reactions?</p>

Answer 23

<p>Chills, fever, headache, anxiety. Tylenol is an appropriate treatment for transfusion reaction symptoms.</p>

Question 24

<p>Heme: What type of diet would be recommended to a person with iron-deficient anemia?</p>

Answer 24

<p>a diet with iron-rich foods like eggs, whole wheat grains, and legumes</p>

Question 25

<p>Heme: People with this type of anemia are at increased risk for infection due to pancytopenia.</p>

Answer 25

<p>Aplastic anemia</p>

Question 26

<p>Onc: How does menstruation effect breast cancer risk?</p>

Answer 26

<p>Early menarche and late menopause are risk factors for breast cancer due to the prolonged estrogen exposure.</p>

Question 27

<p>Onc: Describe the surgical treatment options for breast cancer in terms of survival rates.</p>

Answer 27

<p>Lumpectomy, radiation, and modified radical mastectomy all have comparable survival rates.</p>