Lewis Chapter 32 Elsevier Flashcards
The nurse is assessing a patient’s nutrition-metabolic pattern related to hematological health. Which of the following assessments should the nurse implement?
A. Inspect the skin for petechiae.
B. Ask the patient about joint pain.
C. Assess for vitamin C deficiency.
D. Determine if the patient can perform activities of daily living (ADLs).
A. Any changes in the skin’s texture or colour should be explored when assessing the patient’s nutrition-metabolic pattern related to hematological health. The presence of petechiae or ecchymotic areas could be indicative of hematological deficiencies related to poor nutritional intake or related causes.
The nurse is assessing laboratory values on a patient admitted with septicemia. Which of the following findings should the nurse anticipate?
A. Increased platelets
B. Decreased red blood cells
C. Decreased erythrocyte sedimentation rate (ESR)
D. Increased bands in the white blood cell (WBC) differential
D. When infections are severe, such as in septicemia, more granulocytes are released from the bone marrow as a compensatory mechanism. To meet the increased demand, many young, immature polymorphonuclear neutrophils (bands) are released into circulation. White blood cells (WBCs) are usually reported in order of maturity, with the less mature forms on the left side of a written report. Hence, the term shift to the left is used to denote an increase in the number of bands.
The nurse is reviewing a patient’s laboratory results and notes an elevated neutrophil level. Which of the following symptoms should the nurse recognize as being related to this diagnostic finding?
A. Hypoxemia
B. Infection
C. Hypocoagulation
D. Acute thrombotic event
B. An increase in neutrophil count most commonly occurs in response to infection or inflammation. Hypoxemia and coagulation do not directly affect neutrophil production.
The nurse is caring primarily for older persons on a subacute, geriatric medical unit. Which of the following effects is aging likely to have on hematological function?
A. Hypercoagulability
B. Decreased hemoglobin
C. Decreased blood volume
D. Decreased white blood cell (WBC) count
B. Older persons frequently experience decreased hemoglobin levels as a result of changes to erythropoiesis. Decreased blood volume, decreased white blood cells (WBCs), and alterations in coagulation are not considered to be normal, age-related hematological changes.
A blood type and crossmatch has been ordered for a patient who is experiencing an upper gastrointestinal bleed. The results of the blood work indicate that the patient has type A blood. Which of the following is a correct interpretation related to type A blood?
A. A antigens on red blood cells
B. Can only receive a type A transfusion
C. Can be transfused with type AB blood
D. Antibodies on red blood cells
A. An individual with type A blood has A antigens, not A antibodies, on their red blood cells (RBCs). An AB transfusion would result in agglutination, but they may be transfused with either type A or type O.
The nurse is caring for a patient who has undergone a splenectomy as a result of injuries suffered in a motor vehicle accident. Which of the following phenomena is likely to result from the absence of the patient’s spleen? (Select all that apply.)
A. Impaired fibrinolysis
B. Increased platelet levels
C. Increased eosinophil levels
D. Fatigue and cold intolerance
E. Impaired immunological function
B, E. Splenectomy can result in increased platelet levels and impaired immunological function as a consequence of the loss of storage and immunological functions of the spleen. Fibrinolysis, fatigue, and cold intolerance are less likely to result from the loss of the spleen since coagulation and oxygenation are not primary responsibilities of the spleen.
