What is increased when the term shift to the left is used when referring to the

WBC differential? Bands

The nurse is caring for an elderly patient diagnosed with pernicious anemia. This
results from? the absence of a glycoprotein intrinsic factor secreted by the
gastric mucosa.
What is the most severe risk for a patient with agranulocytosis? Infection
A patient with leukemia is susceptible to hemorrhage. What blood dyscrasia
makes the patient susceptible to this? Thrombocytopenia
the main diagnostic feature of Hodgkins disease? Reed-Sternberg cells
What is a grave disease process in which the patient experiences both bleeding
and intravascular clotting at the same time? Disseminated intravascular
coagulation (DIC
In assessing the patient, which abnormal finding should the nurse relate to
hemostasis abnormalities? Purpura
The nurse collects a nutritional history from a 22-year-old woman who is planning
to conceive a child in the next year. Which foods reported by the woman would
indicate that her diet is high in folate and iron? Spinach, beans, and liver
A 62-year-old male patient with disseminated intravascular coagulation (DIC)
after urosepsis has a platelet count of 48,000. The nurse should assess the
patient for which abnormality? Purpura
A 36-year-old female patient suspected to have leukemia is scheduled for a bone
marrow aspiration. What statement in the patient's health history requires
immediate follow up by the nurse? "I have rheumatoid arthritis and take aspirin
for joint pain."
The nurse instructs an African American man who has sickle cell disease about
symptom management and prevention of sickle cell crisis. The nurse determines
further teaching is necessary if the patient makes which statement? "When my
vision is blurred, I will close my eyes and rest for an hour."
An older patient relates that she has increased fatigue and a headache. The
nurse identifies pale skin and glossitis on assessment. In response to these
findings, which teaching will be helpful to the patient if she has microcytic,
hypochromic anemia? Take the iron with orange juice one hour before meals.
After the diagnosis of disseminated intravascular coagulation (DIC), what is the
first priority of collaborative care? Treat the causative problem.

A patient who has sickle cell disease has developed cellulitis above the left ankle.
What is the nurse's priority for this patient? Maintain oxygenation.
hemarthrosis is a symptom of joint bleeding
pericarditis inflammation of the pericardium. S/S Chest pain (sharp, change with
respiration, relieved sitting forward, worsened lying down/deep
inspiration/swallowing.
Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive
procedure to open up blocked coronary arteries, allowing blood to circulate
unobstructed to the heart muscle.
Anemia - Blood loss
RBC: transport O2 and carbon dioxide
WBC: body defense: destruction of bacteria and viruses.
Platelets: initiate blood clotting
Heparin is used to prevent blood clotting.
Hypovolemic anemia - Abnormally low circulating blood vol due to blood loss.
S/S: restlessness (#1), rise in respirations, weakness, stupor, irritability,
pale/cool/moist skin, rapid/thready pulse. Blood loss can cause shock
Aplastic anemia - Decrease of bone marrow function. S/S pallor, weakness and
dyspnea, Leukopenia - such as recurrent of multiple infections,
Thrombocytopenia: deficiency in the # of circulating platelets. Major signs are
petechiae + ecchymosis.
Iron def. anemia - caused by chronic bleeding. NI: alternate periods of rest and
activity to balance O2 supply and demand. S/S
Sickle cell anemia - Abnormal, crescent-shaped RBC. Aching joints in hands +
feet.
Von willebrands disease - slow coag of blood. (Female).
(DIC) - Over stimulation of clotting + anti-clotting processes from injury
Phagocytosis - engulf any foreign material + digest it.
CBC = red + white cell counts, hct, hgb, erythrocyte indexes, differential WBC
count, + exam of peripheral blood cells.
Hematocrit (hct): measures the volume percentage of RBCs. Dependent on
plasma volume. Too much fluid diluted hct.
Hemoglobin (hgb): carries o2 from lungs to cells + carbon dioxide away from
cells to lungs.

Lymphocytes T cells + B cells. They protect the body by destroying foreign

antigen. B cells search, identify, + bind w/ specific antigens. T cells divide rapidly
+ produce large #s of new T cells that are sensitized to antigen. B cells produce
antibody.
S/S of anemia - hypotension, resp distress, acute mental change,
shortness of breath, fatigue, weakness, lightheadedness. Severe is shock,
severe hypotension, MI, stroke, confusion, + sometimes death.
Spleen: LUQ. Stores 500mL/1 pint of blood, which can be released during
emergencies. Destroys worn-out or defective RBCs.
Acute Lymphocytic Leukemia (ALL) - Young children + adults
Leukemia: enlarged lymph nodes, decreased rbc, thrombocytopenia, increase
wbc, bone marrow aspiration. Malignant disorder of the hematopoietic system in
which an express of leukocytes accumulates in the bone marrow & lymph nodes
Why do leukemia patients hemorrhage? the white blood cells produced in the
bone marrow do not mature normally
Iron Foods: dark green leafy veg and organ meats
Bone marrow transplant: must be irradiated before procedure. Best place to draw
from is post iliac crest.
Hemophilia: Passed from mother to son as sex-linked recessive
characteristic.Tympanic temp.
Jehovah's witness are opposed to blood transfusions.
What is the preferred diagnostic test for evaluating deep lymph nodes? CT
Hemarthrosis: Bleeding into a joint space, a hallmark of severe disease usually
occurring in the knees, ankles, & elbow
AB (univ recip)
O (univ donor)
Hodgkin's disease: reed-sternberg cells. More freq w ppl who have infection w
Epstein-barr virus. Alcohol triggers pain. Inflammation or infectious process that
develops into neoplasm (cancer).
Sickle Cell: abnormal, crescent shape of RBC. NI: increase fluids and admin
opioid analgesics
Pernicious Anemia S/S: Extreme weakness with dyspnea, fever, hypoxia, weight
loss, jaundice with pallor, Edema of the legs, constipation and diarrhea

Schilling Test: To diagnose pernicious anemia. Measures the absorption of

radioactive Vita B12 before and after parenteral injection of intrinsic factor.
The nurse is caring for a patient with hemophilia. Which of the following nursing
diagnoses would be expected on the nursing care plan?
Ineffective tissue perfusion
Fluid volume deficit
Anxiety
Pain
The patient has anemia and has had laboratory tests done to diagnose the
cause. Which results should the nurse know indicates a lack of nutrients needed
to produce new red blood cells?
Increased homocysteine
Decreased cobalamin (vitamin B12)
Increased methylmalonic acid (MMA)
The thrombocytopenic patient has had a bone marrow biopsy taken from the
posterior iliac crest. What nursing care is the priority for this patient after this
procedure? Apply a pressure dressing.
The nurse is caring for a 36-year-old male patient receiving phenytoin (Dilantin)
to treat seizures resulting from his traumatic brain injury while a teenager. It is
most important for the nurse to observe for which hematologic adverse effect of
this medication? Anemia