NUR121 Critical Thinking Midterm 3 Flashcards

Terms Definitions
The three primary types of blood cells in the blood are:

Plasmacytes, erythrocytes and hemocytes
Erythrocytes, leukocytes and histocytes
Thrombocytes, reticulocytes and monocytes
Erythrocytes, leukocytes and thrombocytes
Erythrocytes, leukocytes and thrombocytes
Blood cell formation (hematopoiesis) occurs in the

Bone marrow
Bone marrow
The most frequent symptom & complication of anemia is:

Beefy red tongue
Patients with _______ are at high risk for bleeding.

Elevated levels of vitamin K
A client with thrombocytopenia secondary to leukemia develops epistaxis. The nurse should
instruct the patient to

Hold his nose while bending forward at the waist
Sit upright, leaning slightly forward
Blow his nose, then put lateral pressure on his nose
Sit upright, leaning slightly forward
The nurse is administering vitamin B12 to a client with pernicious anemia, secondary to
gastrectomy. Which route should the nurse use to most effectively administer the vitamin?

Topical route
Transdermal route
By mouth
Intramuscular route
Intramuscular route
During the physical assessment of a patient with thrombocytopenia, the nurse would expect to find

Sternal tenderness
Petechiae and purpura
Jaundiced sclera and skin
Tender, enlarged lymph nodes
Petechiae and purpura
A patient with a hematologic disorder has a smooth, shiny red tongue. The nurse would expect the patient's laboratory results to include

WBC 13,000/mm3
Neutrophils 45%
RBC 6.4 x 10^6
Hgb 9.6 g/dL
Hgb 9.6 g/dL
Bleeding and petechiae do not occur until the platelet count falls below 50,000/mm^3. The
normal value for blood platelets is:

Between 150,000 and 400,000/mm3
Greater than 500,000/mm3
Between 150,000 and 400,000/mm3
A patient is being treated with chemotherapeutic agents. The nurse revises the patient's care
plan based on the CBC results of

* Hct 38%
* Hgb 14.5 g/dL
* WBC 4,000/mm3
* Platelets 80,000/mm^3
WBC 4,000/mm3
In addition to the general symptoms of anemia, the patient with pernicious anemia also manifests

Neurologic symptoms
Coagulation deficiencies
Cardiovascular disturbances
A decreased immunologic response
Neurologic symptoms
The common feature of leukemia is

Increased blood viscosity, resulting form an overproduction of white blood cells
An unregulated accumulation of white cells in the bone marrow, which replace normal
marrow elements
Decreased plasma volume in response to
An unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements
The nursing diagnosis that is most appropriate for a patient with moderate to severe anemia of any etiology is

Impaired skin integrity related to edema and pruritis
Disturbed body image related to changes in appearance and body function
Imbalanced nutrit
Activity intolerance related to decreased hemoglobin and imblanance between oxygen supply and demand
The increased tendency toward coronary and cerebral thrombosis seen in individuals with polycythemia vera is attributable to the

Increased viscocity of the blood
Fragility of the cells
Elevated blood pressure
Immaturity of red blood cells
Increased viscosity of the blood
A femal client has a low hemoglobin level, which is attrributed to a nutritional deficiency of iron. The nurse should recommend an increase in which food in the client's diet?

Which of the following is contraindicated for a patient diagnosed with disseminated intravascular coagulation (DIC)?

Treating the underlying cause
Administering heparin
Administering coumadin
Replacing depleted blood products
Administerin coumadin
What factor besides the degree of neutropenia does the nurse assess in determining the client's risk for infection?

Length of time the neutropenia has existed
Health status before the neutropenia
Body build and weight
Resistance to infection in childhood
Length of time the neutropenia has existed
The nurse evaluates that the client correctly understands how to report signs of bleeding when
the client makes which of the following statements?

"Petechiae are large red skin bruises."
"Ecchymoses are large purple skin bruises."
"Ecchymoses are large purple skin bruises."
Hemophilia is a hereditary bleeding disorder that

Has a higher incidence in males
Is related to a genetic deficiency of a specific blood-clotting factor
Is associated with joint bleeding and swelling
Is associated with all of the above
Is associated with all of the above
The goal of nursing care for a client with acute myeloid leukemia is to prevent

Cardiac arrhythmias
Liver failure
Renal failure
Hemorrhage and infection
Hemorrhage and infection
too few RBC's
too many RBC's
too few WBC's
too many WBC's
too few platelets
too many platelets
carry oxygen & nutrients
transport hormones
remove wastes
deliver cells to prevent infection
stop bleeding
promote healing
hematopoetic functions
enlargement of lymph nodes
enlargement of spleen
increased platelet formation, increased clotting activity
immature WBC's taking over
"shift to the left"
polymorphonuclear leukocyte (segmented neutrophils)
see these cells in "shift to the left"
blood clot
composed of fibrin and blood cells
blocks flow to distal tissues
blood clot
a blood clot that breaks away from vessel wall
Idiopathic Thrombocytopenia Purpura (ITTP)
autoimmune disease in which blood does not clot as it should (platelets are destroyed in spleen)
promote coagulation & stops bleeding from damaged blood vessels
clotting factors
impaired clotting
vitamin K deficiency, reduction in clotting factors due to liver disease
Disseminated Intravascular Coagulation (DIC)
syndrome of uncontrolled bleeding resulting from systemic multiple clots (due to depletion of clotting factors)
organ that filters blood and removes unwanted material
Hemophilia A
X-linked recessive disorder where no factor VIII is generated, leading to excessive bleeding
Von Willebrand Disease
disorder that decreases platelet stickiness
hemorrhage from every opening
abdominal distention
hematuria (blood in urine)
manifestations of DIC
diagnosis and treatment of DIC
accelarated clotting
decreased platelet count
removal of primary event
heparin if organ failure from hypoxemia
plasma with factor VIII
increased HR and RR
skin pallor
decreased hair and skin quality
clinical manifestations of anemia
anemia due to loss of blood
hemorrhagic anemia
hemorrhagic anemia
whole blood is used for this type of anemia
type of anemia caused by excessive destruction of RBC's (bone marrow unable to compensate)
hemolytic anemia
sickle cell anemia
type of anemia caused by hemoglobin "S"
hypoxia (lack of oxygen)
sickling happens in response to...
type of anemia caused by dysfunction of bone marrow to replace dying cells; consequently all blood cell types are affected
aplastic anemia
pernicious anemia
type of anemia caused by lack of intrinsic factor, a substance needed to absorb vit B-12 from stomach (vit B-12 is need for RBC production)
most common type of anemia
iron deficiency anemia
low white blood count (1000 or less)
caused by Epstein-Barr virus, that infects B lymphocytes
swollen lymph nodes, severe sore throat and fever, overwhelming fatigue
cancer of one class of WBC in bone marrow resulting in proliferation of that cell type to the exclusion of others
acute leukemia
poorly differentiated cells
well differentiated cells
chronic leukemia
acute lymphoblastic leukemia (ALL)
childhood leukemia
after 60 years old
acute myeloblastic leukemia usual onset
disease of the elderly
chronic lymphoblastic leukemia (CLL)
chronic myeloblastic leukemia (CML)
worst kind of leukemia (median survival 3-4 years)
symptoms of leukemia
anemia, neutropenia, thrombocytopenia
presence of Reed-Sternberg cell, spreads predictably
Hodgkin's Disease
Hodgkin's Disease
cancer of the lymph
no R-S cell, spreads unpredictably
Non-Hodgkin's Disease
cancer of the plama cells in bone marrow
multiple myeloma
multiple myeloma
bone pain, Bence Jones proteins found in urine, fractures, recurrent infections
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