Hematology/Anemia Lecture

A patient with Thalassemia Major is receiving a blood transfusion. The nurse notes the patient is also prescribed deferoxamine. What is the primary purpose of this medication in this patient?

To treat iron overload (hemosiderosis) caused by chronic transfusions.

A nurse is providing discharge teaching for a patient with newly diagnosed iron-deficiency anemia. Which statement by the patient indicates a need for further instruction?

"I should take my iron and my calcium supplement at the same time to stay organized".

Which clinical manifestation is a unique finding specific to Vitamin B12 (Cobalamin) deficiency that is NOT typically seen in Folic Acid deficiency?

Paresthesias of the hands and feet

During a blood transfusion, the patient suddenly develops a fever, chills, and lower back pain. What is the nurse's first priority action?

Stop the transfusion immediately and maintain IV access with saline.

A patient with a history of a ruptured spleen is at an increased risk for which of the following?

Impaired filtration of old or defective RBCs and bacteria.

Which statement regarding hematologic changes in the older adult is accurate?

Humoral antibody responses and T-cell function may decrease.

Put the following events of hemostasis in the correct sequence (1-6):

• Activation

• Vascular injury and subendothelial exposure

• Clot retraction and dissolution

• Adhesion

• Platelet plug formation

• Aggregation

Vascular injury -> Adhesion -> Activation -> Aggregation -> Plug formation -> Clot retraction

A nurse is caring for a patient on heparin who shows a 50% drop in their baseline platelet count. Which condition should the nurse immediately suspect?

Heparin-induced thrombocytopenia (HIT).

A patient's labs show an MCV of 110 fL and an MCH of 36 pg. Which condition does this most likely indicate?

Folic acid deficiency

Which anemia is characterized by "pancytopenia"—a decrease in all blood cell types (RBCs, WBCs, and platelets)?

Aplastic anemia

What are the three major functions of blood?

Transportation, regulation, and protection

In the laboratory evaluation of iron metabolism, which specific tests are used to differentiate anemias?

Serum levels of iron, TIBC, serum ferritin, and transferrin saturation.

A patient with Hemophilia A is preparing for dental surgery. What is the primary means of supporting this patient?

Prophylactic replacement of the deficient clotting factor.

What distinguishes Hemochromatosis from other iron-related disorders?

It is characterized by increased intestinal iron absorption and tissue iron deposition.

A nurse is monitoring a patient for a delayed transfusion reaction. Which of the following are considered delayed reactions?

Delayed hemolytic reactions, infections, and iron overload.

When administering a blood transfusion, what is the most common cause of a hemolytic transfusion reaction?

Transfusion of ABO-incompatible blood due to improper identification.

What is hemoglobin composed of?

Hemoglobin, a complex protein-iron compound composed of heme (an iron compound) and globin (a simple protein), binds with O2 and CO2.

Which inherited disorder involves an autosomal recessive basis and inadequate production of normal hemoglobin?

Thalassemia

Which life-threatening condition is characterized by the sudden development of noncardiogenic pulmonary edema following a blood transfusion?

Transfusion-related acute lung injury (TRALI)

Your lecture notes list specific nutrients needed for Erythropoiesis. Which of the following is NOT listed in your notes as a required nutrient?

Calcium and Magnesium

What is the primary goal of therapy for a patient with Hemochromatosis?

To remove excess iron from the body and minimize symptoms.

In your lecture notes, "DO2" (Oxygen delivery) is delivered in 3 ways. What are they?

Hemoglobin, Heart, and Lungs.

Your lecture notes mention that the WBC count and differential are generally not affected by aging. However, what specific change does occur in the older person's immune system according to the textbook?

A decrease in humoral antibody response and T-cell function

Which condition results from abnormally initiated and accelerated clotting, leading to the consumption of clotting factors and potentially uncontrollable hemorrhage?

Disseminated Intravascular Coagulation (DIC)

According to Chapter 33, what happens to the osmotic fragility of Red Blood Cells in the older person?

It increases, making the cells more likely to rupture.

Which statement regarding hemoglobin levels in men is correct according to the textbook?

Levels may begin to decrease after middle age.

According to your lecture notes, what does a reticulocyte count of less than 3% generally indicate in an anemic patient?

A production problem or an anemia-related issue.

Which of the following is a rule for blood component therapy as outlined in Chapter 34?

Positive identification of the donor blood and recipient must be made to prevent hemolytic reactions.

According to the textbook, what is a "massive blood transfusion reaction" and when does it occur?

A reaction occurring when 10 or more units of RBCs are transfused within 24 hours.

According to Chapter 34, what is "Autotransfusion" and why is it used?

Removing whole blood from a person and transfusing it back into the same person to avoid incompatibility.

Your lecture notes list "Energy Conservation" as a nursing intervention. Which of the following is a specific example of this from your notes?

Cluster care to disrupt the patient less.

According to Chapter 33, which laboratory test is used specifically to identify the percentage of different types of white blood cells in the circulating blood?

Differential WBC count