N406 Exam 3 Hematological

A nurse is reviewing the lab results of a child with an acute bacterial infection. The nurse knows that which type of white blood cell (WBC) serves as the primary attack cell for killing bacteria and viruses, and will be elevated during acute inflammation?

Neutrophils

The nurse is caring for a child with a suspected hematological disorder. When reviewing the functions of blood components, the nurse notes that platelets are stored in which organ, which is also responsible for destroying old cells and keeping blood in balance?

Spleen

A nurse is evaluating the Complete Blood Count (CBC) of a 4-year-old child being worked up for severe iron deficiency anemia. The nurse notes a Mean Corpuscular Volume (MCV) value of 62 fL. How should the nurse interpret the size of these red blood cells?

Microcytic

The nurse is reviewing a child's laboratory panel and notes an MCH (Mean Corpuscular Hemoglobin) value that is well below 26 pg/cell. The nurse knows that this indicates the red blood cells are hypochromic. Which condition should the nurse most closely evaluate for based on these values?

Iron deficiency anemia

A nurse is preparing to administer a packed red blood cell (PRBC) transfusion to a child with severe anemia. Which action is a mandatory safety guideline before initiating the intravenous infusion?

Double-check the blood product package and patient identification with a secondary nurse.

The nurse has just initiated a packed red blood cell transfusion for a pediatric client. According to facility transfusion protocols, how frequently should the nurse monitor and document the client's vital signs?

Frequently, following the specific facility transfusion protocol.

Ten minutes after a blood transfusion is started, a child develops a sudden fever, chills, severe lower back pain, and tachycardia. What is the nurse's priority action?

Discontinue the transfusion immediately, run normal saline through a new line, obtain vital signs, and notify the provider.

A child undergoing a massive blood transfusion for trauma begins to exhibit severe cardiac dysrhythmias and muscle weakness. The nurse notes the blood product was not fully fresh. Which electrolyte disturbance should the nurse suspect?

Hyperkalemia

A nurse is assessing a 14-month-old toddler during a well-child visit. The mother states that the child drinks 40 ounces of whole cow's milk per day and refuses most solid foods. The nurse knows this dietary pattern puts the child at a high risk for which condition?

Iron deficiency anemia

The nurse is preparing to discharge a child who has been prescribed daily oral iron supplements for iron deficiency anemia. Which instruction should the nurse include to enhance the absorption of the supplement?

Give the iron supplement alongside a beverage rich in Vitamin C, such as orange juice.

A mother asks the nurse why her child's oral iron supplement must be administered through a straw or a medicine dropper placed far back in the mouth. What is the correct clinical rationale?

Daily oral iron preparations can temporarily or permanently stain the teeth.

The nurse is teaching the parents of a 5-month-old infant who was born full-term about introducing iron-fortified dietary items. At what age should iron supplementation or fortified food introduction routinely begin for a full-term infant?

At 4 to 6 months of age.

A nurse is assessing a child with a known history of Hemophilia A. The nurse knows that Hemophilia A is characterized by a hereditary deficiency or dysfunction of which specific coagulation protein?

Factor VIII

The nurse is reviewing the genetic transmission of Hemophilia A and B. Which description accurately identifies the inheritance pattern of these disorders?

X-linked autosomal recessive disorder.

An 8-year-old child with severe Hemophilia A is brought to the clinic presenting with swelling, warmth, pain, and a severely limited range of motion in the right knee joint. What complication should the nurse suspect?

Recurrent bleeding into the joints (hemarthrosis).

A child with Hemophilia A is admitted with a mild laceration on their forearm. What is the primary management goal for a client with this metabolic bleeding disorder?

Prevent bleeding and supply the body with the missing or ineffective factor.

The nurse is providing home safety education to the parents of a toddler who was recently diagnosed with hemophilia. Which over-the-counter medication group must the nurse instruct the parents to strictly avoid?

Aspirin and NSAIDs.

A nurse is assessing a 2-year-old child during a routine screening visit. The nurse notes the family lives in an older home built in 1950 with peeling paint. According to blueprint guidelines, which initial tool should the nurse implement to evaluate for lead poisoning?

A formal risk assessment questionnaire at scheduled intervals.

The nurse is reviewing the physiological tracking logs for a child with a confirmed elevated blood lead level. The nurse knows that lead exerts its most severe toxic effects on which three body systems?

Bone marrow, nervous system, and kidneys.

A nurse is coordinating a community health workshop on environmental toxins. When discussing lead poisoning, the nurse should inform parents that long-term, untreated exposure can lead to which serious complications?

Behavioral problems, learning disabilities, seizures, and brain damage.

The nurse is preparing to care for a child with a laboratory plate count of 32,000 platelets per microliter of blood. The nurse knows that a normal platelet count falls within which reference range?

150,000 to 450,000 platelets per microliter.

A nurse is assessing a child who is receiving an intravenous infusion of plasma. The child suddenly develops a severe cough, dyspnea, crackles in the lung bases, and distended neck veins. Which transfusion complication should the nurse suspect?

Circulatory Overload

The nurse is reviewing the laboratory panel of a child with macrocytic anemia. The nurse knows that an inability to form normal-sized hemoglobin can occur due to a dietary lack of which two essential vitamins?

Vitamin B12 and folic acid.

A pediatric client with hemophilia presents to the clinic with an acute nosebleed (epistaxis). Which action should the nurse implement first to manage the bleeding mechanically?

Apply direct pressure by pinching the soft lower part of the nose while having the child lean forward.

A nurse is reviewing a risk assessment for lead poisoning completed by the parents of a 3-year-old child. The assessment indicates the child plays near an industrial soil yard. Because this indicates a positive risk, which secondary action should the nurse implement?

Perform a blood level screening to evaluate the exact lead concentration.

The nurse is preparing to care for a child who has been diagnosed with iron deficiency anemia due to blood loss from intestinal parasites. When planning long-term monitoring, the nurse knows that iron deficiency anemia is systematically associated with which development delays?

Cognitive delays and behavioral changes.

A nurse is reviewing the lab results of a toddler with chronic inflammation. The nurse should expect to see an elevation in which type of white blood cell?

Monocytes

The nurse is reviewing a complete blood count (CBC) for a child recovering from an injury. The nurse notes the child's basophil count is elevated. The nurse knows that basophils contain histamine, heparin, and serotonin, and serve which primary function?

Increase blood flow to injured tissues while preventing excessive clotting.

A nurse is assessing a child who has an elevated eosinophil count. The nurse should recognize that eosinophils are typically increased in which conditions?

Allergies, parasitic diseases, and certain neoplasms.

The nurse is reviewing the laboratory profile of a child with severe anemia. The Total Iron Binding Capacity (TIBC) is noted to be increased. The nurse knows that an increased TIBC is a classic laboratory indicator of which condition?

Iron deficiency anemia

A nurse is teaching a student nurse about the lifespan of red blood cells (RBCs) compared to platelets in a pediatric client. Which statement by the student is correct?

RBCs live for 90–120 days, while platelets live for 8–10 days.

The nurse is caring for an infant who has been diagnosed with iron deficiency anemia. When exploring the medical history, the nurse notes the infant was born prematurely. The nurse should recognize that prematurity causes anemia through which mechanism?

Inadequate or inadequate iron stores at birth.

A parent of a child with iron deficiency anemia asks the nurse why they cannot give the child their daily iron supplement with a glass of milk. What is the nurse's best response?

Milk causes decreased absorption of the iron supplement; it should never be given with milk.

The nurse is instructing a family on how to administer an oral iron supplement to their child. To maximize safety and absorption, how should the daily dose be scheduled?

In 2 divided doses between meals.

A nurse is preparing an educational pamphlet for parents regarding the prevention of iron deficiency anemia. Which dietary recommendation is essential for children over the age of 1 year?

Limit cow's milk intake to 24 oz/day or less.

During a blood transfusion, a child suddenly develops urticaria (hives), pruritus (itching), and localized flushing. The nurse recognizes these findings as indicative of which type of blood transfusion complication?

Allergic Reaction

A nurse is monitoring a client during a blood transfusion who suddenly develops a fever, chills, and a headache, but no signs of a hemolytic or allergic reaction. The nurse notes this is likely due to leukocyte or platelet antibodies. Which term identifies this complication?

Febrile Reaction

The nurse is caring for a child with Hemophilia B. The nurse knows that Hemophilia B is characterized by a hereditary deficiency of which specific coagulation protein?

Factor IX

The nurse is reviewing the clinical indications for a child with hemophilia who experiences frequent minor lacerations and tooth loss. The nurse notes that bleeding frequently occurs with which daily events?

Loss of deciduous teeth, minor lacerations, and injections.

A nurse is preparing to administer an emergency blood transfusion to an infant under pressure. Which specific non-hemolytic complication must the nurse remain alert for when blood is transfused under pressure?

Air Emboli

A nurse is checking the safety parameters for a client receiving a rapid, massive blood transfusion. In addition to monitoring for hyperkalemia, the nurse should be alert to what other non-reactive transfusion complications?

Hypothermia and electrolyte disturbances.