Hemo Function Questions 1

Question1Which cell of hematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?  Myeloid stem cell Explanation:Myeloid stem cells are responsible not only for all nonlymphoid white blood cells (WBC) but also for the production of red blood cells and platelets. Lymphoid cells produce either T or B lymphocytes. A monocyte is large WBC that becomes a macrophage when is leaves the circulation and moves into body tissues, and not responsible for RBC production. A neutrophil is a fully mature WBC capable of phagocytosis and not responsible for RBC production. Question2A client with severe anemia is admitted to the hospital. Because of religious beliefs, the client is refusing blood transfusions. The nurse anticipates pharmacologic therapy with which drug to stimulate the production of red blood cells?  Epoetin alfa Explanation:Erythropoietin (epoetin alfa) is an effective alternative treatment for clients with chronic anemia secondary to diminished levels of erythropoietin. This medication stimulates erythropoiesis. Filgratism (Neupogen) and Sargramostim stimulate granulocytosis (increasing WBC count), Eltrombopag (Promacta) is used to treat aplastic anemia and thrombocytopenia. Question3Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called  megaloblasts. Explanation:Megaloblasts are abnormally large erythrocytes. Blast cells are primitive WBCs. Mast cells are cells found in connective tissue involved in defense of the body and coagulation. Monocytes are large WBCs that become macrophages when they leave the circulation and move into body tissues. Question4A client wants to donate blood before his or her abdominal surgery next week. What should be the nurse’s first action?  Explain the time frame needed for autologous donation. Explanation:Preoperative autologous donations are ideally collected 4 to 6 weeks before surgery. The nurse should first explain that time frame to this client. Surgery is scheduled in one week which means that autologous blood donation may not be an option for this client. A list of donation centers can be provided to the client; and even though iron is recommended, and 2 units of blood may be suggested, the first action is to tell the client about the needed time frame for donation. Question5The nurse is working at a blood donation clinic. What teaching should the nurse provide to the donor immediately after blood donation?  Remain for observation after eating and drinking. Explanation:After blood donation, the donor receives food and fluids and is asked to remain for observation. After the needle is removed, donors are asked to hold the involved arm straight up, and firm pressure is applied with sterile gauze for 2 to 3 minutes. A firm bandage is then applied. The donor remains recumbent until he or she feels able to sit up, usually within a few minutes. Question6The nurse is caring for a client who had undergone hemodilution during surgery. Immediately after surgery, the nurse expects to see which lab result?  Decreased hematocrit Explanation:The added intravenous solutions used in hemodilution dilute the concentration of erythrocytes and lower the hematocrit. Adverse outcomes include tissue ischemia, particularly in the kidneys. These adverse outcomes can be manifested as low arterial oxygen saturation and elevated creatinine levels. Question7The health care provider believes that the client has a deficiency in the leukocyte responsible for cell-mediated immunity. What should the nurse check the WBC count for?  T lymphocytes Explanation:T lymphocytes are responsible for cell-mediated immunity, in which they recognize material as “foreign,” acting as a surveillance system. Question8A nurse is assigned to care for a patient with ascites, secondary to cirrhosis. The nurse understands that the fluid accumulation in the peritoneal cavity results from a combination of factors including an alteration in oncotic pressure gradients and increased capillary permeability. Therefore, the nurse monitors the serum level of the plasma protein responsible for maintaining oncotic pressure, which is:  Albumin. Explanation:Albumin, only produced in the liver, is essential for maintaining oncotic pressure in the vascular system. A decrease in oncotic pressure due to low albumin causes fluid to leak into the peritoneal cavity. Question9A nurse is caring for a client who will undergo total knee replacement and will have an autologous transfusion. Which statement will the nurse include when teaching the client about the transfusion?  “You typically donate blood 4 to 6 weeks before the surgery.” Explanation:With autologous donation, a client’s own blood may be collected for future transfusion; this is an effective method for orthopedic surgery, where the likelihood of transfusion is high. Preoperative donation is ideally collected 4-6 weeks before surgery. The nurse will not tell the client that the blood will not be needed; orthopedic surgeries often require transfusion of blood. The client will be prescribed iron supplements during the donation time, not calcium. Question10Which blood cell type is matched correctly with its function?  Leukocyte: Fights infection Explanation:Various blood cell types have unique, major functions. Leukocytes fight infection, T lymphocytes are integral in cell-mediated immunity, plasma cells secrete immunoglobulin, and B lymphocytes are integral in humoral immunity.