Objectives & Key Points
What does anemia mean?
A deficiency of erythrocytes or hemoglobin.
A client with anemia has extreme pallor, tachycardia, hypotension, and reduced urine output after blood loss. What type of anemia fits this picture?
Hypovolemic anemia.
What is leukemia characterized by?
Proliferation of leukocytes, usually in immature form.
What is thrombocytopenia in the chapter?
Decreased platelet manufacture by bone marrow or increased platelet destruction by the spleen.
For hypovolemic anemia, what laboratory result should the nurse monitor closely?
CBC results.
Name three major causes of anemia listed in the chapter.
Blood loss, inadequate RBC production, or destruction of RBCs.
Which anemia is caused by lack of intrinsic factor needed for vitamin B12 absorption?
Pernicious anemia.
How are the four forms of leukemia classified in this chapter?
Acute and chronic forms of lymphocytic and myelogenous leukemia.
Name three assessment findings associated with thrombocytopenia.
Purpura, bleeding, and internal hemorrhage.
For pernicious anemia with glossitis and stomatitis, what dietary and oral-care measures are listed?
A soft, bland diet; small, frequent meals; and oral care.
What term describes a condition in which the numbers of all blood cells are reduced?
Pancytopenia.
Which anemia is associated with immature erythrocytes, insufficient dietary folate/B9, a beefy-red tongue, fatigue, and weakness?
Folic acid deficiency anemia.
A leukemia client has bruising, petechiae, fever, fatigue, and bleeding. Name two major nursing risks.
Infection and hemorrhage.
What is hemophilia caused by?
Absence or reduction in a clotting factor; it is inherited from mother to son.
What should a nurse caring for a leukemia client monitor closely for bleeding?
Platelet counts, bruising, petechiae, hematuria, and epistaxis.
What disorder differentiates from leukopenia and it identifies as decreased production of granulocytes.
Agranulocytosis.
Which hereditary hemolytic anemia is associated with alpha- and beta-thalassemias and may require frequent transfusions and iron chelation?
Thalassemia
Multiple myeloma is a malignancy involving what cell type, and what happens to bone?
Plasma cells; osteoclasts break down bone, causing increased blood calcium and pathologic fractures.
A client with hemophilia has bleeding into a joint. Name two medical measures listed in the chapter.
Examples include factor concentrate, fresh frozen plasma, transfusions, direct pressure, or thrombin/fibrin application.
What infection-control nursing measure is listed for agranulocytosis?
Protective/neutropenic isolation and visitor restriction.
Name the two coagulopathies specifically developed in this chapter.
Thrombocytopenia and hemophilia.
A client has chronic premature RBC destruction, jaundice, an enlarged spleen, and possible shock. Identify the disorder and one treatment listed in the chapter.
Hemolytic anemia; treatment may include removing the cause, corticosteroids, blood transfusions, or splenectomy.
A client with multiple myeloma has bone pain and renal calculi. What other findings and nursing priorities should the nurse consider?
Possible anemia, infection, bruising/nosebleeds; assess pain, infection, fatigue, bleeding, thrombus formation and urine; promote safety, fluids, ambulation as appropriate, analgesia, and infection prevention.
A client with hemophilia is being discharged. What are two major nursing teaching priorities?
Prevent trauma/minimize bleeding and teach ways to prevent further episodes; the chapter also emphasizes conserving energy and monitoring transfusions.
A client has aplastic anemia with pancytopenia. Give three nursing priorities from the chapter.
Infection prevention/isolation measures, nutrition support, modified oral hygiene to prevent bleeding/infection, and close monitoring of blood transfusions.