Blood Cells: Formation and Function

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Questions and Answers

In which of the following locations does hematopoiesis primarily occur?

  • Spleen
  • Bone marrow (correct)
  • Liver
  • Lymph nodes

A client with a history of anemia is admitted. Which condition would most likely contribute to decreased or delayed blood cell production?

  • Elevated iron levels
  • Anemic conditions (correct)
  • Increased erythropoietin production
  • Normal hemoglobin levels

The production of red blood cells (RBCs) is dependent on several nutritional factors. Deficiency in which of the following nutrients would most significantly impair RBC production?

  • Calcium
  • Sodium
  • Vitamin C
  • Vitamin B12 (correct)

A client's lab results indicate a low RBC count. To promote normal erythrocyte production, the nurse should encourage the client to increase intake of which nutrients?

<p>Iron, vitamin B12, folic acid, vitamin B6, and protein (C)</p> Signup and view all the answers

Which of the following best describes the primary function of leukocytes (WBCs)?

<p>Carrying out immune functions (A)</p> Signup and view all the answers

After reviewing a client's lab results, the nurse notes an elevated number of band cells. This finding indicates which of the following conditions?

<p>Infection (A)</p> Signup and view all the answers

B-lymphocytes play a crucial role in the body's immune response. What is their primary function?

<p>Producing antibodies against specific antigens (C)</p> Signup and view all the answers

Which of the following describes the role of T-lymphocytes in hemostasis?

<p>Directly attacking infected cells (C)</p> Signup and view all the answers

The nurse is caring for a client with liver dysfunction. Which potential hematologic complication is the client at an increased risk for?

<p>Anemia (D)</p> Signup and view all the answers

A client who experienced significant dehydration is likely to exhibit which alteration in hematocrit levels?

<p>Falsely elevated hematocrit (A)</p> Signup and view all the answers

What is the purpose of the Schilling test?

<p>Assessing vitamin B12 absorption (A)</p> Signup and view all the answers

Which of the following findings is most indicative of Hodgkin's lymphoma?

<p>Presence of Reed-Sternberg cells (C)</p> Signup and view all the answers

A patient is diagnosed with Hodgkin's lymphoma. Which assessment finding is most consistent with this condition?

<p>Painless enlargement of lymph nodes (B)</p> Signup and view all the answers

A nurse is teaching a client who is receiving treatment for Hodgkin's lymphoma about dietary modifications. Which instruction is most appropriate?

<p>Adhere to a neutropenic diet to reduce the risk of bacterial infection (C)</p> Signup and view all the answers

A client with hemophilia is experiencing bleeding into the joints. What sign/symptom should the nurse closely monitor for?

<p>Decreased range of motion (D)</p> Signup and view all the answers

The nurse is caring for a child with hemophilia who has a minor cut. What intervention is appropriate?

<p>Applying pressure to the bleeding site (C)</p> Signup and view all the answers

Parents of a child with hemophilia are seeking advice on appropriate physical activities. Which activity is most suitable and safe for the child?

<p>Swimming (B)</p> Signup and view all the answers

Which of the following is a common cause of sickle cell crisis?

<p>Hypoxia (A)</p> Signup and view all the answers

A nurse is teaching a client with sickle cell anemia about measures to prevent a sickle cell crisis. Which instruction is most important?

<p>Avoid high-altitude environments (B)</p> Signup and view all the answers

During a sickle cell crisis, a client reports severe pain. Which intervention is the most appropriate initial action?

<p>Administer oxygen (C)</p> Signup and view all the answers

A client asks the nurse, “What does hydroxyurea do for sickle cell anemia?” What is the most accurate response?

<p>Hydroxyurea makes red blood cells larger and more flexible (A)</p> Signup and view all the answers

A nurse is preparing to administer a blood transfusion to an older adult client. Which is a critical action to prevent complications?

<p>Assess kidney function, fluid status, and circulation prior to administration (B)</p> Signup and view all the answers

The nurse discovers that the blood bag label does not match the client's information. What action should the nurse take?

<p>Return the blood to the blood bank and notify them of the discrepancy (A)</p> Signup and view all the answers

The order says to transfuse as quickly as possible. What solution could be used in conjunction with blood products to ensure patency in an IV

<p>0.9% Sodium Chloride (A)</p> Signup and view all the answers

A nurse is providing post-procedure care for a client following a bone marrow aspiration. What action should the nurse take?

<p>Placing the client on bedrest for at least 1 hour (C)</p> Signup and view all the answers

What type of cancer would be caused by malignancies of the precursor cells

<p>Blastoma (C)</p> Signup and view all the answers

Upon cleaning the bone marrow biopsy site, which actions are inappropriate

<p>Use ASA (D)</p> Signup and view all the answers

Lack of heme, the product that makes RBC's, could be a result of what disease process

<p>Iron Deficiency Anemia (A)</p> Signup and view all the answers

What is a sign and/or symptom of iron deficiency anemia?

<p>Tachycardia (A)</p> Signup and view all the answers

Which action will increase Iron absorption?

<p>Increase Vitamin C (C)</p> Signup and view all the answers

If a supplement stains the teeth, what is the correct method of administration?

<p>Give medication via straw (D)</p> Signup and view all the answers

When giving ferrous sulfate, when are the ideal times to administer the medication?

<p>On an empty stomach (A)</p> Signup and view all the answers

Which signs and/or symptoms require strict monitoring when giving Erythropoieten medication?

<p>Increased Blood Pressure (C)</p> Signup and view all the answers

What are the tell-tale signs/symptoms of Plummer-Vinson syndrome?

<p>Chronic Iron Deficiency and Dysphagia (D)</p> Signup and view all the answers

Lack of intrinsic factor is the hallmark of what anemia type?

<p>B12 deficiency Anemia (A)</p> Signup and view all the answers

Describe, briefly, the skin of a B12 deficient patient

<p>Lemon Yellow (C)</p> Signup and view all the answers

Which medication should be avoided when B12 deficient?

<p>Alcohol (B)</p> Signup and view all the answers

What foods can B12 deficient individuals consume to increase B12 levels?

<p>Cheese, Eggs, Fish (D)</p> Signup and view all the answers

Alcohol deficiencies, specifically Alcoholic's Anemia, causes what type of problems in the body

<p>Decreased number of platelets, increasing risk of bleeding (C)</p> Signup and view all the answers

What nutritional recommendations apply to those suffering from Folic Acid Deficiency Anemia?

<p>Eat citrus fruits and leafy greens (B)</p> Signup and view all the answers

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Flashcards

Hematopoiesis

Formation of blood cells; occurs in bone marrow.

RBCs (Erythrocytes)

Largest group of blood cells; dependent on nutrition.

Hemoglobin (Hgb)

Oxygen-carrying component of red blood cells.

Hematocrit (Hct)

Count of red blood cells.

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Hemostasis

Blood clotting; body's ability to prevent blood loss.

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Liver's role in erythropoiesis

Promotes erythropoiesis when bone marrow is insufficient.

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Elevated bands

Neutrophils with elevated band cells, indicating ongoing infection.

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B-lymphocytes (B-cells)

Produce antibodies against specific antigens.

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T-lymphocytes (T-cells)

Directly attack infected cells.

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Hodgkin's Disease

Cancer of lymphoid origin characterized by Reed-Sternberg cells.

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Hemophilia

Hereditary bleeding disorder due to deficiency of a coagulation protein.

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Hemarthrosis

Bleeding into the joint.

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Sickle cell anemia

Genetic mutation causing sickling RBCs.

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Sickle cell pathophysiology

Insoluble hemoglobin obstructs blood flow causing ischemia.

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Splenic sequestration

Enlarged spleen rapidly destroys blood cells.

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Aplastic crisis

Inadequate replacement of RBCs.

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Supplemental Oxygen

Helps reduce sickling effect in SCA

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Blanching

Painless superficial area turns white when pressure is applied.

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Bone marrow aspiration

Incision site care after bone marow collection and aspiration

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Iron deficiency anemia (an abnormal lab)

Deficient iron intake leads to reduced production of hemoglobin.

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Neutropenia

Deficiency of mature infection-fighting cells.

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Neutropenic diet

Used to reduce bacteria in food.

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Pernicious anemia

Lack of intrinsic factor leads to malabsorption of B12.

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Vegan B12 recommendations

Supplement for B12 absorption with no animal products.

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Polyethylene glycol 3350 (MiraLAX) Docusate sodium (Senokot)

Laxative agents for constipation.

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Skin cancer risk factors

Heredity, chemical irritants, radiation, chronic irritation

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Skin cancer identifiers

A- Asymmetry, B- Borders, C- Color, D- Diameter, E- Evolving

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Herpes Zoster

Very infections with a specific virus.

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Fungal Tinea Infections

Caused by dermatophytes and yeasts

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Pressure ulcer

Localized injury to the skin and underlying tissue.

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Prvention for pressure ulcers

Excellent nursing care, relieve pressure and good nurtrition.

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Development of pressure ulcers

In Older adults, frail skin with comodities,mobility and more.

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Suspected deep tissue (DTI)

Appears like purple or maroon area with an intact/ bllood filled blister

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Stage II - Pressure ulcers

Open/ Ruptured serum filled and a Shallow crater.

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Stage III ulcers

full thickness skinloss that extends down but not through.

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Stage four ulcers

damages the muscle tendons and supports to joints.

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Unstagable areas

Cantbe staged deep crater the covers the tissue.

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Systemic effects- fluid changes

Dehydration, Glucose increases, and BUN is increased to fluid loss

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Immediate care at scene: burm patient

stop running, cool water, cover skin.

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Study Notes

Bone Marrow

  • Hematopoiesis, the formation of blood cells, occurs in the bone marrow.
  • Blood cells formation and maturation occurs in the bone marrow.
  • In anemic conditions, blood cell production is decreased or delayed.

RBC’s (Erythrocytes)

  • RBCs are the largest group of blood cells.
  • Erythrocyte production relies on adequate nutrition, including vitamins.
  • RBCs are formed in bone marrow.
  • Hemoglobin (Hgb) is contained within RBCs and carries oxygen.
  • Hematocrit (Hct) is contained within RBC's and measures the count of RBCs.
  • Carries antigens, including antibodies which determine blood type.
  • Normal erythrocyte production needs iron, Vitamin B12, folic acid, Vitamin B6, and protein.
  • Normal RBC range is 4.1-5.3 million/mm3.

WBC’s (Leukocytes)

  • Protein is essential for WBCs to perform their functions.
  • Neutrophils are a mature type of WBC involved in phagocytosis and fighting infection.
    • Band cells are immature neutrophils, and elevated levels indicate infection.
    • B-lymphocytes (B-cells) produce antibodies against specific antigens.
    • T-lymphocytes (T-cells) directly attack infected cells.

Hemostasis

  • Hemostasis is the body’s ability to prevent blood loss through blood clotting.

Liver

  • The liver promotes erythropoiesis if bone marrow production is insufficient.
  • Patients with liver dysfunction are at high risk for anemia, endocrine disorders, malnutrition, and drug toxicities.

Diagnostic Tests & Procedures

  • WBC normal range is 5,000–10,000/µL.
  • Hemoglobin (Hgb):
    • Male: 14–18 g/dL
    • Female: 12–16 g/Dl
  • Hematocrit:
    • Male: 40%–52%
    • Female: 37%–47%
  • Platelets: 150–400,000/mm³
  • Schilling Test assesses Pernicious anemia-B12 absorption.

Cell Type and Major Function

  • WBC (Leukocyte): Fights infection.
  • Neutrophil: Prevents or limits bacterial infection via phagocytosis.
  • Monocyte: Enters tissue as macrophage; highly phagocytosis; esp. against fungus.
  • Eosinophil: Involved in allergic reactions (neutralizes histamine); digests foreign protein.
  • Basophil: Contains histamine; integral part hypersensitivity reactions.
  • Lymphocyte: Integral component of the immune system.
  • T lymphocyte: Cell-mediated immunity; recognizes material as “foreign".
  • B lymphocyte: Responsible for antibody-immunity; many mature into plasma cells to form antibodies.
  • Plasma cell: Secretes immunoglobulin; most mature to form B lymphocyte.
  • RBC (erythrocyte): Carries hemoglobin to provide O2 to tissues; lifespan 120 days.
  • Platelet (thrombocyte): Provides bases for coagulation to occur; maintains hemostasis; lifespan 7 days.

Nursing Alerts

  • False elevated hematocrit (Hct.) occurs in fluid volume loss (DEHYDRATION).
  • Falsely lower hematocrit is seen in fluid gain (hemodilution).

Malignant Lymphoma

  • Hodgkin’s disease: Proliferation of malignant Reed-Sternberg cells (looks like an owl) within lymph nodes.
  • Reed-Sternberg cells proliferate in a single lymph node, spreading through the lymphatic system to other nodes and organs.

Assessment Findings of Hodgkin’s Disease

  • Painless enlargement of lymph nodes begins on one side of the neck (cervical or supraclavicular).
  • Other findings include dyspnea, bone pain, dysphagia, edema, and cyanosis of face and neck.
  • Experience recurrent, intermittent fever without apparent reason.
  • Drenching night sweats.
  • Fatigue, malaise, cough, recurrent infection.
  • Weight loss of more than 10% in <6 months.

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