Questions and Answers
What is the main function of the spleen in relation to blood formation?
What is the term for the total arterial blood flow through the tissues?
What is the function of fibrinogen in blood clotting?
What is the term for the process of controlled blood clotting?
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What is the result of the aging process on blood volume?
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What is the function of platelet aggregation in blood clotting?
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What is the term for the process by which blood forms a protein-based structure (clot)?
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What happens to lymphocytes as people age?
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Which of the following is NOT a factor to consider during assessment of a patient's nutrition status?
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What is the purpose of a peripheral blood smear in diagnostic assessment?
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Which of the following is an example of a physical assessment?
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What is the purpose of the Coombs' tests in diagnostic assessment?
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Which of the following is NOT a type of diagnostic assessment?
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What is the purpose of a reticulocyte count in diagnostic assessment?
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Which of the following is an example of additional diagnostic assessment?
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What is the purpose of a platelet aggregation test in diagnostic assessment?
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What is the primary reason for studying bone marrow?
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What should the nurse teach the client to do after a bone marrow aspiration biopsy?
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Why would the nurse ask an 80-year-old client about their dietary habits?
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What is a priority nursing intervention for a client with bleeding gums, fever, fatigue, malaise, and 'chills'?
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What is an important aspect of patient preparation for a bone marrow aspiration biopsy?
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What would the nurse ask an 80-year-old client after asking about dietary habits?
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Why would the nurse ask an 80-year-old client about their medication use?
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What would the nurse provide to the client after a bone marrow aspiration biopsy?
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What is the first action the nurse should take when assessing a client with fatigue, bleeding gums, and chills?
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Why is it important to review laboratory data before administering antibiotic medication?
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What is the primary reason to administer antipyretic medication to a client with fever?
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What is the goal of warfarin therapy for a client?
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What laboratory value would the nurse expect to see in a client receiving warfarin therapy?
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Why is INR a more accurate measure of anticoagulation therapy?
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What is the primary reason to monitor PTT in a client receiving heparin therapy?
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What is the primary purpose of obtaining blood cultures in a client with fever?
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Study Notes
Hematologic System Assessment
- Perfusion refers to the total arterial blood flow through the tissues (peripheral perfusion) and the blood pumped by the heart (central perfusion)
- Clotting is a complex, multi-step process by which blood forms a protein-based structure (clot)
Anatomy and Physiology Review
- Bone marrow is responsible for producing blood cells
- Blood components include:
- Plasma (albumin, globulins, fibrinogen)
- Red blood cells (erythrocytes)
- White blood cells (leukocytes)
- Platelets (thrombocytes)
- Accessory organs of blood formation include:
- Spleen
- Liver
Hemostasis and Blood Clotting
- Hemostasis is a multi-stepped process of controlled blood clotting
- Platelet aggregation is a key step in blood clotting
- There are two blood clotting pathways:
- Extrinsic clotting pathway
- Intrinsic clotting pathway
Anticlotting Forces
- Fibrinolysis is the process by which the body breaks down blood clots
Hematologic Changes Associated with Aging
- Decrease in blood volume with lower levels of plasma proteins
- Bone marrow produces fewer blood cells
- Total RBC and WBC counts are lower
- Lymphocytes are less reactive to antigens and lose immune function
- Hemoglobin levels fall after middle-age
Assessment: Recognize Cues
- Age, gender, and occupation are important factors to consider
- Liver function and nutrition status can affect hematologic health
- Physical assessment should include:
- Skin
- Head and neck
- Respiratory
- Cardiovascular
- Kidney and urinary
- Musculoskeletal
- Abdominal
- Central nervous system
- Psychosocial
- Diagnostic assessment may include:
- Laboratory tests:
- Peripheral blood smear
- CBC
- Reticulocyte count
- Platelet count
- Hemoglobin electrophoresis
- Leukocyte alkaline phosphatase (LAP)
- Coombs' tests (direct and indirect)
- Serum ferritin, transferrin, and TIBC
- Imaging assessment:
- Radioisotopic imaging
- Standard x-rays
- Bone marrow aspiration and biopsy
- Laboratory tests:
Bone Marrow Aspiration and Biopsy
- Patient preparation is important, including providing accurate information and emotional support
- The procedure involves aspirating bone marrow tissue and fluid
- Follow-up care includes teaching the patient to inspect the site every 2 hours for 24 hours and avoiding activity that could result in trauma
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Description
Test your knowledge of the hematologic system, including perfusion, clotting, and blood components. Review anatomy and physiology concepts related to blood cells and production.
