Hematological and Oncological Nursing Flashcards

A patient receiving chemotherapy develops a neutrophil count of 400 cells/mm³. Which intervention is the HIGHEST priority?

Answer: Initiate neutropenic precautions and reverse isolation

A neutrophil count below 500 cells/mm³ indicates severe neutropenia, and reverse isolation (protective precautions) is the priority to prevent life-threatening infection.

Which assessment finding is MOST consistent with a patient experiencing sickle cell crisis?

Answer: Severe localized bone pain and fever

Vaso-occlusive (painful) sickle cell crisis causes severe bone and joint pain due to microvascular obstruction, often accompanied by fever.

A nurse is caring for a patient with thrombocytopenia (platelet count 18,000/mm³). Which action should the nurse AVOID?

Answer: Administering aspirin for headache

Aspirin inhibits platelet aggregation and is contraindicated in thrombocytopenia because it further increases the risk of serious bleeding.

A patient is receiving a blood transfusion and develops chills, fever, and back pain 15 minutes after initiation. What is the FIRST nursing action?

Answer: Stop the transfusion and keep the IV line open with normal saline

Stopping the transfusion immediately while maintaining IV access with normal saline is the priority to prevent further exposure to incompatible blood products.

Which laboratory value requires IMMEDIATE intervention in a patient with multiple myeloma?

Answer: Serum calcium 13.8 mg/dL

A serum calcium of 13.8 mg/dL indicates hypercalcemia, a serious complication of multiple myeloma that can cause cardiac dysrhythmias, altered mental status, and renal failure.

A patient with leukemia is being discharged after chemotherapy. Which statement by the patient indicates a need for FURTHER teaching?

Answer: 'I can visit my grandchildren even if they have a cold; they need me.'

Immunocompromised patients must avoid contact with individuals who have infections, including minor colds, as these can be life-threatening when neutropenic.

Which finding is characteristic of disseminated intravascular coagulation (DIC)?

Answer: Prolonged PT, prolonged aPTT, and elevated D-dimer

DIC involves consumption of clotting factors and platelets, resulting in prolonged PT and aPTT, thrombocytopenia, low fibrinogen, and elevated D-dimer from fibrinolysis.