PCCN Hematology and Immunology Flashcards

A patient with anemia has hemoglobin of 7.2 g/dL and reports dizziness with exertion. Which nursing intervention is the priority?

Answer: Assess activity tolerance and implement fall precautions

Dizziness related to anemia increases fall risk; assessing activity tolerance and implementing fall precautions is the immediate safety priority.

Which laboratory result requires immediate reporting in a patient suspected of having thrombotic thrombocytopenic purpura (TTP)?

Answer: Peripheral smear showing schistocytes

Schistocytes (fragmented RBCs) on peripheral smear indicate microangiopathic hemolytic anemia, a hallmark finding of TTP.

A patient is prescribed filgrastim (G-CSF) following chemotherapy. The nurse understands this medication works by:

Answer: Stimulating neutrophil production

Filgrastim (G-CSF) stimulates the bone marrow to produce neutrophils, reducing the duration and severity of neutropenia after chemotherapy.

Which intervention is contraindicated in a patient with severe thrombocytopenia (platelets < 20,000/mm³)?

Answer: Rectal temperature measurement

Rectal procedures are contraindicated in severe thrombocytopenia due to the risk of rectal trauma and uncontrolled hemorrhage.

A patient receiving multiple blood transfusions develops hypocalcemia. The nurse recognizes this is caused by:

Answer: Citrate preservative in stored blood chelating calcium

Citrate is used as a preservative in stored blood and chelates (binds) free calcium, causing hypocalcemia with massive transfusions.

A patient with aplastic anemia is in protective isolation. Which visitor instruction is most important?

Answer: Avoid visiting if experiencing any illness or infection

Visitors with any illness can transmit infection to an immunocompromised patient with aplastic anemia; exclusion of sick visitors is essential.