PCCN Hematology and Immunology Flashcards

A progressive care patient has a platelet count of 18,000/mm³. Which intervention is the highest priority?

Answer: Initiate bleeding precautions

A platelet count below 20,000/mm³ carries a high risk of spontaneous bleeding, requiring immediate bleeding precautions.

Which laboratory finding is most consistent with disseminated intravascular coagulation (DIC)?

Answer: Low fibrinogen and elevated D-dimer

DIC is characterized by consumption of clotting factors and fibrinogen, along with elevated D-dimer from fibrinolysis.

A patient receiving a blood transfusion develops fever, chills, and flank pain 15 minutes after initiation. What is the nurse's first action?

Answer: Stop the transfusion immediately

Signs of a hemolytic transfusion reaction require immediate cessation of the transfusion to prevent life-threatening complications.

Which finding indicates a patient with sickle cell crisis is developing acute chest syndrome?

Answer: New infiltrate on chest X-ray with hypoxia

Acute chest syndrome is diagnosed by a new pulmonary infiltrate on imaging combined with respiratory symptoms such as hypoxia.

A patient with neutropenia (ANC < 500) develops a temperature of 38.5°C. The nurse should anticipate which intervention first?

Answer: Blood cultures and broad-spectrum antibiotics

Febrile neutropenia is a medical emergency; blood cultures must be obtained and broad-spectrum antibiotics started promptly.

Which blood product is most appropriate for a patient with hemophilia A experiencing an acute bleed?

Answer: Cryoprecipitate or Factor VIII concentrate

Hemophilia A is caused by Factor VIII deficiency; cryoprecipitate or recombinant Factor VIII concentrate replaces the missing factor.