Question

Care of the Patient with a Blood or Lymphatic Disorder Lymphatic Disorder CHAPTER 47 15 During a physical rombocytopenia sical assessment of a patient with penia, the nurse would expect to find: undliced atechiae and purpura. diced sclera and skin. der, enlarged lymph nodes. fender, enlar splenomegaly. Which nursing inter or a patient who ng interventions are necessary when caring nt who has a WBC count of 1800/mm2 calert all that apply.) event patient contact with people who have respiratory tract infections or influenza. Perform hand hygiene before and after patient 21. Which are necessary for the maturation of a red dig cell? (Select all that apply.) 1. Vitamin B12 2. Folic acid 3. Renal erythropoietic factor 4. Capric acid 5. Iron 22. Which represents the correct medical manager the patient with DIC? (Select all that apply.) 1. Addressing and correcting underlying cause 2. Transfusion replacement 3. Cryoprecipitate 4. Administering colony-stimulating factor (file [Neupogen)) 5. Heparin therapy contact & Report temperature elevation. Monitor Hgb. & Assess for signs of bleeding.

Answer 1

19. Thrombocytopenia is the low platelet count in the blood. Platelets helps in clotting of blood, Thus low platelet count leads to bleeding.

Petechiae is the bleeding under the skin looks like reddish- purple pin point spot .Similarly, purpura is the purple colored skin hemorrhages seen on mucous membranes of oral cavity and other organs.these bruises can easily develop all over the body. These are the early bleeding manifestations of  Thrombocytopenia.

Jaundice and enlarged speen also seen in advanced stage, but the most identifiable symptoms are Petechiae and Purpura.

Thus the answer is ,1. Petechiae and Purpura.

20.  The normal WBC count in adult is 5,000 to 10,000/mm3. so the patient have low WBC count which means he / she has low immunity. Thus, precautions needs to be taken to reduce the chance of geetting infection. Contact with people who have respiratory tract infection is neceessary as they are most contageous infections and easily transfered through air or droplets. Frequent hand washing while caring the patient will reduce the chance of infection and monitoring themperature is important because high temperature indicate infection.

WBC count has no effect on HGb and bleeding

Thus the answers are, 1. Prevent patient contact with people who have respiratory tract infection or influenza.

2. perform hand hygiene before and after patient contact.

3. Report temperature elevation.

21. Vitamin B₁₂ and folic acid are necessary for DNA synthesis in the mauration phase of RBC in erythropoiesis. Renal erythropoietic factor is an enzyme which stimulate erythropoitin to ints active form and iron is needed for heam symthesis.the y have no influence in maturation of RBC.

Thus the answers are, 1. Vitamin B_{12 ,} 2. Folic acid

22. Disseminated intravascular coagulation is abnormal clot formation in the blood vessels all over the body. the primary management should be identify the cause and treat them. It can subside DIC by effective treatment of underlying cause. Transfusion replacement with platelets (to correct thrombocytopenia), cryoprecipitate ( to replace fibrinogen), fresh frozen plasma ( to increase level of other clotting factors ) can be done if the patient has risk of bleeding.

Heparin therapy can be usesd as prophylactic therapy for slowly progressive DIC and neupogen is used to trate neutropenia.

Thus the correct medical management for DIC are, treating underlying cause, transfusion replacement and cryoprecipitate.

the answers are, 1. Addressing and correcting underlying cause

2. Transfusion replacement

3. Cryoprecipitate