Nokea
A patient is scheduled for a splenectomy. During discharge education, what teaching point should the nurse prioritize?
- A. The importance of adhering to prescribed immunosuppressant therapy
- B. The need to report any signs or symptoms of infection promptly
- C. The need to ensure adequate folic acid, iron, and vitamin B12 intake
- D. The importance of limiting activity postoperatively to prevent hemorrhage
Correct Answer: B
Rationale: After splenectomy, the patient is instructed to seek prompt medical attention if even relatively minor symptoms of infection occur. Often, patients with high platelet counts have even higher counts after splenectomy, which can predispose them to serious thrombotic or hemorrhagic problems. However, this increase is usually transient and therefore often does not warrant additional treatment. Dietary modifications are not normally necessary and immunosuppressants would be strongly contraindicated.
You may also like to solve these questions
A patient undergoing a hip replacement has autologous blood on standby if a transfusion is needed. What is the primary advantage of autologous transfusions?
- A. Safe transfusion for patients with a history of transfusion reactions
- B. Prevention of viral infections from another persons blood
- C. Avoidance of complications in patients with alloantibodies
- D. Prevention of alloimmunization
Correct Answer: B
Rationale: The primary advantage of autologous transfusions is the prevention of viral infections from another persons blood. Other secondary advantages include safe transfusion for patients with a history of transfusion reactions, prevention of alloimmunization, and avoidance of complications in patients with alloantibodies.
The nurse is caring for a patient who has developed scar tissue in many of the areas that normally produce blood cells. What organs can become active in blood cell production by the process of extramedullary hematopoiesis?
- A. Spleen and kidneys
- B. Kidneys and pancreas
- C. Pancreas and liver
- D. Liver and spleen
Correct Answer: D
Rationale: In adults with disease that causes marrow destruction, fibrosis, or scarring, the liver and spleen can also resume production of blood cells by a process known as extramedullary hematopoiesis. The kidneys and pancreas do not produce blood cells for the body.
A nurse is educating a patient about the role of B lymphocytes. The nurses description will include which of the following physiologic processes?
- A. Stem cell differentiation
- B. Cytokine production
- C. Phagocytosis
- D. Antibody production
Correct Answer: D
Rationale: B lymphocytes are capable of differentiating into plasma cells. Plasma cells, in turn, produce antibodies. Cytokines are produced by NK cells. Stem cell differentiation greatly precedes B lymphocyte production.
A patient is receiving the first of two ordered units of PRBCs. Shortly after the initiation of the transfusion, the patient complains of chills and experiences a sharp increase in temperature. What is the nurses priority action?
- A. Position the patient in high Fowlers.
- B. Discontinue the transfusion.
- C. Auscultate the patients lungs.
- D. Obtain a blood specimen from the patient.
Correct Answer: B
Rationale: Stopping the transfusion is the first step in any suspected transfusion reaction. This must precede other assessments and interventions, including repositioning, chest auscultation, and collecting specimens.
A man suffers a leg wound which causes minor blood loss. As a result of bleeding, the process of primary hemostasis is activated. What occurs in primary hemostasis?
- A. Severed blood vessels constrict.
- B. Thromboplastin is released.
- C. Prothrombin is converted to thrombin.
- D. Fibrin is lysed.
Correct Answer: A
Rationale: Primary hemostasis involves the severed vessel constricting and platelets collecting at the injury site. Secondary hemostasis occurs when thromboplastin is released, prothrombin converts to thrombin, and fibrin is lysed.