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    If the mother was given RhoGAM before or shortly after the birth of the first child, there is little concern. The differential count determines the relative proportion of individual leukocyte types. The diagnosis would be possible infectious mononucleosis, pending test results.

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    If the mother was given RhoGAM before or shortly after the birth of the first child, there is little concern. The differential count determines the relative proportion of individual leukocyte types. The diagnosis would be possible infectious mononucleosis, pending test results.

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    66 views3 pages

    Ch17 Clinical Questions

    Uploaded by

    mgon17
    If the mother was given RhoGAM before or shortly after the birth of the first child, there is little concern. The differential count determines the relative proportion of individual leukocyte types. The diagnosis would be possible infectious mononucleosis, pending test results.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    of 3

    ClinicalQuestions

    1)WhywouldtherebecauseforconcernifayoungpregnantmotherisRh-,herhusbandisRh+,andthisis theirsecondchild? Answer: IfthemotherwasgivenRhoGAMbeforeorshortlyafterthebirthofthefirstchild,thereislittle concern,becausetheRhoGAMpreventedthemotherfromsensitizingherselfagainstherchild.Ifshe didnottakeRhoGAM,thereisachancethesecondchildwilldeveloperythroblastosisfetalisanddie beforebirth.


    Diff:3 PageRef:670

    2)AtotalWBCcountandadifferentialWBCcounthavebeenorderedforMrs.Johnson.Whatinformationis obtainedfromthedifferentialcountthatthetotalcountdoesnotprovide? Answer: Thedifferentialcountdeterminestherelativeproportionofindividualleukocytetypes(avaluable diagnostictool).ThetotalWBCcountindicatesanincreaseordecreaseinnumberofWBCs.


    Diff:2 PageRef:671

    3)Listthreebloodteststhatmightbeorderedifanemiaissuspected. Answer: Thetestsforanemiaarehematocrit,completebloodcount,andmicroscopicstudyoferythrocytes.


    Diff:2 PageRef:671-672

    4)Apersoncomplainsofnoenergy,achronicsorethroat,alow-gradefever,andistiredandachy.Hisdoctor notesanenlargedspleenuponexamination.Whatdiagnosiswouldyouexpectandwhatdefinitivetest wouldyourequest? Answer: Thetestwouldbeadifferentialwhitebloodcellcounttolookforelevatednumbersofmonocytesand atypicallymphocytes.Thediagnosiswouldbepossibleinfectiousmononucleosis,pendingtestresults.


    Diff:2 PageRef:671

    5)AmanofMediterraneanancestrygoestohisdoctorwiththefollowingsymptoms.Heisverytiredallofthe time.Hehasdifficultycatchinghisbreathafterevenmildexercise.Hisdoctorordersthefollowingtests: CBC,hematocrit,differentialWBCcount.Thetestsshowimmatureerythrocytes,fragileerythrocytes,and lessthan2millionRBCspercubicmillimeter.Whatwouldbeatentativediagnosisandsuggestedtreatment? Answer: Thediagnosisisthalassemia.Thetreatmentisbloodtransfusion.


    Diff:3 PageRef:655

    6)A68-year-oldmaleisadmittedtothehospitalforemphysema.Heishypoxicandhislabsreveallowoxygen levels.Hishematocritis65%.Thephysicianhastoldhimthathehasatypeofpolycythemiainwhichhe hasanincreasednumberoferythrocytescirculatinginhisbloodstream.Theclienttellsthenursethathe doesnotunderstandwhatthatmeans.Howwouldthenurseexplainthisintermstheclientwould understand? Answer: Becauseyouhavedecreasedoxygenlevelsinyourblood,yourbodyhasrespondedbyproducing moreredbloodcells,causingatypeofpolycythemia.Thelowoxygenlevelstimulateserythropoietin productioninthekidneystostimulatemoreredbloodcells.


    Diff:3 PageRef:656

    7)Anelderlyclienttellsthenursethatshehasbeenverytiredlatelyandhasdifficultywalkingtohermailbox, withoutgettingveryshortofbreath.Thenursenotesthemucousmembranesarepale.Shestatessinceher husbanddiedthreemonthsago,shehasnotbeeneatingwell.Thephysicianconfirmsthatshehasirondeficiencyanemia.Howaretheclientsclinicalmanifestationsandirondeficiencyanemiarelated? Answer: Theclinicalmanifestationsaredirectlyattributedtothereductionintheamountofoxygenavailableto tissues.Anemicindividualsarefatigued,oftenpale,shortofbreath,andchilly.


    Diff:3 PageRef:655

    8)A17-year-oldblackmaleisadmittedtothehospitalinsickle-cellcrisis.Painmanagementisatoppriority forclientsinsickle-cellcrisis.Explainwhy. Answer: SicklecellanemiaresultsfromadefectivehemoglobinS-producinggenewhichcausesredbloodcells toroughenandbecomesickle-shaped.Suchsicklingcanproducehemolysis.Thealteredcellstendto pileupincapillariesandsmallerbloodvessels,makingthebloodmoreviscous.Normalcirculationis impaired,causingseverepainandswelling.


    Diff:3 PageRef:655-666

    9)A52-year-oldwomanwasdiagnosedwithleukemiaandhasbeenreceivingchemotherapyasanoutpatient. ShetellstheRNthatshehasntbeenfeelingwell.Thepatientsskiniswarmtotouchandshehasalowgradefeverof100.2F.Theneutrophilbloodcountislessthan1000/ul.Thenurseisconcernedaboutthe possibilityofinfectionbecauseoftheneutrapeniaandlow-gradefever.Explainwhy. Answer: Alow-gradefeverinsomeonewhohasneutropeniaisamajorconcernforsurvival.Neutropeniaisa concernbecauseoftheneutrophilsroleinphagocytosis.Thispatienthasadecreasedabilitytofight offinfection

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