Learning Guide
Hematological Disorders
1.
Place a letter beside each of the following disorders indicating which type of blood cell is involved:
_____ Thrombocytopenia
_____ Acute myelocytic leukemia
_____ Fe deficiency anemia
_____ Polycythemia
_____ Aplastic anemia
_____ Thalassemia
_____ Disseminated intravascular coagulation
_____ Hodgkin’s disease
R – Red blood cell
W – Lymphocytes
P – Platelets
_____Multiple myeloma
2.
Match the following terms with the appropriate definition:
_____ Bull’s-eye appearance of RBC in Thalassemia
_____ Malignant cells found in Hodgkins a. b.
_____ Immunoglobulin involved in multiple myeloma c.
Reed-Sternberg cells
Neutropenia
Hematopoeitic stem cell
and leukemia transplant (HSCT)
_____ Replacement of client stem cells used for
_____ High doses of chemotherapy are leukemia
_____ Decrease in circulating neutrophils
_____ Excess of RBC’s
_____ Substance necessary for B12 absorption
_____ Platelet count of <100,000/ml.
_____ Immature red blood cell
_____ Diminished color in RBC
3.
treatment of leukemia administered initially to eradicate e. f. g. h. i. j. k.
L.
M-protein
Hypochromic
Target cells
Thrombocytopenia
Polycythemia
Intrinsic factor
Reticulocyte
Induction
How do the manifestations found in clients with chronic blood loss differ from those with acute blood loss?
4.
Complete each of the following nursing diagnoses related to anemia and designate appropriate interventions: a.
Activity intolerance related to ___________________________________ as evidenced by increased pulse and blood pressure in response to activity and client reports of weakness.
Interventions:

b. Altered nutrition: less than body requirements related to ____________________
as evidenced by weight loss, low serum albumin, decreased iron levels, vitamin
deficiencies.
Interventions:
6.
5.
Describe 3 types of nutritional anemias and explain the pathophysiology of each.
Identify which foods should be recommended for a client with each of the following nutritional anemias: a.
Fe deficiency anemia b.
Folic acid deficiency c.
Cobalamin (B12) deficiency
7.
Clients with pernicious anemia must receive vitamin B 12 injections for the rest of their life.
True False
8.
Which symptoms would be present in a client with anemia resulting from vitamin
B12 deficiency but would not be present with a folic acid deficiency.
9.
What is thalassemia and how is it treated?
10.
What is aplastic anemia and why does it cause pancytopenia?
11.
Which diagnostic test would be used to differentiate between pernicious anemia and other conditions causing malabsorption of B 12? Explain the test.

12.
Describe nursing responsibilities related to the administration of Fe for clients with Fe deficiency anemia.
13.
A client with COPD presents in the ED with C/O headache, night sweats, blurred vision, pruritis and dark redness around the lips, feet, ears and fingernails. What condition might the nurse suspect? Explain your answer.
Describe possible treatments for this client.
14.
Define thrombocytopenia and designate corresponding platelet levels for each of the following: a.
Prolonged bleeding after trauma or surgery - ________ b.
Spontaneous, life threatening hemorrhages - ________ c.
Platelet transfusions are recommended - ________
15.
How would you assess for bleeding in a client with thrombocytopenia?
16.
Risk for Injury related to low platelet count is a priority nursing diagnosis for the client with thrombocytopenia. Indicate appropriate nursing interventions and important points for client teaching to prevent bleeding below. a.
Nursing Interventions: b.
Client teaching:
17.
Describe the following treatments for thrombocytopenia: a.
Platelet transfusions

b.
Plasmapheresis c.
Splenectomy
18.
What factors contribute to the occurrence of leukemia?
19.
Explain the difference between acute and chronic leukemia. What is the basic pathological process?
20.
Differentiate between myelogenous and lymphocytic leukemia. Which type of leukemia is most common in adults?
21.
What causes each of the following signs and symptoms of leukemia? a.
tachycardia b.
bruising c.
fatigue d.
recurrent urinary tract infections e.
Obstruction of renal tubules
22.
Describe the stages of chemotherapy treatment for a client with acute leukemia.

23.
Clients with leukemia can be treated with both allogenic hematopoietic stem cell transplant (HSCT) or with autologous HSCT. What is the difference between these 2 methods and how do the goals of treatment differ?
24.
What is “graft-versus-host disease” (GVHD).
What are the signs and symptoms?
How is it treated?
25.
Place an “X” in the box beside each nursing intervention that would be appropriate for a hospitalized client with leukemia who is receiving chemotherapy?
_____ Assure an adequate intake of milk and milk products
_____ Provide oral hygiene after every meal
_____ Restrict all visitors to prevent infection
_____ Avoid invasive procedures when possible
_____ Encourage citrus fruit juices to increase vitamin C
_____ Provide liquids with varying textures and tastes
_____ Monitor vital signs q. shift
_____ Provide rest periods before meals
26.
Describe the biologic and targeted therapy for treatment of leukemia. What are the side effects?
27.
Which of the following populations is most at risk for developing multiple myeloma?
White women over 40 a.
b.
Black women under 40 c.
Black men over 40 d.
White men under 40
28.
In multiple myeloma, ____________ cells multiply uncontrollably and infiltrate the
_____________, lymph nodes, spleen, and other tissues.
29.
Clients with advanced multiple myeloma may experience lethargy, confusion and weakness. What causes these manifestations?
30.
Urinalysis of a client with multiple myeloma is likely to show which of the following? a.
Decreased protein b.
Reed Sternberg cells c.
Bence Jones protein d.
Increased glucose

31.
Non-Hodgkin’s lymphoma differs from Hodgkin’s in that multiple peripheral lymph nodes are involved.
True False
32.
Diagnosis of lymphomas is usually established by ___________.
33.
What are the early and late manifestations of Hodgkin’s disease?