Anemia Class #9
As you complete this prep guide you will use the following resources:
1. View voice over presentation on Canvas
2. Giddens Chapter 12
3. Harding Chapter 33; Chapter 34
4. Lilley Chapter 54
5. View skills videos on blood transfusions
Link the concepts (read Giddens pp103-106; 165-167)
1. How are the concepts of cellular regulation and perfusion connected to each other?
a. An intricate network of signals regulates cell growth and other cellular activities. When
this communication system goes awry and signals aren't properly conveyed or processed,
many diseases can result, including cancer
b. Perfusion is the passage of fluid through the circulatory system or lymphatic system to an
organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue.
Perfusion may also refer to fixation via perfusion, used in histological studies
2. What are 3 safety concerns that you, as the nurse caring for a client with impaired cellular
regulation, would have for a client with impaired cellular regulation?
a. Protecting the client from injuries related to impaired oxygenation especially if the
patient RBC/HGB are affected
b. If the patients' platelets are affected, safety concerns include protection from injury
related to increased bleeding tendencies
c. Preventing infection is a concern, especially for clients with impaired WBC
production/function
See Harding, Table 33-11 to answer the following questions (#3-6)
3. The client is scheduled for a bone marrow aspiration and biopsy. The new nurse graduate is
completing the pre-procedure checklist but does not understand the rationale for the following
items. How should the nurse preceptor, explain the items below? (Use your own words)
a. Before: Explain procedure to patient. Obtain signed consent form.
Perform a surgical time-out before procedure. Analgesics may be given
to enhance patient comfort and cooperation.
b. After: Apply pressure dressing. Assess biopsy site for bleeding and
apply pressure as needed. Tenderness at the puncture site for a few
days may be normal. Assess for infection.
1|Page
, Anemia Class #9
Verification that informed consent has been The nurse is responsible and
obtained accountable for the verification of and
witnessing that the patient or the legal
representative has signed the consent
document in their presence and that the
patient, or the legal representative, is of
legal age and competent to provide
consent
Verification that coagulation studies completed PT, PT-INR, CBC, Bleeding Time,
Thrombin Time
Pre-procedure sedative ordered Explain the procedure to the patient. A
mild sedative will be given 1 hour
before the test, if ordered. Tell the
patient the test usually takes only 5 to
10 minutes and that more than one
bone marrow specimen may be
required. Let him know a blood sample
will be collected before the biopsy for
laboratory testing
4. When caring for a client scheduled for a bone marrow biopsy, which sites are appropriate? Place
an “X” on the 3 sites which are correct.
2|Page
As you complete this prep guide you will use the following resources:
1. View voice over presentation on Canvas
2. Giddens Chapter 12
3. Harding Chapter 33; Chapter 34
4. Lilley Chapter 54
5. View skills videos on blood transfusions
Link the concepts (read Giddens pp103-106; 165-167)
1. How are the concepts of cellular regulation and perfusion connected to each other?
a. An intricate network of signals regulates cell growth and other cellular activities. When
this communication system goes awry and signals aren't properly conveyed or processed,
many diseases can result, including cancer
b. Perfusion is the passage of fluid through the circulatory system or lymphatic system to an
organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue.
Perfusion may also refer to fixation via perfusion, used in histological studies
2. What are 3 safety concerns that you, as the nurse caring for a client with impaired cellular
regulation, would have for a client with impaired cellular regulation?
a. Protecting the client from injuries related to impaired oxygenation especially if the
patient RBC/HGB are affected
b. If the patients' platelets are affected, safety concerns include protection from injury
related to increased bleeding tendencies
c. Preventing infection is a concern, especially for clients with impaired WBC
production/function
See Harding, Table 33-11 to answer the following questions (#3-6)
3. The client is scheduled for a bone marrow aspiration and biopsy. The new nurse graduate is
completing the pre-procedure checklist but does not understand the rationale for the following
items. How should the nurse preceptor, explain the items below? (Use your own words)
a. Before: Explain procedure to patient. Obtain signed consent form.
Perform a surgical time-out before procedure. Analgesics may be given
to enhance patient comfort and cooperation.
b. After: Apply pressure dressing. Assess biopsy site for bleeding and
apply pressure as needed. Tenderness at the puncture site for a few
days may be normal. Assess for infection.
1|Page
, Anemia Class #9
Verification that informed consent has been The nurse is responsible and
obtained accountable for the verification of and
witnessing that the patient or the legal
representative has signed the consent
document in their presence and that the
patient, or the legal representative, is of
legal age and competent to provide
consent
Verification that coagulation studies completed PT, PT-INR, CBC, Bleeding Time,
Thrombin Time
Pre-procedure sedative ordered Explain the procedure to the patient. A
mild sedative will be given 1 hour
before the test, if ordered. Tell the
patient the test usually takes only 5 to
10 minutes and that more than one
bone marrow specimen may be
required. Let him know a blood sample
will be collected before the biopsy for
laboratory testing
4. When caring for a client scheduled for a bone marrow biopsy, which sites are appropriate? Place
an “X” on the 3 sites which are correct.
2|Page
