Lewis Ch 29 Assessment of Hematologic System

A lymph node biopsy is most often performed to diagnose: a. Leukemia b. Cause of lymphedma c. Hemorrhagic tendencies d. Neoplastic cells in lymph nodes - ANS: D. Neoplastic cells in lymph nodes Lymph node biopsy is usually done to determine whether malignant cells are present in lymph nodes and can be used to diagnose lymphomas as well as metastatic spread from any malignant tumor in the body. Leukemias may infiltrate lymph nodes, but biopsy of the nodes is more commonly used to detect any type of neoplastic cells. A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding? a. Hematocrit of 35% b. Hemoglobin of 11.8 g/dL c. Platelet count of 400,000/µL d. White blood cell (WBC) count of 2800/µL - ANS: D. White blood cell (WBC) count of 2800/µL Because the total WBC count is not usually affected by aging, the low WBC count in this patient would indicate that the patient's immune function may be compromised and the underlying cause of the problem needs to be investigated. The platelet count is normal. The slight decrease in hemoglobin and hematocrit are not unusual for an older patient. A patient is being treated with chemotherapy. The nurse revises the pt's care plan based on which result? a. WBC count 4000/uL b. RBC count 4.3x10^6/uL c. Platelets 50,000/uL d. Hematocrit 39% - ANS: C. Platelets 50,000/uL Any platelet count <150,000/ul is considered thrombocytopenia and could place the patient at risk for bleeding, necessitating special consideration in nursing care. Chemotherapy may cause bone marrow suppression and a depletion of all blood cells. The other factors are all within normal range