Adult Health 1 Study Guide

Hematologic (Blood) Unit 

Chapters 32, 63-64 

Remember that assigned textbook readings should be supplemental to reviewing & studying the Powerpoint presentations. Answers to these study guide questions can be obtained from the textbook chapters, powerpoint presentations, as well as class lectures & in-class activities. 

Chapter 32: Assessment of Hematologic Function & Treatment Modalities – (p. 917-922)

*This chapter is an A&P overview of the hematologic system structures, assessment, & diagnostics. 

Must Know: Blood Transfusions – (p. 917-922)

1. Describe the pre-transfusion assessments & nursing care that is necessary for patients who are to receive a blood transfusion. See Chart 32-2. 

2. Describe the nursing care involved when initiating a blood transfusion for a patient. See Chart 32-2. What additional checks need to be made before hanging & starting the blood transfusion?

3. Describe the nursing care involved following completion of a blood transfusion for a patient. See Chart 32-2.

4. There are many different types of transfusion reactions that can occur in patients. What are some signs and symptoms of transfusion reactions? 

5. What should the nurse do if he/she suspects the patient is having a transfusion reaction? 

Chapter 33: Management of Patients with Nonmalignant Hematologic Disorders – (p. 925-931, p. 933-941)

Conditions to Know: Anemias, Iron deficiency anemia, Megaloblastic anemia, Pernicious anemia, Sickle cell anemia 

1. What is anemia and what are some of the common causes of this condition? 

2. What are some risk factors for anemia?

3. What are some signs and symptoms of anemia? 

4. What lab values or cultures do we look at to diagnose anemia? 

5. What is iron-deficiency anemia and what is the most common cause? 

6. What is the primary treatment method for iron-deficiency anemia? What are patient teaching points we would want to include in our patient education regarding this treatment modality? See Chart 33-3. 

7. Patients with iron-deficiency anemia should also be encouraged to consume foods high in iron. What are some foods that are high in iron that we should recommend? 

8. Megaloblastic anemias develop slowly (over months) and the body can compensate well for a long time before symptoms of anemia will develop. The erythrocytes produced in this type of anemia are abnormally large. Megaloblastic anemia results from a deficiency of which two sources? 

9. What are risk factors for the development of folic acid deficiency anemia?

10. What is pernicious anemia? 

11. What are some signs and symptoms of pernicious anemia? 

12. How is folic acid deficiency and pernicious anemias treated? What teaching points would we want to include in our patient education regarding this treatment modality? 

13. What are foods that are high in folic acid or vitamin B12? 

14. What is sickle cell anemia & how do patients inherit this disorder? 

15. Describe the nursing care that is necessary when caring for a patient in sickle cell crisis. 

Let’s return to the ethical scenario presented within Page 2 of the Explore section of Week 4 to consider it further. Upon learning that a medication error occurred resulting in a child’s death, the Chief Nursing Officer (CNO) of a regional acute care facility held a press conference to announce the mistake. The conference centered on reporter questions about why the nurse was not fired. The CNO explained that the nurse was highly regarded and that the problem was a “system” problem, not simply a problem of an incompetent nurse. The CNO also explained that an examination of the medication administration procedures was ordered and that an electronic medication error avoidance system would be implemented to ensure that such an error would not happen again. Consider this scenario to address the following.

1-As the CNO in the scenario, defend your decision to disclose the incident to the media. How does this decision influence value-based healthcare? What risks might you encounter? What impact might this decision have on you personally and professionally?

2-At a regional health consortium, fellow CNOs remark that they would not disclose such an incident to the media. Provide two justifications for withholding disclosure of the error to the public. How does this decision influence value-based healthcare?

3-Imagine you are the patient’s family. How would you want the issue to be handled by the CNO? Explain your rationale.

Please answer each question separated and use at least 3 sources no later than 5 years. 

Instructions for Answer to 4 Question

1- After Each DQ (question), write down references

2- 300 minimum words for every DQ, you can go up to 800 words but answer should be complete.

3- 2-3 Peer Reviewed/ scholarly references for each question

4- References should be within 4 years

5- I am in acute care nurse practitioner program.

6- The response to the DQ is expected to be a minimum of 300 words. A minimum of two peer reviewed/ scholarly  resources are expected. These need to be appropriate for a clinical professional to guide decisions about patient care. If a textbook is used for one of these responses, the other needs to be journal or professional-level website. The references need to be correctly formatted, as do the citations for those references.  “ Question words” don’t count towards 300 minimum count”

Devise a strategy for the six types of non-adherence to help an elder to adhere to a drug regime for the six types of non-adherence.

1. Hesitance to initiate therapy (You have prescribed a drug and discover the elder has not started taking it.)
2. Skipped doses (The elder forgets or is not home to take the drug.)
3. Medication discontinuation (The elder perceives that the medication is not working and stops taking it.)
4. Dose self-adjustment (The elder adjusts the dose to save money.)
5. Over-adherence (The elder takes more of the drug because symptoms worsen.)
6. Inappropriate administration (The elder misuses or abuses the drug.)

Please cite your references using APA style. Min 350 words

 Briefly reflect on your general education capstone experience and address the following questions:

• What are the key takeaways from this class that you will carry with you?  
• What did it take to bring your paper and presentation together, and how has that experience shaped your professional outlook?
• What recommendations or advice would you provide for students who will take this capstone course in the future?