Question

1) Why would there be cause for concern if a young pregnant mother is Rh-, her husband is Rh+, and this is their second child?

2) A total WBC count and a differential WBC count have been ordered for Mrs. Johnson. What information is obtained from the differential count that the total count does not provide?

3) List three blood tests that might be ordered if anemia is suspected.

4) A patient complains of no energy, a chronic sore throat, a low-grade fever, and is tired and achy. His doctor notes an enlarged spleen upon examination. What diagnosis would you expect and what definitive test would you request?

5) A man of Mediterranean ancestry goes to his doctor with the following symptoms. He is very tired all of the time. He has difficulty catching his breath after even mild exercise. His doctor orders the following tests: CBC, hematocrit, differential WBC count. The tests show immature erythrocytes, fragile erythrocytes, and less than 2 million RBCs per cubic millimeter. What would be a tentative diagnosis and suggested treatment?

6) A 68-year-old male is admitted to the hospital for emphysema. He is hypoxic and his lab tests reveal low oxygen levels. His hematocrit is 65%. The physician has told him that he has a type of polycythemia in which he has an increased number of erythrocytes circulating in his bloodstream. The patient tells the nurse that he does not understand what that means. How would the nurse explain this in terms the patient could understand?

7) An elderly patient tells the nurse that she has been very tired lately and has difficulty walking to her mailbox without getting very short of breath. The nurse notes the mucous membranes are pale. The patient states that since her husband died three months ago, she has not been eating well. The physician confirms that she has iron-deficiency anemia. How are the patient's clinical manifestations and iron-deficiency anemia related?

8) A 17-year-old black male is admitted to the hospital in sickle-cell crisis. Pain management is a top priority for patients in sickle-cell crisis. Explain why.

9) A 52-year-old woman was diagnosed with leukemia and has been receiving chemotherapy as an outpatient. She tells the RN that she hasn't been feeling well. The patient's skin is warm to the touch and she has a low-grade fever of 100.2°F. The neutrophil blood count is less than 1000/μl. The nurse is concerned about the possibility of infection because of the neutropenia and low-grade fever. Explain why.

Answer 1

1.This is called as Rh incompatibility. During first pregnancy if the child is Rh positive, mother exposes to the Rh antigens during the rupture of placenta and she got sensitised. First child doesn't have any risk.Now sensitised mother's body prepares Rh antibodies in her body. Now for the second child if the child is Rh positive, child got exposed to the Rh antibodies and get killed his own blood cells.There will increase in production of cells to compensate the blood cell loss and releases immature cells into the child's circulation.