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Worksheets 1 NRSG 308 – ADULT HEALTH I: ADDITIONAL WORKSHEETS TO ACCOMPANY LIBRARY VIDEOS Rationale: Additional worksheets provided to help the student understand the concepts associated with the different disease processes. Worksheets are for student edification only and are NOT to be turned in for points. Worksheets DO NOT count towards any paperwork grade. However, EXAM QUESTIONS will be taken from the worksheets. Worksheets 2 NRSG 308 – ADULT HEALTH I Blood Count Quiz Understanding the Complete Blood Count (Red Blood Cells, White Blood Cells, and Platelets) Platelets 1. What does hematology mean? a. Study of WBC’s b. Study of CBC’s c. Study of the blood d. Study of Platelets 2. True or False. Blood has both fluid and solid components in it. a. True b. False 3. The fluid portion of blood is called what? a. Fluid b. Blood c. Platelets d. Plasma 4. The solid portion of blood is composed of what 3 things? 1.__________________ 2. ___________________ 3.__________________ 5. What does CBC stand for? ________________________________ 6. What is the role and significance of the platelets? 7. What cells are platelets formed from? a. Stem Cells b. Bone Cells c. CSF Fluid d. RBC’s Worksheets 3 8. What is another name for platelets? ___________________________________ 9. What is the life span of platelets? a. 4-11 days b. 3-5 days c. 15-20 days d. 1-2 days 10. What organ is most significant in platelet formation? a. Brain b. Heart c. Liver d. Kidney 11. What is the platelet count? ________________________________________ 12. Stored blood contains no platelets because they are so fragile and they must be transfused separately. a. True b. False 13. What is the normal platelet count? a. 100-400 x103 platelets/uL b. 150-400 x103 platelets/uL c. 200-500 x103 platelets/uL d. 50-150 x103 platelets/uL 14. All of the following are causes of variations to the platelet count except: a. Age b. Relation to menstrual cycle c. Altitude d. Season e. Exercise f. Stress 15. A decrease in platelet count is called? ___________________________________ Worksheets 4 16. What is the main complication to thrombocytopenia? a. Decrease bleeding with the inability to form an adequate clot b. Increased bleeding with the ability to form an adequate clot. c. Increased bleeding with the inability to form an adequate clot. d. Decreased bleeding 17. All of the following are possible causes of increased platelet counts except: a. Exercise b. Stress c. Hemorrhage d. Recent splenectomy e. Menstrual cycle 18. A Patient taking a platelet aggregation inhibitor following an angiogram such as Integrilin, Reopro, or Plavix require frequent monitoring of potential bleeding sites. a. True b. False 19. When drawing a specimen for a platelet count you should keep the sample at? a. Room temperature b. In the Refrigerator 20. When a nurse sees the following: a 50% drop in platelets, & platelet count below 100,00/uL and has no underlying cause she should suspect what? a. Thrombocytopenia b. Heparin induced thrombocytopenia c. Cancer of the blood White Blood Count 21. White Blood Cells are often referred to as? a. WBC b. RBC c. CBC d. Plts 22. Another name for WBC is? a. Agranulocytes b. Granulocytes c. Leukocytes d. Eosinophils 23. As White blood cells mature they become smaller. a. True b. False Worksheets 5 24. What are the two groups of WBC’s? ________________________&___________________________ 25. 50-75% of WBC are what type of WBC’s? a. Basophils b. Granulocytes c. Eosinophils d. Neutophils 26. Granulocytes are produced in the bone marrow. a. True b. False 27. What are the three types of Granulocytes? 1.____________________ 2. _____________________ 3. _____________________ 28. What are the two types of Agranulocytes? 1.____________________ 2. _____________________ 29. The RBC count is smaller than the WBC count. a. True b. False 30. What is the normal WBC? a. 2-8x109 WBCs.L b. 4-10x109 WBCs.L a. 10-20x109 WBCs.L b. 4-5x109 WBCs.L 31. What percent of available WBCs are circulating in the blood? a. 1-2% b. 5-7% c. 2-3% d. 3-4% 32. 90% of WBCs are found in the following places except. a. Bone marrow b. Capillary linings c. Lungs d. Liver e. Spleen f. Plasma Worksheets 6 33. An increase in the number of circulating WBCs is called? 34. What is the most common cause of Leukocytosis? a. Stress b. Acute infection c. Cancer d. Blood disorder 35. All of the following are causes of physiologic leukocytosis except. a. Physical exercise b. Labor c. Pain d. Cold e. Menstruation f. Emotional stress g. Plane flights 36. What is the difference between ordering a normal WBC and a WBC with differential? ________________________________________________________________________ 37. When the WBC is increases the most common cause is? a. Leukocytosis b. RBC’s c. Neutrophils 38. Neutrophil count is increased with the following except. a. Acute infections b. Stress c. Medications d. Tissue necrosis e. Hemolysis f. Myeloproliferative disease g. Chronic Infection 39. Neutrophil count is decreased in the following except. a. Acute viral infections b. Any prolonged infection c. Malnutrition d. Splenomegaly e. Bone marrow dysfunction f. Certain medications g. Acute infection Worksheets 7 40. We don’t completely understand the role of the eosinophil. a. True b. False 41. In the hospital setting when the eosinophil increases we often suspect? a. Stress b. Acute Infection c. Drug reaction d. Malnutrition 42. 20-40% of the WBCs are Lymphocytes. a. True b. False 43. Immature neutophils are also known as bands. a. True b. False 44. If there is an acute infection we expect to see what increased? a. RBC’s b. Bands c. Plts Red Blood Cells 45. RBC become smaller as they mature. a. True b. False 46. How long does is take to make a mature RBC? a. 1 day b. 3 days c. 2 days d. 5 days 47. How long does a mature RBC live? a. 100 days b. 50 days c. 120 days d. 200 days 48. What is a normal RBC? a. 3.0-7.4 x 1012 RBCa/L b. 4.0-15.4 x 1012 RBCa/L c. 4.0-5.0 x 1012 RBCa/L d. 4.0-5.4 x 1012 RBCa/L Worksheets 8 49. If a person does not have enough RBCs they are called: ________________________________________________ 50. Smokers have a higher RBC count. a. True b. False 51. Hemoglobin is also part of the CBC. a. True b. False 52. What is a normal Hemoglobin level? a. 12-17 gm/dL b. 10-15 gm/dL c. 2-7 gm/dL d. 20-30 gm/dL 53. What is the main function of Hemoglobin? ____________________________________________________________ 54. Sickel Cell is a hemoglobin disorder. a. True b. False 55. Hemoglobin is the main component of the RBC. a. True b. False 56. The most common cause of hemoglobin increase is? a. Stress b. Acute Illness c. Dehydration d. Blood Loss 57. Hematocrit is the % of RBC per volume of whole blood. a. True b. False 58. H&H levels vary based on age and sex of a person. a. True b. False Worksheets 9 NRSG 308 ADULT HEALTH I Hip Fracture Video Worksheet 1. Hip fractures have ______________ over the past 30 years. 2. What percent of hip fractures occur during a fall? a. 90% b. 70% c. 60% d. 50% 3. What is the first step in caring for a patient with a hip-fracture and what are the three things it should include? The first step is ____________________. The three things it should include are: 1. _____________________ 2. __________________ 3.__________________________ 4. What should the effected leg show upon a physical exam? a. Shortening and external rotation b. Lengthening and internal rotation c. Shortening and external rotation d. Lengthening and external rotation 5. What should be checked to assess circulation in the effected leg? a. Popliteal pulses b. Femoral pulses c. Pedal pulses d. Radial pulses 6. If the fracture is pinned or plated, hip positioning is not critical but weight bearing usually requires limits. a. True b. False Worksheets 10 7. If the treatment for the fracture is a partial or full hip replaced, then hip positioning is critical., but the hip is usually capable of bearing weight. a. True b. False 8. What are the positioning precautions for a partial hip replacement? a. No internal rotation, No hip abduction b. No hip flexion over 90 degrees. No internal rotation during hip flexion. No hip abduction (crossing legs) c. No hip flexion over 60 degrees. No internal rotation during hip flexion. No hip abduction d. Hip flexion under 90 is ok, no other restrictions 9. What are some common equipment needed to care for a patient with a hip replacement circle all that apply? a. b. c. d. Elevated Chairs toilet seats Abduction pillow Hospital bed 10. What is the most systemic way to go about a post op assessment? List below: 1. 2. 3. 4. 5. 6. 7. 11. When is the best time to start a patient controlled Analgesia Machine (PCA)? a. Unit b. ER c. OR d. Recovery room Worksheets 11 12. When does discharge planning begin? a. b. c. d. Time for discharge At admission. When 1st arrived on the Unit In the Pre-op room 13. Discharge planning is continued through what percent of the hospital stay? a. 50% b. 45% c. 70% d. 100% 14. What percentage of patients with hip fractures regain their independence? a. b. c. d. > 60% < 50% > 20% < 40% Worksheets 12 NRSG 308 ADULTH HEALTH I Knee Replacement Video Worksheet 1. What is a top priority a nurse should focus on after the surgery? 2. On admission to the patient unit,the nurse should expect that the patient will require? 3. What are post-op day 1 Goals? 4. Where should a pillow not be placed on a knee replacement patient? 5. What are the post-op goals for day 2 6. What would be the ideal day for the foley catheter to come out? 7. What are two indicators that it would be ok to remove the patients IV? 8. What needs to be assessed during a dressing change? Worksheets 13 9. What are the patient goals for day 3? 10. What is the range on the CPM that you want to achieve by discharge? 11. What are the goals of Day 4? 12. When should the physician be notified about the wound?