Vision: A PREMIER UNIVERSITY delivering

“Excellent nursing education that

world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

NCM 112
Care of clients with problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory
and immunologic response, Cellular Aberrations, Acute and Chronic.

WORKSHEET 4
NAME: [ ] SCORE:________
SECTION: [ ] DATE: _________

PART 1: SHORT ANSWER

Read each statement carefully. Write your response in the space provided.
1. The volume of blood in humans is about _____________ L.

2. Blood cell formation (hematopoiesis) occurs in the ______________________________.

3. Red bone marrow activity is confined in adults to the _______________________, ____________________,

_______________________, and _______________________.

4. The principal function of the erythrocyte, which is composed primarily of ________________________, is to:
___________________________________________________.

5. Each 100 mL of blood should normally contain ________ g of hemoglobin.

6. Women of childbearing years need an additional _____________________ daily of iron to replace that loss
during menstruation.

7. The nurse advises a patient who is iron deficient to take extra vitamin ________________, which is known for
increasing iron absorption.

8. The major function of leukocytes is to: _________________________________________________________;

the major function of neutrophils is: __________________________________________________________.

9. Plasma proteins consist primarily of:_____________________________ and __________________________.

10. The two most common areas used for bone marrow aspirations in an adult are: ________________ and
________________.

11. The average life expectancy for someone with sickle cell anemia is ________ years.

12. Distinguish between primary and secondary polycythemia.

_____________________________________________________________________________________________
____________.

13. Secondary polycythemia is caused by: ___________________________________, which may be in response to

____________________________________________.

14. The thalassemias (hereditary anemias) are characterized by: _________________________,

______________________________, ____________________________, and ____________________________.

PART 2: MATCHING TYPE

 Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”
INSTRUCTIONS: Match each of the anemic states with both the etiologic and morphologic classifications
(answers may be used more than once). 1
Type or Cause of Anemia Etiology (cause) Morphology (form)

1. Malaria

2. Thalassemia

3. Acute trauma

4. Aplastic anemia

5. Pernicious anemia

6. Sickle cell anemia

7. Anemia of gastritis

8. Anemia of leukemia

9. Iron-deficiency anemia

10.Anemia of renal failure

11.Glucose-6-phosphate dehydrogenase (G6PD)

12.Anemia associated with prosthetic heart valve

Etiologic
1. Decreased RBC Production
2. Blood loss
3. Increased RBC production

Morphologic
4. Normocytic, normochromic
5. Macrocytic, normochromic
6. Microcytic, hypochromic

PART 3: ARRANGEMENT

Number from 1 to 8 (1 being the first event and 8 being the last event) in sequence the events that occur in
disseminated intravascular coagulation (DIC).

_____a. Activation of fibrinolytic system

_____b. Uncompensated hemorrhage

_____c. Widespread fibrin and platelet deposition in capillaries and arterioles

_____d. Release of fibrin-split products

_____e. Fibrinogen converted to fibrin

_____f. Inhibition of normal blood clotting

_____g. Production of intravascular thrombin

_____h. Depletion of platelets and coagulation factors

 Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience, gender equality, institutional professional foundation for the
development and partnerships. practice of nursing.”

PART 4: NURSING INTERVENTIONS IN BLOOD TRANSFUSION

Priority Decision: The nurse is preparing to administer a blood transfusion. Number the actions in order of priority

(1 is first priority action; 10 is last priority action).

_______a. Verify the order for the transfusion.

_______b. Ensure that the patient has a patent 18-gauge IV.

_______c. Prime the transfusion tubing and filter with normal saline.

_______d. Verify that the physician has discussed risks, benefits, and alternatives with the patient.

_______e. Obtain the blood product from the blood bank.

_______f. Ask another licensed person (nurse or MD) to assist in verifying the product identification and the patient
identification.

_______g. Document outcomes in the patient record. Document vital signs, names of personnel, and starting and
ending times.

_______h. Adjust the infusion rate and continue to monitor the patient every 30 minutes for up to an hour after the
product is infused.

_______i. Infuse the first 50 mL over 15 minutes, staying with the patient.

_______j. Obtain the patient’s vital signs before starting the transfusion.

PART 5: EXPLAIN THE FOLLOWING LABORATORY FINDINGS IN ANEMIA 8

FINDING EXPLANATION

Reticulocyte counts are increased in chronic blood loss

but decreased in cobalamin (vitamin B12) deficiency.

Bilirubin levels are increased in sickle cell anemia but

are normal in acute blood loss.
 Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
Benguet State University
sustainable development amidst climate
change.
provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable La Trinidad, Benguet “The College of Nursing is committed
communities, industry innovation, climate www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
resilience,
Mean gender equality,
corpuscular volume institutional
(MCV) is increased in folic professional foundation for the
development and partnerships. practice of nursing.”
acid deficiency but decreased in iron-deficiency anemia.

PART 6: CASE STUDY: Blood Transfusion

Jerry is to receive one unit of packed red cells because he has a hemoglobin level of 8 g/dL and a diagnosis of
gastrointestinal bleeding.

1. Before initiating the transfusion, the nurse needs to check:

a. for the abnormal presence of gas bubbles and cloudiness in the blood bag.
b. that the blood has been typed and crossmatched.
c. that the recipient’s blood numbers match the donor’s blood numbers.
d. all of the above.

2. Administration technique should include all of the following except:

a. adding 50 to 100 mL of 0.9% NaCl to the packed cells to dilute the solution and speed up delivery
of the transfusion.
b. administering the unit in combination with dextrose in water if the patient needs additional
carbohydrates.
c. administering the unit of blood over 1 to 2 hours.
d. squeezing the bag of blood every 20 to 30 minutes during administration to mix the cell.

3. The nurse is aware that a transfusion reaction, if it occurs, will probably occur:
a. 1 to 2 minutes after the infusion begins.
b. during the first 15 to 30 minutes of the transfusion.
c. after half the solution has been infused.
d. several hours after the infusion, when the body has assimilated the new blood components into the
general circulation.

4. If a transfusion reaction occurs, the nurse should:

a. call the physician and wait for directions based on the specific type of reaction.
b. stop the transfusion immediately and keep the vein patent with a saline or dextrose solution.
c. slow the infusion rate and observe for an increase in the severity of the reaction.
d. slow the infusion and request a venipuncture for retyping to start a second transfusion.

Prepared by:

DOMINADOR B. ABAD JR.

 Vision: A PREMIER UNIVERSITY delivering
“Excellent nursing education that
world-class education that promotes
sustainable development amidst climate
change.
Benguet State University provides graduates with self-
direction, competence and

Mission: To provide quality education to

COLLEGE OF NURSING compassion.”

enhance food security, sustainable
communities, industry innovation, climate
Course Facilitator
resilience, gender equality, institutional
development and partnerships.
La Trinidad, Benguet “The College of Nursing is committed
www.bsu.edu.ph/ 422- 2127 to provide a strong academic and
professional foundation for the
practice of nursing.”