SCHOOL OF HEALTH AND ALLIED HEALTH SCIENCES

Nursing Department
NUR 146
SELF-DIRECTED LEARNING 4 (CLINICAL AREA)

Name: ___________________________________Group: ________ Date: _____

TEST I.

Define the following:

1. direct bilirubin - also known as conjugated bilirubin, is the modified form of the
product obtained after the catabolism of haemoglobin. The bilirubin is conjugated
with glucuronic acid by the enzyme glucuronyltransferase. This conjugation makes
the direct bilirubin less toxic and easy to excrete. Direct bilirubin is soluble in water.
2. erythroblasts - a polychromatic nucleated cell of red marrow that synthesizes
hemoglobin and that is an intermediate in the initial stage of red blood cell
formation.
3. erythropoietin - a hormone that is produced predominantly by specialised cells
called interstitial cells in the kidney. Once it is made, it acts on red blood cells to
protect them against destruction. At the same time it stimulates stem cells of the
bone marrow to increase the production of red blood cells.
4. hemoglobin - is a protein in your red blood cells that carries oxygen to your
body's organs and tissues and transports carbon dioxide from your organs and
tissues back to your lungs.
5. hemolysis - the destruction of red blood cells which leads to the release of
hemoglobin from within the red blood cells into the blood plasma.
6. leukocytes - a type of blood cell that is made in the bone marrow and found in
the blood and lymph tissue. Leukocytes are part of the body's immune system.
They help the body fight infection and other diseases.
7. leukopenia - is a condition where the body doesn't have enough disease-fighting
leukocytes in the blood. It is associated with a low white blood cell count. White
blood cells are produced by the bone marrow.
8. petechiae - are pinpoint, round spots that appear on the skin as a result of
bleeding. The bleeding causes the petechiae to appear red, brown or purple.
9. polycythemia - means having a high concentration of red blood cells in your
blood. This makes the blood thicker and less able to travel through blood vessels
and organs.
10. purpura - occurs when small blood vessels burst, causing blood to pool under
the skin. This can create purple spots on the skin that range in size from small dots
to large patches.
11. reticulocytes - are immature red blood cells (RBCs) produced in the bone
marrow and released into the peripheral blood where they mature into RBCs within
1 to 2 days.
12. sickle cell crisis - pain that can begin suddenly and last several hours to several
days. It happens when sickled red blood cells block small blood vessels that carry
blood to your bones.
13. sickle cell trait - a blood disorder that runs in families. In some cases, a
person's red blood cells become C-shaped or curved like a sickle instead of round.
The curved cells can get stuck in and block small blood vessels. Blood can't flow
normally, which can lead to pain and organ damage.
14. thrombocytes - are pieces of very large cells in the bone marrow called
megakaryocytes. They help form blood clots to slow or stop bleeding and to help
wounds heal.
15. thrombocytopenia - a condition that occurs when the platelet count in your
blood is too low.

TEST II.

CASE STUDY:

Phyllis, age 12, has been experiencing problems from sickle cell anemia since she
was 1-year-old. She has been admitted to the pediatric ward of a children’s hospital
with an admitting diagnosis of sickle cell crisis.

1. Because Phyllis has previously been diagnosed with sickle cell anemia, what
characteristics would the physician most probably find on this admission?

2. What are the primary nursing goals when caring for Phyllis?

3. What precautionary measures are there to consider when administering IV fluids

to Phyllis?
4. What findings on the assessment would suggest that Phyllis needs oxygen
supplementation?