The nurse is explaining the underlying cause of bruising with a client who is recently diagnosed with acute leukemia. Which pathophysiology is a result of the myeloblastic dysfunction of leukemia?
Oxyhemoglobin provides less oxygen to tissues.
Insufficient platelets delay the clotting process.
Phagocytic cells are inadequate in fighting infection.
Lack of iron causes hypochromic blood cells.
The Correct Answer is B
Acute leukemia, including acute myeloid leukemia (AML), involves the proliferation of abnormal myeloblasts (immature white blood cells) in the bone marrow, leading to decreased production of normal blood cells. Here's the breakdown of the pathophysiology contributing to bruising in acute leukemia:
A) Oxyhemoglobin provides less oxygen to tissues:
Oxyhemoglobin refers to hemoglobin bound to oxygen, and its role is in oxygen transport, not in the process of bruising. Therefore, this option is not directly related to the pathophysiology of bruising in acute leukemia.
B) Insufficient platelets delay the clotting process:
Correct. Thrombocytopenia, or low platelet count, is a common complication of acute leukemia due to the replacement of normal bone marrow cells with leukemia cells, leading to inadequate production of platelets. Platelets play a crucial role in hemostasis and clot formation. Insufficient platelets result in delayed clotting, leading to easy bruising and bleeding tendencies in patients with acute leukemia.
C) Phagocytic cells are inadequate in fighting infection:
Leukopenia, or low white blood cell count, can occur in acute leukemia due to suppression of normal hematopoiesis by leukemia cells in the bone marrow. While leukopenia predisposes patients to infections due to impaired immune function, it is not directly related to the pathophysiology of bruising.
D) Lack of iron causes hypochromic blood cells:
Iron deficiency anemia can result in hypochromic red blood cells, but this is not typically associated with the pathophysiology of bruising in acute leukemia. Anemia may contribute to other symptoms such as fatigue and pallor, but bruising primarily results from thrombocytopenia-induced clotting abnormalities.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Fatigue and weakness:
Correct. The client's hemoglobin and hematocrit levels are below the reference ranges, indicating mild anemia. Anemia, characterized by low red blood cell count or hemoglobin levels, can lead to symptoms such as fatigue, weakness, and shortness of breath, as the body's oxygen-carrying capacity is reduced. Fatigue and weakness are common manifestations of anemia and are indicative of tissue hypoxia due to decreased oxygen delivery.
B) Cardiac dysrhythmias:
While severe anemia can lead to cardiac complications, such as dysrhythmias, the client's hemoglobin and hematocrit levels are only slightly below the reference ranges, indicating mild anemia. Cardiac dysrhythmias are more commonly associated with severe anemia or acute changes in hemoglobin levels rather than the mild anemia indicated in this scenario.
C) Fever and infection:
Anemia is not typically associated with fever and infection. While anemia may occur secondary to chronic inflammatory conditions or certain infections, the client's symptoms of fatigue and weakness are more directly related to the decreased oxygen-carrying capacity of the blood due to mild anemia.
D) Decreased clotting time:
Anemia is not directly associated with changes in clotting time. While severe anemia can lead to alterations in platelet function and clotting factors, the client's hemoglobin and hematocrit levels are only slightly below the reference ranges, indicating mild anemia. Decreased clotting time is not a typical manifestation of mild anemia.
Correct Answer is C
Explanation
Hypothyroidism is characterized by deficient production of thyroid hormones by the thyroid gland, leading to a decrease in circulating levels of triiodothyronine (T3) and thyroxine (T4). As a compensatory mechanism, the pituitary gland releases increased amounts of thyroid stimulating hormone (TSH) in an attempt to stimulate thyroid hormone production.
A) Increased triiodothyronine (T3) and thyroxine (T4) and decreased thyroid stimulating hormone (TSH):
This pattern of laboratory findings is not consistent with hypothyroidism. Hypothyroidism is characterized by decreased levels of T3 and T4 due to impaired thyroid function, leading to increased TSH levels as a compensatory response. Therefore, this option is incorrect.
B) Increased triiodothyronine (T3) and thyroid stimulating hormone (TSH):
While TSH levels are typically increased in hypothyroidism, T3 levels are usually decreased. Therefore, the combination of increased T3 and TSH is not indicative of hypothyroidism. This option is incorrect.
C) Decreased triiodothyronine (T3) and thyroxine (T4) and increased thyroid stimulating hormone (TSH):
Correct. In hypothyroidism, there is a decrease in both T3 and T4 levels due to impaired thyroid function. As a compensatory mechanism, the pituitary gland releases increased amounts of TSH to stimulate the thyroid gland. Therefore, this pattern of laboratory findings is consistent with hypothyroidism.
D) Decreased thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4):
Decreased levels of TSH, T3, and T4 are not indicative of hypothyroidism. Hypothyroidism is characterized by elevated TSH levels and decreased T3 and T4 levels. Therefore, this option is incorrect.
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