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EMRG 1230- CARDIAC UNIT > Blood disorders > Flashcards

Blood disorders Flashcards

1
Q

How much blood does a human body approx. contain?

A

5L of blood

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2
Q

How much (%) of our blood is plasma?

A

55%

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3
Q

What is anemia?

A

reduction in oxygen transport in the blood caused by a decrease in hemoglobin content

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4
Q

Not enough blood = ____O2 delivery!

A

LOW

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5
Q

What are some causes of anemia in terms of RBC?

A

declining in RBC production
decreased in RBC

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6
Q

What is iron deficient anemia/?

A

insufficient iron impeded/stops the creation of the hemoglobin, reduces the amount of oxygen carried in the blood!!

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7
Q

What size & concentration are the red blood cells in iron deficient anemia?

A

SMALLER, low concentration of hemoglobin in each cell

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8
Q

What are causes of iron deficient anemia?

A

low iron diet
chronic blood loss (ulcers)
hemorrhoids
cancers
excessive menstral flow

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9
Q

What are the s/s of iron deficient anemia?

A

mild- asymptomatic!

pallor of skin and mucous membranes
fatigue lethargy and cold intolerance
irritability (CNS responce to hypoxia)
brittle hair, rigid nails, dry skin
tachycardia
menstral irregularities
delayed healing
tachycardia

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10
Q

How do you treat I.D.A?

A

find out underlying cause, depends on cause
iron rich foods or iron supplements

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11
Q

What is Pernicious Anemia B12 Deficiency?

A

caused by LARGE, immature RBC’s
deficit of folic acid (b9 or b12)
develop gradually, first 2 months of pregnecny

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12
Q

Pernicious Anemia B12 Deficiency is the lack of _______?

A

intrinsic factor production!!!

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13
Q

Why does a lack of intrinsic factor occur???

A

when the body produces antibodies AGAINST the intrinsic factor and subsequent the immune response and causes atrophy of the gastric mucosa and glands

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14
Q

What is the intrinsic factor?

A

a substance secreted by the stomach which enables the body to absorb vitamin B12!!!

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15
Q

What does a B12 impairment lead to? (in terms of RBC)

A

IMMATURE RBC production
destroyed prematurely when they are being reproduced
results in low RBC count –> ANEMIA

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16
Q

What is the cause of Pernicious Anemia B12 Deficiency?

A

RARELY cause by dietary insufficiency, we need a very ow amount…..

COMMON CAUSE- malabsorption!
- caused from either an autoimmune response (body attacks itself)
- older people (chronic gastritis, atrophy of gastric mucosa!
- chronic inflammatory conditions

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17
Q

What are the signs and symptoms Pernicious Anemia B12 Deficiency?

A

same as anemia!!
BRIGHT RED TONGUE!!! enlarged tongue, red sore and shiny
decrease in gastric acid leads to digestive discomfort often with nausea and diarrhea
tingling/burning sensations

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18
Q

Treatment of Pernicious Anemia B12 Deficiency

A

B12 injections or oral supplements

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19
Q

What is aplastic anemia?

A

impairment or failure of bone marrow function, loss of stem cels and decreased numbers of RBC’s, leukocytes and platelets

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20
Q

S/S of aplastic anemia??

A

pallor, weakness, dyspnea
multiple and recurrent infections
tendency to bleed excessively

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21
Q

What is the treatment of aplastic anemia?

A

bone marrow transplants
stem cells transplants

22
Q

What is sickle cell anemia?

A

inherited characteristic leads to abnormal hemoglobin!

23
Q

S/S of sickle cell?

A

evident at 12 months old
pallor, weakness, dyspnea
jaundice in skin and white of the eyes

24
Q

Is there a treatment for sickle cell?

A

NOPE

25
Q

What is hemolytic anemia?

A

Premature destruction of RBC’s
classified as either inherited or acquired

26
Q

What are the causes of hemolytic anemia?

A

infectious diseases
inherited disorders
toxic agents (venom) or drugs

27
Q

What is polycythemia?

A

primary- increased production of RBC’s in the bone marrow

secondary- increase in RBC secondary to hypoxia

28
Q

What does an increased production of RBC result in?

A
  • higher blood volume, often viscous
  • blood vessels are distended
  • blood flow is sluggish, leads to frequent clots and infarctions
  • BP is elevated
  • heart is hypertrophied> LARGER
  • hemorrhage is frequent in places where the vessels are distended
29
Q

Who does polycythemia usually develop in? and what kind of compensation mechanism does it provide?

A

40-60 yrs old

compensation mechanism intended to provide increased oxygen transport in the presence of chronic lung or heart disease

30
Q

What is hemophilia?

A

deficiency of clotting factors
most common inherited clotting disorder!!!

31
Q

In mild forms of hemophilia excessive bleeding occurs when?

A

Only after trauma!!!

32
Q

In severe forms of hemophilia excessive bleeding occurs when?

A

SPONTANEOUS bleeding is common

33
Q

What are signs/symptoms of hemophilia?

A

prolonged or severe hemorrhage after minor tissue trauma

persistent oozing of blood after minor injuries

34
Q

What is DIC?

A

Disseminated Intravascular Coagulation
- body creates clots when it doesn’t need them, causes multiple thrombosis and infarct
- this uses up the clotting factors so when the body needs it, it is not available, resulting in excessive bleeding, hypotension or shock!!!

35
Q

Is DIC deadly?

A

Yes! it is most likely the cause of death! No one lives with DIC!

36
Q

What is leukemia?

A
  • blood disorder involving the white blood cells
  • one or more leukocyte types are present
  • immature , non functional!
  • multiply uncontrollably in the marrow and are released into the circulation
37
Q

Is the cause of leukemia known?

A

NO!!

38
Q

What is leukemia typically marked by?

A

marked by an infection that is unresponsive to treatment or by excess bleeding
- multiple infections
- hemorrhage
- signs of anemia
- bone pain, even during rest
- weight loss and fatigue
- fever
- enlarged lymph nodes
- if the cells infiltrate the nervous system, headaches, drowsiness, vomiting, visual disturbances

39
Q

What are the two types of lympthoma?

A

Hodgkins
Non Hodgkins
Primarily involves the lymph nodes of the body

40
Q

What are the s/s of signs of early and later Hodgkins lymphoma?

A

first- an enlarged lymph node that is painless/ non tender
later- enlarged lymph node in other locations may cause pressure effects

41
Q

What is the biggest tell-sign of cancer in someone?

A

WEIGHT LOSS
recurrent infection

42
Q

What is non hodgkins?

A
  • multiple node involvement scattered through the body
  • non organized pattern of widespread metastases
  • often involve intestinal nodes and organs
43
Q

What is HIV?

A

Human Immunodeficiency from a virus that affects the lymphocytes and suppresses the immune system

44
Q

What cell does HIV attack?

A

T cells, leading to low numbers and increased risk of increased risk of infections and cancers

45
Q

What is AIDS?

A

AIDS- Acquired Immune Deficiency Syndrome
10 yrs after HIV!

46
Q

What are some questions to ask when speaking to pts with blood disorders?

A

Look for:
Changes in LOC?
Vertigo, fatigue, syncope?
Dyspnea, chest pain?
Coughing blood?
Dizzy? (can’t even open my eyes, everything is moving!)
Muscle pain/stiffness
Burning/itching?
Bleeding from the mouth, nose, gums or insides?

47
Q

What is the general management of a pt presenting with any problems related to blood disorders?

A

Oxygen- amount needed based on condition
Fluids- IV
ECG- monitor and treat rhythms
Transport- closet, most appropriate facility
Pharmacology- pain management (nausea- gravol, pain- ASA)
Psychological support- be supportive and communicate with the pt

48
Q

General treatment for lymphomas pts:

A

Aggressive pain management- they are often in constant extreme pain
IV fluid if inadequate perfusion
ECG to watch for and treat dysrhythmias
Transport to appropriate facility if possible
Supplemental O2 if needed
Support pt. And their families
Chemo precautions

49
Q

General treatment for DIC pts:

A

Maintain the airway and give supplemental O2
Keep the pt warm
Treat early shock aggressively
Provide meds for pain
Heart rhythm control- last care if absolutely necessary

50
Q

General treatment for Hemophilia pts:

A

Treatment of heart dysrhythmias
IV line is temporary measure to help raise the bP in the interim, ultimately the pt will need a transfusion or plasma
Analgesics for pain (ASA, acetaminophen, ketorolac)
At times, when you arrive, the bleeding may have stopped
Some pts have their own replacement clotting factor they can self administer
These patients should still go to the ER

51
Q

General treatment for sickle cell pts:

A

High levels of O2 are recommend to prevent further deformation of the RBC’s due to hypoxia
IV fluid if needed
Analgesia, higher doses as these patients have often lived with this pain for long periods of time as have built up a high pain threshold

EMRG 1230- CARDIAC UNIT (11 decks)

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