Blood Lecture Flashcards
(28 cards)
Blood Production Problems regarding production
Underproduction - hypoproliferation
Overproduction
Impaired production - microcytic (small RBC)
- macrocytic (big RBC)
- hypochromic (decrease Hgb)
- hyperchromic (increase Hgb)
Purpose of Circulation
Moves nutrients and medications
Oxygenation
Homeostasis: maintains fluid balance
maintains acid/base balance
What does Albumin do?
- maintains fluid balance
- binds substances to transfer in plasma i.e. medications
- maintains osmotic pressure so fluid does not leak out of bloodstream and into tissues
(like egg white or serum in blood)
Testing for CBC
You can pull blood from a vein artery or capillary
Don’t massage - false low
If you leave tourniquet on for too long - false high
then you have to take it off, wait a while, and do it again
Mean Corpuscular Hemoglobin (MCH)
Amount of Hgb in average blood cell 26-33
Too high - macrocytic anemia
-B12 and folic acid deficiency
Too low - microcytic anemia
- Fe++ deficiency
- blood loss
Mean Corpuscular Volume (MCV)
Amount of space taken up by an average blood cell. 78-98 micrometers um3
Red cell Diameter Width (RDW)
Variance of size in blood cells 11-14.5%
What is urticaria also known as?
Gives
Hemochromatosis
Too much Fe++ in blood
- Fe++ absorbed in GI tract
- more common in white people
Loss of sexual drive, arthritis, cardiac problems, endocrine problems, cirrhosis, fatigue
S/S of iron deficiency
Early: fatigue, weakness, pallor
Late: dyspnea, chest pain, muscle pain, cramping
Iron deficiency is the most common type of anemia
Pica eating non-food items
Vitamin B12 deficiency/Pernicious Anemia
Schillings test is used to see if they have intrinsic factor or not. If the test is positive then they have a problem with intrinsic factor and if the test is negative then there is something else causing the deficiency and they have normal intrinsic factor.
You need intrinsic factor to absorb B12 so if you don’t have intrinsic factor then you can’t take B12 pills because you won’t absorb it and you need a B12 shot.
Schillings test is used to evaluate B12 absorption and check for pernicious anemia.
Folic Acid Deficiency
- Macrocytic and normochromatic
- malnutrition
- alcoholics: alcohol increases demand for folic acid
- Spina Bifida
Antibiotics: ampicillin and tetracycline
Aplastic anemia
- decrease in RBC WBC Hgb Pla
- Do bone marrow aspiration
- WBC do not recognize stems cells from bone marrow and so the WBC attack the stem cells and stem cells cannot become RBC and you get anemia.
S/S: infection and bleeding
Kidney Dysfunction Patients
Kidneys produce erythropoietin and erythropoietin produces RBC.
So if the kidneys dysfunction then they will produce less erythropoietin and uremia: the bone marrow will be less responsive to the erythropoietin that is being produced and less RBC will be made and you get anemia.
Hemolysis
•destruction of RBC
- hereditary spherocytosis: the cell breaks down and collapses on itself
- heavy metals: metal poisoning pulls oxygen out of the cell
Pregnant women have decrease RBC
- dilution: dilutional anemia is when the woman is pregnant but she shares blood for two people
- fluid retention dilutes RBCs
Polycythemia
Overproduction of RBCs
- sluggish blood flow
- increased clotting
- hypoxia
- high altitude
Polycythemia Vera
Overproduction of all types of blood cells
Treatment: blood removal or bone marrow suppression drugs
Surface of skin is VERY red because of increased number of blood cells
Hypoxia occurs when there is low oxygen content in the blood. So when a person is in high altitude there is less oxygen so they breathe in the same amount of air but they get less oxygen. So as a result the body increases the production of erythropoietin and that increases the production of RBCs which is polycythemia. As a result of polycythemia there is “high traffic” in the blood vessel so the blood is thicker and blood flow is sluggish and it increases clotting.
When people are at high altitudes they breathe in the same amount of air but there is less oxygen so in order to compensate the body increases the production of RBCs which is polycythemia in order to grab as much oxygen as possible.
Hypoxia occurs when there is low oxygen content in the blood. So when a person is in high altitude there is less oxygen so they breathe in the same amount of air but they get less oxygen. So as a result the body increases the production of erythropoietin and that increases the production of RBCs which is polycythemia. As a result of polycythemia there is “high traffic” in the blood vessel so the blood is thicker and blood flow is sluggish and it increases clotting.
When people are at high altitudes they breathe in the same amount of air but there is less oxygen so in order to compensate the body increases the production of RBCs which is polycythemia in order to grab as much oxygen as possible.
What else increases the production of RBCs
Dehydration
Smoking
Drugs
Thrombocytopenia
Not enough platelets
- coagulation problems
- at risk for bleeding/bruising so they are a fall risk
- nurse safety measures: when patient is shaving, toothbrush, medications
Petechiae- red/purple bleeding in skin
Purpura- rash of red/purple spots that occur due to internal bleeding of small blood vessels
DIC
Disseminated Intravascular Coagulation
- clotting and bleeding at the same time
- abnormal clotting of the blood (microvascular thrombi) that use up the body’s clotting factor and so the other parts of the body cannot clot and those areas are at risk for bleeding.
- life threatening
Caused by tissue damage, infection, vessel damage cancer shock trauma allergic reactions & emergency situations
Nursing Care:
- maintain optimal oxygenation
- fluid replacement: blood transfusion in 2 hours so it’s quick because you want to fix hypovolemia
- maintain electrolyte balance
- vasopressor meds: epi, norepi, vasopressin, dopamine
PT and PTT
PT- has to do with tissue added to blood and then see how long it takes for blood to clot
PTT- see how long it takes for blood to clot and used for unexplained clotting or bleeding
Bone marrow biopsy
Needle is inserted into the spongy bone in order to pull out bone marrow.
(left hip in fetal position on edge of bed)
