Chapter 41 and 42 Hematology Flashcards Preview

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Flashcards in Chapter 41 and 42 Hematology Deck (55):
1

Fibrinolytics

Selectively degrade fibrin threads in the formed blood clot

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Platelet Inhibitors

prevent platelets from becoming active or activated platelets from clumping together

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Anemia

Reduction in RBC's, hemoglobin, or hematocrit

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Sickle cell disease

Genetic
chronic anemia, pain, disability, organ damage, increased risk for infection, and early death

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Sickle Cell Disease: Pathophysiology

Formation of abnormal hemoglobin chains

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Iron Deficiency Anemia cause

blood loss, poor intestinal absorption, or inadequate diet

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Iron Deficiency Anemia sx

weakness and pallor
abnormal bleeding, especially from the GI tract

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Causes of Vitamin B12 Deficiency Anemia

small bowel resection, tapeworm, overgrowth of intestinal bacteria

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Result of Vitamin B12 Deficiency Anemia

improper DNA synthesis of RBCs.

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Pernicious Anemia

failure to absorb vitamin B12
Caused by a deficiency of intrinsic factor

11

Aplastic Anemia

Deficiency of circulating RBCs
failure of the bone marrow to produce RBC's

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Aplastic Anemia tx

Blood transfusions
Immunosuppressive therapy
Splenectomy

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Polycythemia Vera

Cancer of the RBCs
Increase in blood hemoglobin or hematocrit
Over production of red blood cells, leukocytes and platelets

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Polycythemia Vera tx

Phlebotomy
Hydration
Anticoagulants

15

Myelodysplastic Syndromes

caused by the formation of abnormal cells in the bone marrow

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Drugs for iron overload

deferasirox and deferoxamine mesylate

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Leukemia

of cancer with uncontrolled production of immature white blood cells in the bone marrow

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Laboratory assessment of leukemia

Decreased H&H
Low platelets
Abnormal WBC (high)

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Hodgkin’s Lymphoma: Interventions

One of the most treatable types of cancer
External radiation
Chemotherapy

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Hodgkin’s Lymphoma marker

Reed-Sternberg cell
Spreads to different lymph nodes in an orderly fashion

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Hodgkin’s Lymphoma sx

Large, painless lymph node, usually in the neck, becomes painful when alcohol ingested; fever, drenching night sweats, and unexplained weight loss

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Non-Hodgkin’s Lymphoma

more than 12 types
do not have Reed-Sternberg cell
Not orderly

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Multiple Myeloma

White blood cell cancer that involves a more mature lymphocyte called a plasma cell

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Multiple Myeloma interventions

Chemotherapy
Autologous stem cell transplant
Analgesics
Bisphosphonates

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Autoimmune Thrombocytopenic Purpura

Total number of circulating platelets is greatly reduced even though production in the bone marrow is normal.
Patients make an antibody directed against the surface of their own platelets.

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Autoimmune Thrombocytopenic Purpura drug therapy

corticosteroids, azathioprine, IV immunoglobulin, IV anti-Rho, or low doses of chemotherapy
Platelet transfusions`

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Thrombotic Thrombocytopenic Purpura (TTP)

Rare
platelets clump together abnormally in the capillaries, and too few platelets remain in circulation

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Thrombotic Thrombocytopenic Purpura (TTP) tx

plasmapheresis, aspirin, alprostadil, plicamycin, and immunosuppressive therapy

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Types of Transfusions

Red blood cell
Platelet
Plasma—fresh frozen plasma
Cryoprecipitate
Granulocyte (white cell)

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Function of albumin in the blood

increases osmotic pressure of the blood, preventing the plasma from leaking into the tissues

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Functions of globulins in the blood

transport substances, protect the body from infections, and are the main protein of antibodies

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Components of plasma

albumin, globulins, and fibrinogen

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RBC's

Majority of blood cells
4.2-6.1 million
Live 120 days
produce hemoglobin

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Function of hemoglobin

carries O2
Needs iron to function

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Function of the spleen in blood

balances blood cell production with blood cell destruction and assists with immunity. It destroys old or imperfect RBC’s, breaks down the hemoglobin , stores platelets, and filters antigens

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Trigger of blood clotting

formation of a platelet plug

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Most common sx of anemia

fatigue

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Most common cause of anemia

GI bleed

39

Sickle cell anemia sx

pain #1
may be asymptomatic
Jaundice
SOB, fatigue
Murmur, poor tissue perfusion
tachycardia, priaprism
pallor

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Labs seen in sickle cell anemia

low hematocrit
high reticulate count (due to release of immature blood cells)
high bilirubin
increased WBC

41

Sickle cell anemia interventions

pain related to hypoxia to tissues: tx w/ O2 and opioids
hydrate
promote venus return
RBC transfusion

42

Polycythemia Vera sx

dark flushed skin
itching caused by dilated blood vessels and poor tissue perfusion
HTN
Distended veins
sluggish blood flow

43

Chelation

chemical binding of iron and its removal from the body

44

Leukemia without tx

PT will die of infection of hemorrhage

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Acute leukemia sx

echymosis, petechiae, open infected lesions, pallor, bleding gums, anorexia, weiht loss, enlarged liver and spleen, hematuria, tachycardia, orthostatic hypotension, palpitations, dyspnea on exertion, fatigue, h/a, fever, bone pain, joint swelling and pain

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Chronic leukemia sx

murmurs, bruits, slow cap refill, respiratory changes, chronic repeated infections, pallor, coolness of extremities, petechia, easy bleeding, weight loss, nausea, anorexia

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Bone marrow transplant

typical tx for luekemia

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Graft vs host disease (GVHD)

cells of the donated marrow recognize the patients cells as foreign and start an attack
Drugs are given to suppress the immune function

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Oprevlakin (Neumega)

given to leukemia PT's to induce platelet growth after chemo

50

Autoimmune Thrombocytopenic Purpura sx

o Ecchymosis, petechial rash on the arms, legs, upper chest, and neck, musosal bleeding, anemia and low H&H if bleeding episodes have happened

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Autoimmune Thrombocytopenic Purpura complication

Rare: intracranial bleed-induced stroke

52

Hemophilia transmission

• X linked recessive trait passed from women to their daughters who will be carriers and to their sons who will have the disease

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Hemophilia A

deficiency of factor VIII and accounts for 80% of cases

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Hemophilia B

deficiency of factor IX- accounts for 20% of cases

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Platelet count to qualify for transfusion

<10,000