Disorders Hematological and Lymphatic Systems

Question 1

CHARACTERISTICS OF BLOOD:
PLASMA:
BLOOD CELLS:
PH:
VOLUME:

Answer 1

PLASMA: 55% Plasma – liquid portion of the blood Makes up 55% of “whole” blood
BLOOD CELLS: 45%
PH: 7.35-7.45
VOLUME: 10-12

Question 2

Red blood cells (RBCs) AKA: Erythrocytes CONTAIN A PROTEIN MOLECULE CALLED______.
BREAK DOWN THIS PROTEIN.
WHAT DOES HEMOGLOBIN DO?
LIFE SPAN?

Answer 2

HEMOGLOBIN
HEME (IRON)
GLOBIN (PROTEIN)
IT CARRIES O2 AND IRON
120 DAYS

Question 3

_________ (released by the kidney) production rises as a consequence of hemorrhage

_______ (process of RBC production)

Hematocrit = volume percentage of the total blood volume

Answer 3

ERYTHROPOIETIN

ERYTHROPOIESIS

Question 4

WHAT ARE THE COMPONENTS OF A CBC? AND THEIR VALUE RANGES

Answer 4

RBC 4-6 PRIMARY JOB: CARRY O2 WHICH IS DONE VIA HEMOGLOBIN
HEMOGLOBIN 12-18 OXYGEN, IRON
HEMATOCRIT 34% TO 50% ALWAYS A PERCENTAGE
WBC 3,500 TO 10,500 OR 5,000 TO 10,000 IMMUNE
PLATELET 150-450 CLOTTING

Question 5

WHERE ARE ALL, ALL BLOOD CELLS MANUFACTURED?

Answer 5

RED BONE MARROW

Question 6

WHITE BLOOD CELLS (LEUKOCYTES) ARE
HIGHER WHEN….
ARE LOWER WHEN…
WHATS THE value RANGE OF THESE CELLS?

Answer 6

HIGHER WHEN FIGHTING INFECTION OR INFLAMMATION
LOWER WHEN IMMUNOCOMPROMISED
RANGE- 3,500 TO 10,500 OR 5,000 TO 10,000

Question 7

THE DIFFERENTIAL OF A WBC CONTAINS SPECIFIC CELLS. WHAT ARE THEY AND THEIR PERCENTAGES.
NEVER LET MONKEYS EAT BANANAS

Answer 7

NEURTROPHIL 60% TO 70%
LEUKOCYTES 20% TO 40%
MONOCYTES 2% TO 6%
EOSINOPHILS 1% TO 4%
BASOPHILS 0.5% TO 1%

Question 8

Hemostasis: A body process that arrests the flow of blood and prevents hemorrhage
WHAT CELLS DO THIS?

Answer 8

THROMBOCYTES- PLATELETS
COUNT 150,000 TO 450,000

Question 9

THERE ARE 8 DIFFERENT BLOOD TYPES
WHAT ARE SUBSTANCES THAT CAN TRIGGER AN IMMUNE RESPONSE IF THEY ARE FOREIGN TOTHE BODY?

Answer 9

antigens – substances that can trigger an immune response if they are foreign to the body

Question 10

1) Type AB IS CONSIDERED WHAT KIND OF RECIPIENT?
2) TYPE O IS CONSIDERED WHAT KIND OF DONOR?

Answer 10

1) UNIVERSAL RECIPIENT
2) UNIVERSAL DONOR- IT IS CONSIDERED THE SAFEST TO GIVE FOR BLOOD TRANSFUSION.

Question 11

The ABO Blood Group System
GROUP A… antigen ____ on surface of RBC and __ antibody in plasma
Group B… antigen ___ on surface of RBC and __ antibody in plasma
Group AB..antigen ___ on surface of RBC and ___ antibody in plasma
Group O… antigen ___ on surface of RBC and ___ antibody in plasma

Answer 11

GROUP A… antigen A on surface and B antibody in plasma
Group B.. antigen B on surface of RBC and A antibody in plasma
Group AB… antigen AB on surface of RBC and NO antibody in plasma
Group O… NO ANTIGEN ON SURFACE OF RBC AND HAS A,B ANTIBODY IN PLASMA

Question 12

The Rh antibodies destroy some of the fetal red blood cells. This causes ________ _____, where red blood cells are destroyed faster than the body can replace them.

Answer 12

HEMOLYTIC ANEMIA

Question 13

INR is a standardized test, results will be the same and is figured out using the results of the prothrombin time (PT) test.
WHAT IS THE NORMAL INR RANGE?

Answer 13

International normalized ratio
INR 0.8 to 1.2

Question 14

COAGULATION STUDIES
Used to monitor patients taking anticoagulant – PROLONGED IF > abnormal values

Anticoagulation therapy is prescribed for patients after myocardial infarction to dissolve thrombus.
• Also used for chronic atrial fibrillation or cardioversion – restoring heart normal rhythm by delivering shock through two metal paddles placed on patient’s chest.

Prothrombin time PT _____ TO _____seconds

Answer 14

Prothrombin time PT 11-14 seconds

Question 15

COAGULATION STUDIES
NORMAL RANGE FOR PTT: ___ TO ___ SECONDS

Answer 15

Partial thromboplastin time
PTT 25-35 seconds

Question 16

Disorders Associated with Erythrocytes: Name the description of the disorder below:

• Disorder characterized by RBC and hemoglobin and hematocrit levels below normal range
• Causes delivery of insufficient amounts of oxygen to tissues and cells

Answer 16

Anemia

Question 17

Average adult has approximately 6 liters (12 pints) of total blood volume
WHAT CONDITION CAN RESULT IF NOT ENOUGH BLOOD VOLUME?

Answer 17

HYPOVOLEMIC ANEMIA OR BLOOD LOSS ANEMIA

Question 18

Oliguria – (small amount of urine- less than 400 ml in 24 hours) AND IS ASSOCIATED IN THE SLIDES WITH WHAT DISORDER?

Answer 18

HYPOVOLEMIC ANEMIA/SHOCK

Question 19

THREE STAGES OF SHOCK:

WHAT STAGE OF SHOCK IS (also called compensated, or nonprogressive), when low blood flow (perfusion) is first detected.
S/S: confused with cool and clammy skin, decreased urinary output

Answer 19

STAGE 1

Question 20

THREE STAGES OF SHOCK
WHICH STAGE of shock is irreversible, the length of time that poor perfusion has existed begins to take a permanent toll on the body’s organs and tissues.
Patient becomes unconscious. The endpoint of This stage is patient death.

Answer 20

STAGE 3

Question 21

Where is the intrinsic factor located and what causes it to be absent?
A LACK OF INTRINSIC FACTOR CAUSES PERNICIOUS ANEMIA.
HAPPENS OFTEN AFTER GASTRIC SURGERY!

Answer 21

Intrinsic factor is a protein that helps your intestines absorb vitamin B12. It is made by cells in the stomach lining. Intrinsic factor binds to vitamin B12. VITAMIN B12 IS NEEDED FOR RBC TO FORM AND GROW.
PERNICIOUS ANEMIA IS CAUSED BY NOT GETTING ENOUGH VIT B12

Question 22

What is the medical management of sickle cell anemia?

Answer 22

Increase fluids (at least 8 glasses of fluid daily)
More fluid means lower viscosity/thickness
 Analgesics
Pain control is necessary during crisis – morphine and
hydromorphone (Dilaudid)

Question 23

What is a Blood disorder characterized by hyperplasia (overgrowth) of the bone marrow with Manifestations of Overproduction of circulating erythrocytes (erythrocytosis), granulocytes, and platelets?
It is characterized by an ^ of RBC in bloodstream, ^ hemoglobin and hyper viscosity, excess wbc and platelets.

Answer 23

Polycythemia (erythrocytosis)
There is an ^ of bleeding disorders

Question 24

MM and NI for Polycythemia (erythrocytosis)
+Reduction of blood viscosity
+Repeated Phlebotomy – removal of 500 to 2000 ml of blood until Hct level is maintained at 45-48%
What are the normal values for HCT and HGB?

Answer 24

HCT 35-45%
HGB 12-18

Question 25

Potentially fatal condition - Severe reduction in the number of granulocytes (basophils, eusinophils and neutrophils) WBC extremely low (leukopenia) - less than 200/mm3 adverse medication or toxicity is primary cause Chemotherapy Radiation Neoplastic disease

Answer 25

Agranulocytosis

Question 26

Malignant disorder of the hematopoietic system = EXCESSIVE number of ABNORMAL LEUKOCYTES accumulate in the bone marrow and lymph nodes =Normal WBC in the bone marrow and replaced with abnormal numbers and forms rapidly dividing cells which then spread to circulation and infiltrate lymph nodes, spleen and other organs

Answer 26

Leukemia

Question 27

Condition in which the number of platelets is reduced below 150,000/mm3 Most common cause of increased destruction of platelets is Idiopathic thrombocytopenia purpura ITP– auto immune disease

Answer 27

THROMBOCYTOPENIA MEDICATION: Corticosteroid therapy Heartburn and Moon-face common with long term USE

Question 28

Hereditary coagulation disorder, characterized by absence of certain blood-clotting factors. = Hemophilia A – more common – factor VIII is absent = Hemophilia B (Christmas disease) much rare – factor IX is absent = X-linked hereditary trait

Answer 28

HEMOPHILIA S/S: Internal and external bleeding (petechiae and echymosis) Hemarthrosis (bleeding into joint)

Question 29

Inherited bleeding disorder characterized by abnormally SLOW coagulation of blood, episodes of GI bleeding, epistaxis and gingival bleeding. • Similar to hemophilia; not limited to males Desmopressin (DDAVP) – treatment of choice

Answer 29

VON WILLEBRAND’S DISEASE Clinical manifestations/assessment • Spontaneous episodes of • GI bleeding • Epistaxis • Gingival bleeding Desmopressin (DDAVP) – treatment of choice

Question 30

-Grave coagulopathy resulting from overstimulation of clotting and anticlotting processes in response to disease or injury. -Due to sepsis, blood transfusions, liver failure, cancer (especially leukemia), and even giving birth -When clotting factors are “used up” or the body realizes there are clots... there is excessive / abnormal bleeding BLEEDING- CLOTTING- BLEEDING- CLOTTING….

Answer 30

Disseminated intravascular coagulation (DIC) • There will be prolonged bleeding!!!

Question 31

COMPARE THESE AND GET THEM STRAIGHT! Lymphangitis ET= Inflammation of one or more lymphatic vessels S/S= Fine red streaks from the affected area M/M= Avoid injections and IVs on the affected side

Answer 31

Lymphedema ET= Due to compression or obstruction of return of lymph, Accumulation of lymph in the soft tissue. For example> radical mastectomy S/S= Massive edema and tightness of affected extremity and Pain M/M= diuretics NI= Elevate extremity affected

Question 32

Compare these two: Hemophilia • Etiology/pathophysiology • A serious, lifelong bleeding disorder inherited as an X-linked recessive disorder

Answer 32

Idiopathic Thrombocytopenic Purpura • Etiology/pathophysiology • A marked decrease in the amount of circulating platelets with resultant bleeding beneath the skin and Platelet count drops below 20,000.

Question 33

Aldosterone actions..

Answer 33

It’s a strong vasoconstrictor Retain water and salt in kidneys which ^ body water = increase in BP