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Respiratory semester 3 > exam 2 > Flashcards

exam 2 Flashcards

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1
Q

causes of thrombocytopenia

A

Commonly from ingestion of high doses of certain drugs
Autoimmune diseases
Increased platelet consumption Splenomegaly
Bone marrow suppression/failure
can be caused from heparin , quinine, sulfa abx

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2
Q

Diagnostic studies for COPD

A

H&P, spirometry, CXR, 6-min walk test, COPD assessment test, Clinical COPD questionnaire, ABGs

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3
Q

what is neutropenia

A

ANC < 1000
severe neutropenia <500
Patient has little or no ability to fight infection

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4
Q

moderate anemia

A

Hgb: 6-10
Cardiopulmonary s/sx at rest

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5
Q

what is sickle cell anemia

A

autosomal recessive disorder
abnormal hgb = Hgb S
Hgb S causes erythrocyte to stiffen and elongate taking on sickle shape in response to low O2 levels

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6
Q

Thrombocytopenia diagnostics

A

↓ Platelet count
Prolonged bleeding < 50,000
Hemorrhage < 20,000
Peripheral blood smear
Medical history
Clinical examination
Lab parameter comparisons
increased LDH
PT, INR

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7
Q

An autosomal recessive, disorder
altered transport of sodium and chloride ions in and out of epithelial cells
Affects primarily lungs, skin, GI tract (pancreas/biliary tract) , repro tract.

A

Cystic fibrosis

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8
Q

what is Hodgkins lymphoma

A

malignant neoplasm that originates in bone marrow , goes to lymphatic structures resulting in proliferation of lymphocytes

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9
Q

what does a peripheral blood smear show in sickle cell disease

A

may reveal sickled cells and increased abnormal reticulocytes

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10
Q

iron rich foods

A

liver, dried fruits, legumes, dark greens, whole grains, beans, cereals

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11
Q

acute asthma exacerbation symptoms

A

tripod position, prominent wheezing, RR >30, pulse > 120, accessory muscles to the neck, agitation

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12
Q

What education should be provided for patients with sickle cell disease

A
  1. Avoiding exposure to crowds to prevent infection
  2. severe exercise could cause hypoxia and causes changes in permeability
  3. Remove any constrictive clothes
  4. avoid anything that can trigger crisis
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13
Q

symptoms of DIC

A

bleeding from venipuncture sites, hemoptysis, hypotension, tachycardia, bloody stools, hematuria

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14
Q

shape of RBCs in sickle cell

A

rigid, elongated, crescent shape

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15
Q

asthma drug triggers

A

beta blockers: propranolol, metoprolol, timolol
Ace inhibitors: lisinopril, trigger dry cough

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16
Q

How is sickle cell disease diagnosed

A

Peripheral blood smear
Sickling test
Electrophoresis of hemoglobin
Skeletal x-rays
Magnetic resonance imaging (MRI)
Doppler studies
X-rays

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17
Q

Defective DNA synthesis in RBCs

A

Megaloblastic Anemia

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18
Q

progressive disease associated with an enhanced chronic inflammatory response in the airways and lungs, primarily caused by cigarette smoking that results in persistent airflow limitation. .

A

COPD

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19
Q

PEFR yellow zone

A

50-80% of personal best
indicates caution, something triggering asthma

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20
Q

asthma exacerbation assessment

A

RR/HR, accessory muscle use, lung auscultation, PEFR to monitor airflow obstruction, pulse ox, ABGs

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21
Q

purpose of peak expiratory flow rate

A

measures the maximum speed of expiration, can help predict an asthma attack or monitor severity of disease, measures degree of obstruction

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22
Q

stages of Hodgkins lymphoma

A

Stage 1 is one lymphnodes
2 – is two or more
3 – lymph nodes affected above and below diaphragm
4 – even on sides of diaphragm

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23
Q

COPD patho

A

Chronic inflammation of airways, lung parenchyma (bronchioles and alveoli), and pulmonary blood vessels
Airflow limitation, air trapping, gas exchange is abnormal, mucous hypersecretion

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24
Q

mild anemia

A

Hgb: 10-12
Palpitations, dypnea, fatigue

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25
3rd leading cause of death in US
COPD
26
what other symptoms accompany pain during sickle cell crisis
Fever , swelling , tenderness, tachypnea, HTN, N/V
27
severe anemia
Hgb: <6 Pallor, Jaundice, Pruritus Elevated HR, systolic murmurs, angina pectoris, MI, HF, cardiomegaly, congestion, ascites, edema
28
Peak flow results: green zone
80-100% , remain on meds
29
what is polycythemia
increased number of RBCs, causes hyperviscosity and hypervolemia
30
Diminished availability of erythrocyte precursors
Aplastic Anemia
31
what is an immunologic transfusion reaction
reaction when donor blood and recipient blood weren't compatible
32
drug/food additive triggers of asthma
aspirin, NSAIDs, salicylic acid,
33
chronic long-term condition, intermittent inflammation that narrows airways in lungs, causes limitations of bronchiole responsiveness
asthma
34
abnormal lymph node assessment
tender = inflammation enlarged > 1 cm hard/fixed = malignancy
35
what meds can be used to treat neutropenia
Neupogen and filgastrim
36
Treatment for DIC
stabilize pt, oxygen, volume replacement , control bleeding, might need blood, vitamin k
37
COPD symptoms
chronic intermittent cough/sputum production dyspnea difficulty breathing wheezing/chest tightness underweight with anorexia chronic fatigue paroxysmal nocturnal dyspnea
38
How is polycythemia diagnosed
lab and bone marrow aspiration
39
Inadequate production of Hgb. Autosomal recessive genetic disorder
Thalassemia
40
what is thrombocytopenia
reduction of platelets < 100, results in prolonged or spontaneous bleeding
41
COPD risk factors
Cigarette smoking occupation chemicals and dusts air pollution infection genetics aging asthma gender
42
mild allergic transfusion reaction
hives pruritis facial flushing
43
Symptoms of Cobalamin deficiency (pernicious anemia)
palpations fatigue dyspnea pallor sore red, beefy, shiny tongue anorexia N/V abdominal pain weakness, paresthesias decreased senses ataxia, muscle weakness impaire thoughts
44
Treatment of pernicious anemia
parenteral or intranasal admin of cobalamin most common is 1000 mg of B12 IM , everyday for 2 weeks, then once a week until Hgb is normal , then once a month for life
45
management o f neutropenia
Put pt in isolation to protect pt. remove fresh plants monitor labs any s/s of infection (fever = early sign) keep eye on IV for infection teach personal hygiene instruct to take all meds especially antibiotics check temp q4h
46
what is an acute transfusion reaction
reaction occurs during the transfusion
47
extra info about Hodgkins lymphoma
If begins above diaphragm,it will have slow progress, if below diaphragm itll spread quick A is for pts with no symptoms B is for pts with symptoms
48
causes of aplastic anemia
can be autoimmune but also caused by alcohol , radiation, viral or bacterial infection
49
symptoms of Hodgkins lymphoma
Enlargement of cervical, axillary, or inguinal lymph nodes, mediastinal nodes Painless unless: Exert pressure on nerves, Alcohol
50
what is aplastic anemia (idiopathic)
pancytopenia with hypo cellular bone marrow low bc, low rbc, low platelets
51
triggers of sickle cell
low o2 in blood hypoxia or low oxygen in blood can be cause by infection, high altitude , stress, surgery, blood loss, dehydration, acidosis, lowered body temp
52
thalassemia major treatment
blood transfusions with chelating agents meds splenectomy monitor hepatic, cardiac, pulmonary function hematopoietic stem cell transplant
53
asthma triad
nasal polyps, asthma, sensitivity to aspirin and NSAIDs
54
anemia due to Decreased Hgb synthesis
Iron-Deficiency Anemia Thalassemia
55
how does aging cause COPD
lung loses recoil or stiffness of chest wall causing alteration in gas exchange, lungs become rounder and smaller, decreased number of alveoli and happens due to loss of tissue in airway
56
what causes polycythemia
due to gene mutation but not inherited can be caused by radiation or exposure to toxic substances
57
what causes an increase in Hgb
polycythemia and dehydration
58
What is DIC
Serious bleeding and thrombotic disorder that results from abnormally initiated and accelerated clotting DIC is not a disease, abnormal response of normal clotting cascade caused by a disease process or disorder
59
COPD patient presentation
prolonged expiratory phase wheezes decreased breath sounds barrel chest tripod position pursed lip breathing
60
Megaloblastic anemias
folic acid and cobalamin (vitamin b12) anemias
61
asthma risk factors
genetic factors environmental factors male gender before puberty obesity
62
Late COPD manifestations?
polycythemia and cyanosis hypoxemia increased production of RBCs bluish-red color of skin Hgb concentration may reach 20 g/dL or more
63
hemolytic transfusion reaction
low back pain hypotension tachycardia fever and chills chest pain tachypnea hemoglobinuria
64
causes of pernicious anemia
absence of intrinsic factor GI surgery (small bowel resection ) chronic GI disease (celiac or crohns) excessive alcohol or hot tea ingestion (decreases acidity) smoking long term use of H2 blockers and PPIs strict vegetarians
65
Treatment for transfusion reactions
antihistamines antipyretics stop transfusion keep iv line open with normal salin e monitor VS q15 min post transfusion blood sample treat s/sx
66
symptoms of aplastic anemia
fatigue dypsnea will have neutropenia (infection risk) will have thrombocytopenia (bleeding risk)
67
the presence of cough and sputum production for at least 3 months in each of 2 consecutive years, is an independent disease that may precede or follow the development of airflow limitation.
Chronic Bronchitis
68
why are iron and TIBC elevated in aplastic anemia
iron is floating in blood
69
asthma diagnostic studies
history and physical, spirometry, peak expiratory flow rate, chest x-ray, oximetry, allergy testing, blood levels of eosinophils
70
Symptoms of polycythemia
headache, vertigo, dizziness, tinnitus, visual disturbances, pruritis, paresthesias, erythromyalgia, angina, intermittent claudication , thrombophlebitis
71
cystic fibrosis treatment
antibiotics for infections pulmozyme, inhaled hypertonic saline, and CPT to clear secretions digestive enzymes replacement to provide adequate nutrition high calorie, high fat, high protein diet supplemental fat soluble vitamins (A, d, e, K)
72
what causes pain in sickle cell
pain from vessel occlusion (tissue ischemia) RBCs have hard time passing cuz of shape
73
what is a delayed transfusion reaction
reaction can happen days or weeks after transfusion
74
symptoms of salicylic/NSAID use
wheezing in 2 hrs, rhinorrhea, congestion, tearing, angioedema
75
treatment of intermittent and persistent asthma
avoid triggers of acute attacks pre-mediate befor exercising short medication (rescue med) long term or controller med
76
Iron deficiency Anemia: S/sx
pallor glossitis cheilitis headache paresthesias burning sensation
77
Cystic fibrosis symptoms
fatigue chronic cough w/ thick/sticky mucus recurrent URIs chronic hypoxia clubbing, barrel chest decreased absorption of vitamins and enzymes abdominal distention decreased digestive enzymes greasy, smelly stools (steatorrhea) meconium ileus in newborn rectal prolapse
78
How does electrophoresis of hgb diagnose sickle cell disease
determines amount of hgb s and scd from other variants
79
what does a "shift to the left" indicate
bone marrow releases more immature neutrophils during an infection when the body cannot keep up with WBC production , levels being to normalize when infection is gettin better or body can keep up
80
what are indications for a bone marrow biopsy
Used to diagnose disease determine stage of progression of disease check iron levels monitor treatment of disease check for anemia check for cancer such as leukemia, lymphoma, multiple myeloma sometimes to investigate fevers
81
symptoms of thrombocytopenia
Patients are often asymptomatic Mucosal bleeding (nose or gingival bleeding) Petechiae Purpura Ecchymoses heavy menstrual flow in women LOC changes internal bleeding signs
82
asthma symptoms
prolonged expiration, expiratory wheezing, air trapping, lung hyperinflation, chest tightness, dyspnea, cough, accessory muscle use
83
spirometry use
assess lung function, measures how much air pt can inhale/exhale, diagnoses asthma and COPD, can be used to monitor treatment for chronic lung disease
84
Nursing interventions for bone marrow biopsy
apply pressure with sterile dressing assess for bleeding and lay on site for 30-60 min monitor VS educate that area will be sore for 3 days
85
anaphylactic transfusion reaction
SOB bronchospasm anxiety hives pruritis
86
diagnosis of Hodgkins lymphoma
Peripheral blood analysis CBC abnormalities are variable and not diagnostic Excisional lymph node biopsy Bone marrow examination Radiologic evaluation
87
Thalassemia major
Thalassemia major = life threatening Physical and mental delay Jaundice Splenomegaly Hepatomegaly Cardiomyopathy Bone marrow hyperplasia
88
Treatment of thrombocytopenia
Prevent or control hemorrhage Any bleeding needs evaluation and treatment Watch for bleeding that can be difficult to detect Avoid IM injections Closely monitor platelet count, coagulation studies, Hgb, and Hct Platelet Transfusions Manage blood loss from excessive menstrual bleeding Avoid SQ injections if possible , apply pressure and ice packs right after if given soft toothbrush
89
febrile reaction symptoms
chills fever headache flushing tachycardia anxiety
90
asthma triggers
cockroaches, furry animals, fungi, pollen, molds, cigarette or wood smoke, vehicle exhaust, concentrated pollution, physical exertion
91
why are fluids given during a sickle cell crisis
to reduce blood viscosity and prevent dehydration , maintain kidney function
92
Symptoms of sickle cell disease
asymptomatic except during sicking episodes Symptoms: pain from tissue hypoxia and damage pallor of mucus membranes jaundice from hemolysis prone to gallstones skin may have gray cast
93
systematic symptoms of lymphoma
Weight loss, fatigue/weakness, fever/chills, tachycardia, night sweats, itching Advanced pts: hepatomegaly, splenomegaly, anemia
94
how do you treat an exacerbation of polycythemia
aspirin, ambulation, lukewarm bath
95
which pts may have high risk of acquiring DIC
pts with sepsis, notify HCP if septic and starts bleeding
96
complications of polycythemia
scurrying of bone marrow cuz it is overworked and can lead to leukemia, feeling full due to splenomegaly, splenectomy may be needed
97
COPD treatment
smoking cessation evaluate for environmental or occupational irritants breathing retraining (pursed lip, diaphragmatic breathing) airway clearance CPT vaccines drug therapy similar to asthma
98
what is nonimmunologic reaction
due to blood being damaged during transportation
99
what is included in a CBC with differential
Neutrophils, lymphocytes, eosinophils, basophils, monocytes
100
what is the treatment for polycythemia
reduce blood volume and viscosity by removing blood through phlebotomy
101
causes of Hodgkins lymphoma
Epstein Barr Virus (EPV) Genetic predisposition, Occupational toxins HIV
102
treatment of aplastic anemia
hematopoietic stem cell transplant and immunosuppressive therapy with cyclosporine will have ongoing blood transfusion , iron binding agent to prevent iron overload
103
iron deficiency anemia diagnostics
CBC Low Hgb/Hct Low serum iron High TIBC Low ferritin Stool Occult blood test Endoscopy/Colonoscopy Bone Marrow Biopsy
104
the destruction of the alveoli and is a pathologic term that explains only one of several structural abnormalities in COPD patients
emphysema
105
diagnosis of aplastic anemia
Low Hgb, WBC, and platelet values Low reticulocyte count Elevated serum iron and TIBC Hypocellular bone marrow with increased fat content (yellow marrow)
106
PEFR red zone
50% or less of personal best indicates serious problem, action must be taken with HCP
107
Normal lymph node assessment
not palpable, < 1 cm, firm, contender

Respiratory semester 3 (2 decks)

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