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MedSurg > Exam 2 Review: Hematologic Problems > Flashcards

Exam 2 Review: Hematologic Problems Flashcards

(58 cards)

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1
Q

What patient population might have the most issues with anemia?

A

Women

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2
Q

What are the signs and symptoms of anemia caused by?

A

Body’s response to tissue hypoxia

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3
Q

What expected patient outcome of anemia displays that the patient is trying to compensate for low RBC levels?

A

Tachycardia, the heart is beating faster to circulate more blood in order to compensate for low fluid levels

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4
Q

What is the ultimate goal of anemia?

A

Correcting the cause of anemia

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5
Q

What treatment option is prioritized for patients with anemia?

A

Oxygen therapy

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6
Q

Anemia patients are treated with what supplement? What is a side effect?

A

Iron; constipation

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7
Q

What are some underlying causes of anemia? (5)

A
  • iron deficiency
  • bleeding
  • chronic disease/inflammation
  • renal insufficiency
  • hematologic cancer
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8
Q

Why is it difficult to diagnose older patients with anemia?

A

Because there may be no identifiable cause of anemia in the older adult

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9
Q

What signs and symptoms may not be recognized for anemia? (4)

A

Pallor, cyanosis, confusion, fatigue

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10
Q

In severely anemic patients, what would you expect to find?

A

Dyspnea and tachycardia

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11
Q

A client with anemia may be tired due to a tissue deficiency of what substance?

A

Oxygen

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12
Q

What is the most common nutritional disorder in the world?

A

Iron deficiency anemia

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13
Q

What can iron deficiency anemia be caused by? (4)

A
  • inadequate dietary intake
  • blood loss
  • hemolysis
  • chronic GI blood loss
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14
Q

Signs and symptoms of iron deficiency anemia? (3)

A
  • pallor: most common
  • glossitis: inflammation of the tongue
  • cheilitis: inflammation of the lips
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15
Q

Iron deficient patients will receive what supplement? What is it best absorbed with? What patient teaching should be included?

A
  • iron
  • best absorbed with vitamin C (orange juice)
  • warn patient that stool will be dark and tarry
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16
Q

What is thalassemia?

A

Inadequate production of normal hemoglobin resulting in a decrease in erythrocyte production

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17
Q

How is thalassemia managed? (3)

A
  • blood transfusions
  • iron/zinc supplements
  • chelating agents to bind iron
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18
Q

What is the primary pathophysiology underlying thalassemia?

A

Inadequate hemoglobin of synthesis

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19
Q

Megaloblastic anemia is caused by?

A

Impaired DNA synthesis causes the RBCs to become large (macrocytic) and abnormal

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20
Q

What are the GI signs and symptoms of pernicious anemia? (4)

A
  • soreness
  • red
  • beefy tongue
  • anorexia
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21
Q

Patients with pernicious anemia have the inability to absorb? How is it treated?

A

Unable to absorb vitamin B12 due to a lack of intrinsic factor; treated using an IM injection of B12

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22
Q

What are the neuromuscular signs and symptoms of pernicious anemia? (3)

A
  • muscle weakness
  • paresthesia of exts
  • impaired thought process
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23
Q

What deficiency can cause megaloblastic anemia?

A

Folic acid deficiency (needed for the synthesis of RBC)

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24
Q

What is the normal serum folate level?

25
Folic acid deficiency is treated with replacement therapy. What is the usual dose?
1 mg per day PO
26
The nurse should instruct the patient to eat which food to obtain the best supply of vitamin B12?
Meats and dairy products
27
Patients with pernicious anemia have which lab result?
Intrinsic factor, absent
28
Patient with pernicious anemia asks the nurse why she must take vitamin B12 injections for the rest of her life. What is the best response?
You are unable to absorb the vitamin because your stomach is not producing enough intrinsic factor
29
What is aplastic anemia?
Disease in which patient has peripheral blood pancytopenia, a decrease in all types of RBC (WBC, platelets, red blood cells)
30
What is the main concern for patients with aplastic anemia?
The patient will not have a high functioning immune system
31
Which lab finding supports the diagnosis for aplastic anemia?
Reduced RBCs (WBC, platelets, red blood cells)
32
What is the main vital sign that a nurse should be concerned about in a patient with acute blood loss?
O2 saturation
33
Why is pain assessment important for patients with acute blood loss?
To determine internal hemorrhage
34
Chronic blood loss is related to? It is considered as?
Depletion of iron stores and is considered an iron-deficiency anemia
35
How is chronic blood loss managed? (2)
- identifying the source and stop the bleeding | - supplemental iron
36
Hemolytic anemia is caused by?
destruction or hemolysis of RBCs at a rate that exceeds production
37
What is the major focus during treatment for a patient with hemolytic anemia?
Maintain renal function (kidneys are not getting perfused because of low RBC and must work extra hard to filter the hemolyzed RBC)
38
Sickle cell disease is caused by?
Hemoglobin S, causes the erythrocyte to stiffen and take on a sickle shape due to inadequate oxygen
39
Sickle cell anemia affects what part of ventilation?
transportation
40
What can cause a sickling event? (8)
- infection - high altitude - emotional/physical stress - surgery - blood loss - dehydration - hypoxemia - temp variations esp cold weather
41
Sickle cell crisis causes?
acute exacerbation causing vaso-occlusive crisis which causes severe pain
42
How to prevent pulmonary embolism in patients with sickle cell anemia? (2)
ambulation and SCD devices
43
Sickle cell anemic patients are on high alert because they are at risk for?
respiratory failure
44
A patient who is having a sickle cell crisis asks the nurse why the sickling causes such pain. The nurse explains that the pain is caused by?
Tissue hypoxia caused by small blood vessel occlusion, leading to tissue necrosis
45
What should be part of the patient teaching for sickle cell disease? (2)
- avoid dehydration | - avoid high altitudes
46
Acquired hemolytic anemia is treated by? (3)
- supportive care until the causing agent is found - aggressive hydration - electrolyte replacement
47
What are additional treatment options for acquired anemia? (3)
- corticosteroid - blood products - remove the spleen
48
Acquired hemolytic anemia is caused by? (3)
Hemolysis of RBCs from extrinsic factors: - physical destruction - antibody reaction - infectious agents
49
Hemochromatosis is?
Iron overload disorder
50
What are nonspecific signs and symptoms of hemochromatosis? (5)
- PAIN - fatigue - arthralgia - impotent - weight loss
51
Hemochromatosis is mostly seen in?
Men
52
What is the normal iron level?
2-6 g
53
Thrombocytopenia is?
Platelet below 150,000 (needed to clot)
54
Signs and symptoms of thrombocytopenia? (3)
- mucosal bleeding - petechiae - superficial ecchymosis
55
When there are multiple petechiae, what is this called?
purpura
56
What is the antidote for heparin?
protamine sulfate
57
Nursing management for thrombocytopenia? (2)
- discourage OTC (gingko, garlic, ginger) | - keep surroundings clean and cover sharp corners
58
What risk factor increases the chances of sickle cell crisis?
dehydration

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