True or False: Anemia may have no symptoms until hemoglobin and hematocrit fall below one half of normal.
What are the early signs of anemia?
What platelet level would be considered life threatening? What is the associated condition called?
What area of the body must you always inspect if you suspect or are aware of a hematological disorder?
nail beds and skin on hands
If rapid onset of anemia occurs after major surgery, which of the following symptom patterns might develop?
a. continuous oozing of blood from the surgical site
b. exertional dyspnea and fatigue with increased heart rate
c. decreased heart rate
d. no obvious symptoms would be seen.
- can check vitals and O2sat to make sure patient isn't "just tired".
- patient may require surgeon to look at again to ensure no leaking internally
- patient may need a transfusion
Chronic GI blood loss sometimes associated with NSAIDs can result in which of the following problems?
a. increased incidence of joint inflammation
b iron deficiency
c. decreased HR and bleeding
d. weight loss, fever, and loss of appetite
- most common problem with chronic blood loss
- not c because HR will increase if losing volume
- not d or a due to taking NSAIDs
Under what circumstances would you consider asking a client about a recent change in altitude or elevation?
RBC count may have changed- answer from class
From book: When you live at an elevation of 3500 ft above sea level (or higher) and the pt. reports unknown origins of symptoms: headache, dizziness, fatigue, changes in sensation in hands and/or feet, tingling (polycythemia)
joint pain, swelling, loss of motion (sickle cell)
Pre-op, clients cannot take aspirin or anti-inflmmatory meds because these:
a. decrease leukocytes
b. increase leukcytes
c. decrease platelets
d. increase platelets
e. none of the above
NSAIDs derease platelet levels
Dr. T said "e" in class, but she is wrong and was also contradicting on of her pp slides
Skin color and nail bed changes may be observed in the client with:
a. thrombocytopenia reulting from chemo
b. pernicious anemia resulting from vit B12 deficiency
c. luekocytosis resulting from AIDS
d. All of the above
In the case of a client with hemoarthrosis associated with hemophilia, what PT intervention would be contraindicated?
- any modalities with heat, includes continuous ultrasound b/c there is a heating component
- mobilizations- do not want to move tissue where there is a continued slow bleed
* at greater risk for contractures, if not balancing bleeding component and trying to not stress those tissues well.
Bleeding under the skin, nosebleeds, bleeding gums, and black stools require medical evaluation as these may be indications of:
d. sickle cell anemia
due to low blood count, easy bleeding with thrombocytopenia
Describe two tests used to distinguish an iliopsoas bleed from a joint bleed
- Pain with trunk flexion indicates more iliopsoas
- Pain with hip rotation implicates joint issue
What is the significance of nadir?
When blood counts, particularly WBC and platelets are at their lowest point, typically with chemotherapy
When exercising a client with known anemia, what two measures can be used as guidelines for frequency, intensity, and duration of the program? (8)