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2.0 Adult Nursing Exam 4 > Hematologic part 1 > Flashcards

Hematologic part 1 Flashcards

1
Q

Name the main four components of blood?

A

Plasma
RBCs
WBCs
Platelets

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2
Q

What are the different functions of blood? (5)

A
  1. Transports oxygen and nutrients
  2. Forms clots
  3. Carry cells and antibodies to fight infections
  4. Bring waste products to kidneys and liver
  5. Regulates body temperature
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3
Q

Stem cell categories

A

Myeloid Stem Cells
Lymphoid Stem Cells

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4
Q

What are the different types of Myeloid Stem Cells

A

Erythrocytes (RBC)

Leukocytes (WBC)

Platelets

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5
Q

What are the types of Lymphoid Stem cells

A

T lymphocytes

B lymphatocytes

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6
Q

Where does blood transport oxygen and nutrients to?

A

The lungs and tissues of the body

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7
Q

Why does blood form clots?

A

To prevent excess blood loss

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8
Q

Why are cells and antibodies carried in the blood?

A

Prevents and fights infection

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9
Q

Why is blood taken to the kidneys and liver?

A

Waste is filtered out of the blood and cleaned

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10
Q

How does blood regulate body temp?

A

Perfusion and blood circulation creates warmth

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11
Q

What are RBC’s responsible for?

(Extra: What type of stem cell is this again?)

A

Carrying oxygen to tissues and remove carbon dioxide from tissues

(RBCS are considered to be myeloid stem cells)

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12
Q

What do WBC’s do? And how many of them are there?

A

WBC’s or leukocytes fight infection.

There are 5 different types of WBCs.

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13
Q

Romaneschi asks you a question about Erythrocytes. What do you refer to those as?

A

RBC’s

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14
Q

You know all the information about wbcs. If Romaneschi asks you a question, what else might she refer to them as?

A

Leukocytes

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15
Q

What is the role of our platelets?

A

To stop bleeding from happening.

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16
Q

What may Romaneschi refer to platelets as?

A

Thrombocytes

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17
Q

Platelets/Thrombocytes have a nucleus.

True or False? Explain.

A

False. They do not have a nucleus because they are fragments of cytoplasm belonging to megakaryocytes of bone marrow.

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18
Q

Which Lymphoid stem cells create antibodies? And what part of the body are they created in?

A

B lymphocytes

They create them in the Bone marrow.

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19
Q

Which Lymphoid stem cells control immune response? Where are these made and found?

A

T lymphocytes.

They are made in the bone marrow but can be found maturing in the Thymus.

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20
Q

You get your lab panel back. Which lymphoid stem cell can be used to evaluate immune function?

A

T lymphocytes

  • especially in those with HIV
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21
Q

What are the 5 types of WBCs?

A

Neutrophils

Eosinophils

Basophils

Monocytes

Lymphocytes (that are myeloid)

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22
Q

Which wbcs are responsible for fighting off pathogens?

A

Neutrophils

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23
Q

You go to the doctor after feeling a little off. Your lab shows a high amount of eosinophil wbcs. What does this mean?

A

Allergies or parasite

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24
Q

You went to the doctor and found out you have a parasitic organism. Which wbc should’ve fought them off & therefore be high?

A

Eosinophils will be high

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25
Q

Which wbc fights off bacteria, fungi, and viruses &&& is the largest wbc in the body?

(Where are they produced?)

A

Monocytes

They are formed in the bone marrow.

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26
Q

Which wbc will determine the specificity of the immune response when dealing with infectious organisms?

A

Lymphocytes

27
Q

How big is the lymphocyte population compared to other wbcs?

A

20-40% of wbcs are lymphocytes

28
Q

What do Basophil wbcs release?

A

Heparin, Histamine, and other mediators

29
Q

What is a simple way to describe Leukemia?

A

Neoplastic proliferation or replication of one cell

30
Q

What is a common indicator of Leukemia?

A

Unregulated proliferation or replication of WBC in bone marrow (sort of like popcorn).

31
Q

What happens to the other cells, besides wbcs, when a person has leukemia?

A

Other cells don’t have enough room for cell production

32
Q

How is leukemia classified?

A

They draw labs and try to distinguish if its lymphoid or myeloid. And then they decide if its acute or chronic.

  • these things will determine the type of tx someone gets
33
Q

What determines treatment for leukemia?

A

The classifications of the leukemia

34
Q

What are acute leukemias characterized by?

A

Abrupt onset of a blast phase

35
Q

What are chronic leukemias?

A

Where symptoms evolve over months to years with a majority of mature leukocytes

36
Q

What is common lab trend for leukemia?

A

Elevated wbcs (since there is unregulated proliferation)

37
Q

What is the Blast phase of Leukemia?

A

Acute onset when there are more than 30% of blast cells from samples from invading tissue and organs outside of the bone marrow home.

38
Q

What word would you use to describe the blast phase of leukemia ?

A

Acute phase

Blast crisis

Aggressive leukemia

39
Q

What is Acute Myeloid Leukemia?

A

Type of leukemia that affects myeloid cells such as rbcs, platelets, and monocytes

40
Q

What is Acute Myeloid Leukemia related to?

A

Previous cancer treatment from Hodgkins Lymphoma. So, it is a secondary cancer.

41
Q

Explain the relationship between Hodgkins Lymphoma and AML ?

A

A lot of times those who are “cured” of Hodgkins lymphoma develop Acute Myeloid Leukemia after cancer treatment

42
Q

What will Acute Myeloid Leukemia appear as at first?

What impact does this have?

A

The flu

It means the AML can be ignored.

43
Q

What condition do those with AML end up with?

What symptoms will there be?

A

Pantocytopenia which means all their labs are low across the board.

Fever, infection, weakness, fatigue, bleeding - all ties into the flu.

44
Q

Patient with a history of Hodgkins Lymphoma comes into the doctor complaining of pain in the abdomen, bleeding gums, and bone pain. Why is this concerning?

A

They could have Acute Myeloid Leukemia as evidence by cell growth in organs like the liver and spleen, hyperplasia of gums, and bone expansion.

45
Q

What labs would you expect to be decreased for AML?

A

RBCs, Platelets, and normal leukocytes

46
Q

In AML, what will the blast cell percentage be?

A

Only greater than 20% due to it progressive towards aggressive - but it’s not there yet.

47
Q

With AML, what are the major causes of death?

A

Infection & Bleeding

  • bc pantocytopenia , decrease in the other wbc, rbc, and platelets
48
Q

What skin issues will we present with AML and why?

A

Ecchymosis

Petechiae

Which is due to the pancytopenia.

49
Q

What clue indicates imminent bleeding risk in AML?

What bleeds are we talking about?

A

The platelet count being less than 10,000.

GI, pulmonary, intracranial

50
Q

What is a clue that the AMl patient is at risk for systemic infection?

A

A neutrophil count less than 100.

51
Q

What risk increases if the neutrophil count being decreased is prolonged?

What should we assess for?

What is treatment?

A

Fungal infections

Assess for oral thrush.

  • tx with antifungals like flagels
52
Q

If your patient has AML and is therefore at risk for neutropenia or low neutrophils, how do we typically protect them?

A

Neutropenia precautions

  • no plants
  • no fresh fruits or veggies
  • wash hands
  • private room
    • PPE!!!
53
Q

Goal of treatment for patients with AML?

A

Complete remission

54
Q

What are the steps of chemo used for Acute Myeloid Leukemia?

A
  1. Induction therapy
  2. Consolidation
  3. BMT
    1. Could consider supportive care if they don’t wanna go through all this.
55
Q

What is induction therapy?

What does this lead to in addition?

A

First step of therapy for acute myeloid leukemia which is an aggressive chemo to destroy leukemic & normal cells to try to make sure they get it all.

Makes them definitely be in pancytopenia & they’ll need supportive care.

56
Q

What is consolidation?

When do we start it?

A

Second step for AML where you have lower doses of chemo to get rid of any remaining leukemia cells.

Start it when they recover from induction.

57
Q

What is the usual form of chemo for consolidation?

What type of care will those undergoing consolidation need?

A

Cytarabine

Need supportive care especially for nausea so Zofran.

58
Q

What is BMT?

A

Bone marrow transplant for AML. Replacing bad bone marrow hematopoietic function with donor stem cells that are healthy.

  • so they can build up a good immune system without all the issues
59
Q

What is complication of AML treatment?

A

Tumor lysis syndrome

60
Q

What is tumor lysis syndrome?

A

Intracellular electrolytes and fluids entering the systemic circulation.

61
Q

What does an increased uric acid and phosphorus due to tumor lysis syndrome cause?

A

Gout

Renal stone & Colic

Acute Renal Failure

62
Q

What does an increase in potassium but decrease in calcium due to the tumor lysis syndrome cause?

A

Dysrhythmias

Hypotension

Neuromuscular effects

Confusion

Seizures

63
Q

What can we use to treat complications of tumor lysis syndrome?

A

Allopurinol for gout

High fluid intake

Kayexalate to bind potassium so it leaves the body

Hemodialysis to remove toxins

2.0 Adult Nursing Exam 4 (8 decks)

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