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Med surge 2 Final > Hematological > Flashcards

Hematological Flashcards

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1
Q

What is iron deficiency anemia and how does it affect the body?

A

Anemia caused by low iron. Iron is needed to make hemoglobin, which allows red blood cells to carry oxygen. Without enough iron, red blood cells can’t function properly, leading to poor oxygen delivery to tissues.

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2
Q

Hallmark physical signs of IDA?

A

Koilonychia (spoon nails) and painful, swollen red tongue

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3
Q

Other symtoms of IDA d/t low oxygen

A

Fatigue, pallor

Tachycardia, tachypnea, dyspnea

Hypoxia

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4
Q

Why is hemoglobin and hematocrit low in IDA?

A

Less iron → less hemoglobin → fewer/smaller RBCs.

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5
Q

How can IDA lead to heart failure?

A

The heart works harder due to low oxygen, causing strain.

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6
Q

How can IDA cause kidney issues?

A

Poor perfusion → pre-renal AKI.

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7
Q

Cognitive/Psychomotor impairment complication in IDA

A

AMS, unsteady gait, cognitive/motor impairment.

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8
Q

Impaired thermoregulation in IDA

A

Cold extremities due to poor oxygen delivery.

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9
Q

Best dietary sources of iron?

A

Fish, meat, poultry.

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10
Q

Other food sources of iron?

A

Leafy greens, nuts, fruit, whole grains.

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11
Q

What helps iron absorption?

A

Vitamin C.

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12
Q

What decreases iron absorption?

A

Calcium.

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13
Q

Common side effects of iron supplements?

A

Constipation, cramping, black tarry stools

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14
Q

What does iron do to teeth

A

Stains them

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15
Q

What diagnostic testing would you do for IDA

A

CBC & Serum Iron Test

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16
Q

What is the normal range for hemoglobin (Hgb)?

A

12-15

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17
Q

What happens to hemoglobin in IDA?

A

Hemoglobin is low due to reduced iron for Hgb production.

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18
Q

What is the normal range for hematocrit (Hct)?

A

36–48%.

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19
Q

What happens to hematocrit in IDA?

A

Hematocrit is low because RBCs are fewer and smaller.

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20
Q

What does a serum iron test measure?

A

The amount of circulating iron in the blood.

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21
Q

What is included in a serum iron test

A

Transferin, Ferritin, TIBC

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22
Q

What is the role of transferrin? What levels will it have in IDA

A

Transferrin transports iron to tissues like the liver, spleen, and bone marrow.

Increased (the body tries to carry more iron, even though there’s less of it).

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23
Q

What is ferritin?

A

A protein that stores iron in the body.

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24
Q

What happens to ferritin in IDA?

A

Decreased—it reflects low iron storage.

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25
What is TIBC (Total Iron Binding Capacity)?
A measure of how well transferrin can bind and carry iron.
26
27
What happens to TIBC in IDA?
Increased—more capacity to bind iron because there’s not enough iron bound.
28
What causes pernicious anemia?
Lack of vitamin B12 due to absence of intrinsic factor needed for absorption
29
What is intrinsic factor?
A protein in the stomach that helps absorb vitamin B12 in the GI tract.
30
What test helps confirm pernicious anemia?
Positive intrinsic factor antibodies
31
What makes B12 anemia different from other types of anemia?
It causes neurological and psychiatric symptoms.
32
What is the hallmark symptom of B12 deficiency?
Peripheral neuropathy — numbness, tingling, burning in hands and feet.
33
Why are B12 patients a fall risk?
Neuropathy affects balance and sensation.
34
How is B12 deficiency linked to mental health?
It can cause altered mental status and is linked to depression.
35
What oral symptom may appear in B12 deficiency?
A smooth, sore red tongue.
36
What low perfusion symptoms occur in B12 anemia?
Tachycardia, tachypnea, shortness of breath, and fatigue.
37
How is pernicious anemia treated?
Monthly vitamin B12 injections (lifelong).
38
What dietary changes should someone with vitamin B12 anemia make?
Eat more animal-based proteins like eggs, meat, seafood, and dairy to boost B12 levels.
39
What is sickle cell anemia?
An inherited disease where RBCs die early and become sickle-shaped, blocking blood flow and causing pain.
40
What causes the RBCs to turn into sickle cell ?
Hemoglobin S is sensitive to low oxygen, causing RBCs to turn into a sickle shape
41
How is sickle cell anemia inherited?
Both parents must carry the sickle cell trait to pass it on to their child.
42
What is the most common type of sickle cell crisis?
Acute vaso-occlusive crisis – sickled RBCs block blood vessels, causing hypoxia and pain.
43
What happens during an aplastic crisis in sickle cell anemia?
The bone marrow temporarily stops making RBCs, leading to severe anemia
44
What is sequestration crisis in sickle cell anemia?
Massive pooling of RBCs in the spleen, causing hypovolemic shock and cardiovascular collapse.
45
Why might a patient with sickle cell need a splenectomy?
: An enlarged spleen may bleed or trap blood; removal may be needed if it's life-threatening.
46
What is a major risk after splenectomy in sickle cell patients?
Increased infection risk – they must stay up to date on vaccinations.
47
What happens during a hemolytic crisis in sickle cell anemia?
Rapid breakdown of RBCs, leading to high levels of jaundice.
48
What are general anemia symptoms seen in sickle cell anemia?
Fatigue, tachycardia, and shortness of breath (SOB).
49
What complications can occur with sickle cell?
Organ failure/ bone pain, stroke (CVA) acute chest syndrome pregnancy problems/developmental delays.
50
Why is oxygen used in sickle cell crisis? Is it a priority ?
To relieve hypoxia, which helps prevent sickling of RBCs.
51
Why are IV fluids (IVF) important in treatment?
To hydrate, deliver meds, and prevent clumping of sickled cells
52
What is a major concern with pain management in sickle cell patients?
Risk of opioid dependence due to frequent severe pain.
53
Why is folic acid given to patients with sickle cell anemia?
To stimulate bone marrow to make more healthy red blood cells.
54
Why are blood transfusions used in sickle cell anemia?
To replace sickled RBCs with healthy red blood cells.
55
What should patients with sickle cell anemia avoid to prevent a crisis?
Avoid low oxygen situations like overexertion, smoking, and high altitudes.
56
Why is avoiding infection important in sickle cell anemia?
Infections can trigger a crisis and worsen complications due to a weakened immune system
57
What health precautions should sickle cell patients take?
Stay up to date on vaccines and avoid large crowds to reduce infection risk.
58
What is sickle cell anemia?
An inherited disorder where RBCs become sickle-shaped and die early, blocking blood flow and causing pain.
59
What is aplastic anemia?
A condition where bone marrow is damaged (Myelosuppresion) reducing the production of RBCs, WBCs, and platelets, often due to cytokine suppression
60
Is aplastic anemia a primary or secondary condition?
It is usually secondary to a pre-existing condition or exposure(e.g., drugs, infections, toxins).
61
What precautions are needed for patients with aplastic anemia?
Bleeding precautions, fall precautions, and neutropenic precautions (to prevent infection).
62
Why is the mortality rate high in aplastic anemia?
Due to severe risk of bleeding and infection from low blood cell counts
63
What diagnostic tests are used for aplastic anemia?
CBC, coagulation studies, iron levels, and bone marrow biopsy.
64
What is the first line of treatment for aplastic anemia ?
Blood transfusion
65
What types of blood prodcuts are used to treat aplastic anemia?
Epogen/Erythropoietin: Stimulates RBC production Neupogen: Stimulates WBC production
66
What other treatment is common for aplastic anemia?
Blood transfusions and blood product support to manage anemia and prevent complications.
67
What are the two main types of leukemia progression?
Chronic: Slow onset, can progress to acute Acute: Sudden, fast onset, more deadly
68
AML (Acute Myeloid Leukemia)
20% blast cells Fatigue, bleeding, hepatomegaly
69
ALL (Acute Lymphocytic Leukemia)
Affects children ages 4–12 Mostly involves B and T cells
70
CLL (Chronic Lymphocytic Leukemia)
Average age: 72 10% progress to Richter’s lymphoma Anemia, thrombocytopenia, swollen lymph nodes
71
CML (Chronic Myeloid Leukemia)
Average age: 55–60 Often asymptomatic at first Femur pain, dyspnea, splenomegaly, hepatomegaly
72
How long is a blood transfusion unit good for once started?
4 hours
73
How long is blood tubing good for?
2 units
74
What size IV is required for a transfusion?
18-20 gauge
75
Who must verify a blood transfusion before starting it?
2 Registered Nurses (RNs)
76
What must be obtained before a blood transfusion?
Informed consent
77
How long is a type and screen valid for before transfusion?
72 hours
78
How often are vital signs monitored during a transfusion?
Every 15 minutes for the first hour Once after the transfusion ends
79
Febrile non-hemolytic reaction — signs & cause?
Caused by the body reacting to white blood cells in donor blood
80
T/F patient can have allergic reaction to blood
True
81
Acute hemolytic reaction — what happens?
The body sees the blood as foreign and breaks it down fast
82
What is the most dangerous type of reaction
Acute hemolytic reaction
83
Circulatory overload — signs & treatment?
SOB, crackles, HTN, distended neck veins Give Lasix, and slow the infusion
84
Delayed hemolytic reaction — when does it occur?
Happens up to 14 days later Caused by a gradual immune response
85
What do you do if a transfusion reaction occurs?
Stop the transfusion immediately Take vital signs and call the provider Return blood bag and tubing to blood bank Start new IV line with normal saline Document using transfusion reaction form Send labs and urine specimens as ordered
86

Med surge 2 Final (8 decks)

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