Hematological Flashcards
(68 cards)
1
Q
Bleeding Time
A
1-9 mins
2
Q
Bicarbonate
A
22-26
3
Q
Partial Pressure Oxygen
A
80-100
4
Q
Oxygen Sat
A
95-100&
5
Q
aPTT
A
30-40 (1.5-2.5x higher w/ heparin)
6
Q
Sodium
A
135-145
7
Q
BUN
A
10-20
8
Q
Cholesterol
A
<200
9
Q
pH
A
7.35-7.45
10
Q
Glucose
A
70-110
11
Q
K+
A
3.5-5
12
Q
Creatinine
A
0.5-1.2
13
Q
HGB A1C
A
<6%
14
Q
Partial Pressure Carbon Dioxide
A
35-45
15
Q
Platelet
A
150-400
16
Q
Hemoglobin
A
12-18
17
Q
PT
A
11-12.5 (1.5-2.5x higher w/ coumadin)
18
Q
PTT
A
25-35 (1.5-2.5x higher w/ heparin)
19
Q
WBC
A
5-10
20
Q
Hematocrit
A
37-52
21
Q
INR
A
0.9-1.2 (2-3 on coumadin)
22
Q
Allergic Blood Transaction S/S
A
facial flushing. hives. rash. wheezing. decreased BP
23
Q
Febrile Blood Transaction S/S
A
headache. tachycardia. tachypnea. fever. chills.
24
Q
Hemolytic Blood Transaction S/S
A
decreased BP. Increased RR. apprehension. low back pain. fever. tachycardia. chills. chest pain. hemogloulinuria.
25
Blood Transfusion Rules
only compatible with NS. need Y tubing. 2 RN verification. LPN can NOT give. type and cross 1st. know ABO complatibility and rh factor. verify informed consent, allergies, and past reaction to blood. premedicate 30 mins prior with benadryl. IV access needs to be 18 or larger (no smaller than 20g). VS: q 15x1 then q 1hr until done (stay with patient). must be hung within 30 mins or will have to return to blood bank. must be completed w/in 4 hours. if the blood has to be delivered slowly (longer than 4 hrs) due to fluid overload make sure blood bank is aware so blood is not wasted and they can give multiple bags. keep red hazard bag in room. use blood warmer if pt is hypothermic or if the blood needs to be administered extremely quickly (emergencies)
26
Iron Deficiency Anemia Patho
decreased iron, decreased RBC to hemoglobin, decreased O2 perfusion to body
27
Iron Deficiency Anemia Causes
pregnancy. poor diet. vegetarian and vegan. gastric bypass. gastric surgery. celiac disease. blood loss: GI bleeds, heavy periods, hemorrhage.
28
Iron Deficiency Anemia S/S
lethargic. easily overexerted. SOA. pica (weird cravings). pallor. glossitis. increased HR. reduced hgb. hypochromic (pale) and microcytic (small) RBC. koilonychias (spoon nails). neuro changes.
29
Iron Deficiency Anemia Care
pain management. IVF. check for bleeding. give iron. give O2. possible blood transfusion.
30
Iron Administration
give oral iron through straw (perform oral care), on empty stomach with full glass of water or vitamin c (OJ). do NOT give with antacids, milk, or calcium. will have dark black stools and can cause constipation. iron injections given using Z track method.
31
Folic Acid Deficiency Patho
anemia caused by decrease of folate
32
Folic Acid Deficiency Causes
decreased diet of fruits, veggies, and fortified cereals. overcooked foods. GI diseases. medications.
33
Folic Acid Deficiency S/S
fatigue. gray hair. mouth sores. tongue swelling. growth defects. pale. SOA. irritable.
34
Folic Acid Deficiency Care
educate about diet of green leafy veggies, liver, yeast, citrus, dried beans, and nuts. folic acid turns pee dark yellow. decrease folic acid in pregnancy can lead to tubal defects.
35
Folic Acid Deficiency Treatment
fluids. pain management replace folate. prenatals with folic acid.
36
B12 Deficiency (pernicious anemia) Patho
autoimmune condition where body does NOT produce intrinsic factor to help absorb vit b12
37
B12 Deficiency (pernicious anemia) Causes
genetics. elderly. Addison's. DM. thyroid issues.
38
B12 Deficiency (pernicious anemia) S/S:
parasthesia. clumsy. depression. muscle weakness. HR. red beefy tongue. upset stomach. jaundice. pallor. confused. unsteady gait. SOA.
39
B12 Deficiency (pernicious anemia) Care
Schilling Test (determines pernicious anemia vs. malnutrition). B12 injections for life. blood transfusion. educate about safety. eat foods high in iron, vitamin c, and folic acid. oral hygiene d/t red beefy tongue.
40
Sickle Cell Anemia Patho
abnormal stiff and sticky C shaped RBC
41
Sickle Cell Anemia Cause
genetics
42
Sickle Cell Anemia Tests
Sickledex (dithionite). hemoglobin electrophoresis.
43
Sickle Cell Anemia Crisis Triggers
blood loss (trauma/surgery). illness. climbing/flying high altitudes. stress. low fluid intake. dehydration. elevated temp (fever or exercising)
44
Sickle Cell Anemia Crisis S/S
WONT HAVE UNTIL CRISIS OCCURS! vaso-occlusive: RBC stick together and decrease O2 perfusion. hyperhemolytic (increase RBC death leading to increased bilirubin). jaundice. aplastic (no RBC production). spleen not working (swelling, congested, infected). gallstones. increased risk for stroke. vision changes
45
Sickle Cell Anemia Care
IVF. O2. pain meds. bed rest. check respiratory. elevate extremities and use warm compresses when dactylitis (swelling of hands/feet) occurs. no restrictive clothing. folic acid. blood transfusion. prevent infection/PNA. neuro checks. eye checks.
46
Sickle Cell Anemia Crisis Prevention
vaccines. no high altitudes. hand hygiene. no sick people. hydrate. decrease stress. no smoking. do not over exercise.
47
Sickle Cell Anemia Medication
Hydroxyurea (creasted fetal hbg to decrease sickling; decrease WBC and leads to higher risk of infection). Stem cell transplant
48
Universal Doner
O-
49
Universal Reciever
AB
50
ITP Patho
autoimmune. bleeding disorder (low platelet and increased bruising)
51
ITP Labs
decreased platelet. NORMAL CBC AND COAGS!
52
ITP Care
corticosteroids and immunosuppressants. spleenectomy if pt does not respond to meds
53
TTP Patho
lacking an enzyme in blood. clotting disorder in small blood vessels that leads to decreased platelets
54
TTP Labs
decreased platelet. normal OR slightly increased CBC and coags
55
TTP Care
glucocorticoids. vincristine. rituximab. cyclosporine A. plasmapheresis.
56
HIT Patho
immunity mediated clotting disorder. abnormal antibodies that activate platelets to cause thrombosis
57
HIT Risk
on heparin for longer than 1 wk
58
HIT Labs
decreased platelet
59
HIT Care
anticoagulants with direct thrombin inhibitors (argatroban, lepirudin, bivalirudin)
60
DIC Patho
secondary to other complications. bleeding and clotting at the same time
61
DIC Risk
septicemia. cardiac arrest. pulmonary arrest. trauma. OB complications. cancer
62
DIC Labs
decreased platelets. decreased hgb. decreased fibrinogen. increase coags. increase d-dimer.
63
DIC Care
heparin. assess and correct underlying cause. prevent organ damage by replacing clotting factor. check for microemboli.
64
Expected S/S for Bleeding Disorders
bleeding gums. epistaxis. ozzing/trickling from incision/lacterations. petechiae. ecchymoses. hematuria. excessive bleeding from venipuncture/injection sight. tachycardia. hypotension. sweating. organ failure secondary to microemboli. respiratory distress. redness/pain/warmth/swelling in lower extremities (HIT)
65
General Care for Bleeding Disorders
assess regularly. check for s/s organ failure or intracranial bleed (decreased LOC and oliguria). check labs for clotting factor. give fluids. give blood and blood products. avoid NSAIDs. give O2. avoid valsalva. start bleeding precautions.
66
Heparin Antidote
protamine sulfate
67
Coumadin Antidote
vitamin K
68
Transfusion Reaction Steps
stop transaction. discontinue and remove tubing. replace with new tubing and flush NS. notify MD and blood bank. stay with patient.
