Hematology Flashcards

Question

Nursing dx PPV

Answer 1

Ineffective protection Risk for bleeding Risk for ineffective tissue perfusion

Answer 2

PRECANCEROUS STATE — abnormal cell formation in bone marrow — destroyed by body after release; decrease in all blood cell types — Pancytopenia — 30% develop leukemia Risk factors: — >65 age — exposure to chemicals — tobacco smoke — chemo/radiation

Answer 3

— cytogenetic testing -> looks at chromosomes that are identified as abnormal — peripheral blood smears -> cell abnormalities Medical tx: — supportive care — blood/platelet transfusion — epogen injections

Answer 4

— local bleeding-petichiae — easier to control — Idiopathic thrombocytopenic purpura -> immune system destroys platelets — Thrombotic thrombocytopenic purpura -> platelets clump together and forms clots

Answer 5

— occurs deeper in the body — bleeding in joint spaces; SQ — deeps bleeds difficult to control and often restarts — hemophilia — heparin-induced thrombocytopenia

Answer 6

Decreased production — cancers and tx — aplastic anemia — toxins; meds, alcohol Increased destruction — autoimmune — infections, meds, spleen disorder, cancers Increased consumption — disseminating intravascular coagulation - body is running out of platelets

Answer 7

150,000-400,000

Answer 8

TOO FEW PLATELETS — 40,000-80,000 platelets — risk for bleeding with mild trauma <20,000 risk for spontaneous bleed <5,000 risk for fatal bleed in CNS or GI hemorrhage Idiopathic thrombocytopenic purpura

Answer 9

TOO MUCH PLATELET — platelets >60,000 — risk for clotting Thrombotic thrombocytopenic purpura

Answer 10

Autoimmune disorder — patients makes antibodies against own platelets — macrophages destroy Viral infections thought to trigger condition Most common in women 20-40 Dx: serial law platelets and bone marrow biopsy — shows bone marrow is putting out normal rate — body is chewing it up (platelets) Tx: — immunosuppressive drugs (prednisone) — platelet transfusion — splenectomy -> last resort

Answer 11

Autoimmune disease — platelets clump together abnormally in capillaries and too few available in circulation — clotting occurs but also fails to clot when trauma occurs — tissue becomes ischemic -> kidney failure, MI, CVA — FATAL IN 3 MO. IF NOT TREATED Tx: — plasmaphoresis — fresh frozen plasma to provide platelet aggregation inhibitors — platelet inhibitor drugs

Answer 12

Genetic disorder — chance of giving disorder to offspring — women carrier Types: A = factor 8 (VIII) — 80% B = factor 9 (IX) — 20% Symptoms: — abnormal bleeding to any trauma, specifically joints — bleeding longer than normal — problem forming stable fibrin clot -> allows for extensive bleeding

Answer 13

11-12.5 Warfarin therapy Liver failure

Answer 14

60-70 seconds Heparin therapy

Answer 15

Complications most common -> joint problems from repeated episodes of bleeding Dx -> prolonged PTT Tx -> replace missing factor with infusion of synthetic factors

Answer 16

Minimize trauma and other causes of bleeding — thrombocytopenia precautions — risk assessment -> protect pt from injury Assess s/s bleeding Prepare to admin platelet infusion for counts below 10,000 — replace missing clotting factors with transfusion of synthetic factors — educate patient and family -> risk for bleeding

Answer 17

— leukemia — lymphoma — multiple myeloma

Answer 18

Uncontrolled NORMAL cell production — cancer occurs in stem cells of bone marrow -> overcrowded with nonfunctional cells Overproduction of blasts cells -> immature WBC Exact cause unknown — genetic and environmental factors involved — 50% of pt have abnormal chromosomes Normal cell production decreased results in: — Pancytopenia — neutropenia — anemia — thrombocytopenia — infiltration of tissue/organs

Answer 19

Sudden onset of abono al blood cells

Answer 20

Abnormal cells replicate slowly

Answer 21

By cell type — lymphoid cells: lymphocytic — myeloid cells: myelogenous

Answer 22

Acute lymphocytic leukemia — most common type in young children Acute myelogenous leukemia — most common type in adults Chronic lymphocytic leukemia — most common chronic adult leukemia Chronic myelogenous leukemia — asymptomatic for years enforce entering fast growth phase

Answer 23

— prior exposure to chemo or ionizing radiation — bone marrow hypoplasia (slow growth) — genetic -> Down syndrome — immune deficiency — virus

Answer 24

Bone marrow biopsy

Answer 25

Abnormal WBC — high blast cells -> poor prognosis — low hgb + hct — low platelet Chromosome analysis X-ray, CAT scan, MRI

Answer 26

Systemic: — weight loss — fever — frequent infections Psychological: — fatigue — loss of appetite — SOB — weakness (lack of oxygen) — pain/tenderness in bones/joints — lymph node swelling — spleen/liver enlargement Skin: — night sweats — easy bleeding and bruising — purplish patches or spots

Answer 27

— provide info to pt about blood cells and production Nursing: — prone or side lying position — sedatives — needle and incision will be made Follow-up care: — control bleeding — inspection of site q2 hr — pain control

Answer 28

Induction therapy — started as soon as dx confirmed — hospitalized 2-3 wk in protective isolation S/S: — severe bone marrow suppression — alopecia — n/v — stomatitis — organ toxicity Consolidation therapy: once recovered — repeat drugs or bone marrow transplant Maintenance: — months and years to maintain remission

Answer 29

Hodgkin’s lymphoma — teens and adults in 50s-60s Nonhodgkin’s lymphoma — all other lymphomas — over 60 types — older adult men

Answer 30

Starts in single lymph node in neck, underarm, or chest — proceeds in orderly fashion to next — fatigue, anorexia, SOB — sweats, fever, itching, weight loss — pain in node areas after alcohol intake

Answer 31

Risk factors: — viral infections — chemical exposure Tx: — external radiation and chemo — CURABLE

Answer 32

CHRONIC/NOT CURABLE — lymphadenopathy in multiple sites — spreads to other organs by the time of dx Risk factors: — autoimmune — immunosuppressive disorders -> HIV — chemicals Tx: — chemo/monoclonal antibodies — radiation — not curable

Answer 33

Overgrowth of plasma cells — plasma cells overproduce gamma globulin (gammopathy) — excess antibodies in blood CLOG BLOOD VESSELS of KIDNEY and other organs -> infects the organs Produces excess cytokines — increase cancer growth rate and destroy bone Dx testing: — serum electrophoresis test detects monoclonal immunoglobulin (high levels of calcium) — bone marrow -> greater than 10% infiltrated plasma cells — X-ray -> osteolytic bone lesions

Answer 34

— fatigue — anemia — easy bruising — bone pain — infections

Answer 35

— bone factures — kidney dysfunction — HTN — RARE: hypercalcemia, hyper viscosity syndrome Leads to progressive bone destruction, bleeding, kidney failure, immunosuppression and death

Answer 36

Tx: — chemo agents — bone marrow transplant — INCURABLE Nursing: — care of immunocompromised patient — pain control

Answer 37

INFECTION PROTECTION — prophylactic drugs -> antiviral, antibiotic, anti fungal — neutropenic precautions — monitor labs daily — monitor for early manifestations of infection — hygiene/skin care THROMBOCYTOPENIC PRECAUTIONS (bleeding precautions) — energy conservation — teach self care -> avoid large crowds — psychosocial support

Answer 38

Infection protection — avoid crows, children, ill people — wear mask — hand hygiene — good personal hygiene, mouth care — avoid constipation — shave with electric razor — do not handle feces — NO FRESH FLOWERS OR GARDENING — no invasive procedures — no sexual relations — no fresh fruits/veggies, raw meat, eggs, cheese — assess temperature

Answer 39

Bleeding precautions — assess for s/s of bleeding -> bruises/nose/gums/urine/stool/severe headache — avoid IM/SQ/IV or invasive procedures — NO ASPIRIN/NSAID — soft toothbrush — no flossing/dental procedures — no razor blades -> electric — stool softeners to prevent straining — hold pressure for 5 min on venipuncture sites — teach s/s of bleeding — avoid situations where falls may occur

Hematology Flashcards

(64 cards)