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NCLEX > Hematology > Flashcards

Hematology Flashcards

(51 cards)

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1
Q

erythrocytes

A

carry oxygen, concave disk, bendy and can fit through tight spaces in arteries, capillaries and veins

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2
Q

Rhesus (Rh) Factor

A

inherited protein attached to the surface of red blood cells, either positive or negative

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3
Q

Universal blood donor

A

O-

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4
Q

Rh positive can receive

A

positive or negative blood

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5
Q

Rh negative can only receive

A

negative blood

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6
Q

When giving blood can always give

A

only what they already OR less protein markers than what they have, blood won’t have anything for the body to respond

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7
Q

thrombocytes

A

clump together to achieve hemostasis; platelet plug and agglutination

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8
Q

Intrinsic coagulation

A

triggered by changes in the blood

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9
Q

extrinsic coagulation

A

triggered by something occurring outside the blood vessels (such as trauma)

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10
Q

Erythropoietin

A

produced by kidneys and stimulates production of erythrocytes

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11
Q

thrombopoietin

A

produced by spleen; controls thrombocyte production, 20% of thrombocytes are stored in the spleen, spleen breaks down old erythrocytes

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12
Q

clot is formed by

A

thrombin -> fibrinogen -> fibrin -> clot

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13
Q

clotting factors are produce in the

A

liver

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14
Q

anticoagulants

A

heparin, anti platelets, warfarin, factor Xa inhibitors

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15
Q

Heparin

A

anticoagulant; enhances antithrombim III which inhibits thrombin and prevents clots from forming; Intrinsic pathway

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16
Q

Heparin nursing considerations

A

monitor for bleeding- hematuria, hematemesis, bruising, monitor aPTT

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17
Q

heparin antidote

A

protamine sulfate

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18
Q

For a pt on heparin we want the aPTT to be

A

1.5-2x the normal

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19
Q

Heparin Induced Thrombocytopenia and Thrombosis (HITT)

A

heparin complication, occurs 5-10 days after heparin exposure, unexplained platelet drop and get clots, adverse response

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20
Q

HITT S&S and Tx

A

skin lesions at heparin injection sites, chills, fever dyspnea, chest pain, complications: DVT and PE

discontinue all heparin and start a different anticoagulant

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21
Q

Low molecular weight heparins

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A

“parin”; prevents clots, always given SC, not interchangeable with heparin, dose is based on body size, no labs monitored, only anticoagulants that can be used in pregnancy

22
Q

Warfarin

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A

disrupts liver synthesis of vitamin K dependent clotting factors; monitor for bleeding, PT and INR (therapeutic is 2-3), contraindicated in pregnancy

23
Q

low molecular weight heparins are porcine derived which means

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A

they come from pigs and could have cultural or religious complications

24
Q

warfarin antidote

25
ASA
Decrease platelet aggregation leading to decrease clotting
26
ASA nursing considerations
risk of bleeding , don’t give with anticoagulants, not given to pediatrics
27
Salicylism and S&S
ASA toxicity; nausea, tinnitus, headache, delirium, hyperventilation, pulmonary edema, Overdose; resp depression and acidosis
28
ASA antidote
sodium bicarbonate
29
Fibrinolytics/Thrombolytics
“kinase”, tPA (alteplase); break up existing clots by converting plasminogen to plasminogen
30
door to tPA time for a stroke
60min OR 4.5hrs since last known normal
31
Polycythemia vera
excessive number of erythrocytes, leukocytes, and thrombocytes, blood becomes thick/hyper viscous, thicker blood = more problems with perfusion
32
Polycythemia vera S&S
skin dark purple, cyanotic appearance, distended veins causing itching, htn, thrombosis, hypoxia
33
Polycythemia vera Tx and education
Apheresis: withdrawal of blood and removal of excessive components and reinfuse back to pt, anticoagulated (too many thrombocytes = risk for thrombi, hydration education: clot prevention; hydration, avoid constrictive/tight clothin, compression stockings, elevate feet, no smoking, stop activity at first sign of chest pain
34
anemia
reduction in number of erythrocytes, can occur with many different disease processes, several types and causes
35
iron deficiency anemia causes
inadequate dietary intake, chronic alcholism, malabsorption syndromes, partial gastrectomy, rapid metabolic activity
36
Vitamin B12 deficiency anemia causes
dietary deficiency, failure to absorb vitamin B12 from intestinal tract
37
aplastic anemia
body stops producing enough new blood cells caused by myelotoxic agents; radiation, benzene, chloramphenicol, alkylating agents, antimetabolites, sulfonamides, insecticides
38
anemia S&S
tachycardia, orthostatic hypotension, dyspnea on exertion, decreased SpO2, fatigue, pallor, cool, mottled, delayed cap refill, unable to tolerate cold
39
anemia tx
depends on type of anemia; iron supplements, B12 increase in diet and supplements, aplastic anemia tx depends on cause, blood transfusions
40
sickle cell anemia
causes the red blood cells to sickle and break down, is autosomal recessive, not able to carry oxygen, due to shape can get caught in vessels and cause obstruction
41
Sickle cell crisis
decreased blood flow to tissues leads to hypoxia, ischemia, and infarction, severe joint pain, sequestration (blood pools, often in spleen, splenomegaly and tenderness, acute exacerbation can be caused by hypoxia, high altitude (due to low O2), and fever
42
Sickle cell anemia S&S
pallor, pain, fatigue, arthralgia, chest pain, respiratory distress
43
sickle cell anemia tx
IV fluids (dilute blood so they are not concentrated), blood transfusion (optimize perfusion), O2 (increase oxygen to tissues if hypoxic), pain management, hydroxyurea
44
hydroxyurea
increases production of fetal hemoglobin to reduce crises
45
Disseminated Intravascular Coagulation (DIC)
disorder in which the proteins that control blood clotting become overactive; caused by a precipitating event which leads excessive clotting and excessive bleeding
46
DIC triggers
blood transfusion, cancer, pancreatitis, liver disease, severe tissue injury (burns, head injury), pregnancy complication
47
DIC bleeding S&S
ecchymosis, hematomas, hemoptysis, melena, pallor, hematuria
48
DIC clotting S&S
depends where clot goes Chest: chest pain, SOB, dyspnea Legs: pain, redness, warmth, swelling Brain: headache, speech changes, paralysis, dizziness
49
Lab findings in DIC
decrease in platelet count and fibrinogen; increase in PT/INR, PTT, D-dimer
50
DIC treatment
determine underlying cause and treat, administer clotting factor, administer platelets, bleeding precautions
51

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