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NURSING 3 > Hematology Disorders > Flashcards

Hematology Disorders Flashcards

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1
Q

Slide 1 - types of anemia

A

Go look

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2
Q

Slide 1 - types of WBC

A

go look

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3
Q

How much of the blood does plasma make up compared to cellular component?

A

Plasma - 55%

Cellular component - 45%

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4
Q

What does plasma consist of?

A 
Albumin
Globulin
Fibrinogen
Clotting factors
Electrolyes
Waste Products
Nutrients
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5
Q

what does the cellular component of the blood consist of?

A

Erythrocytes (RBCs)
Leukocytes (WBCs)
Thrombocytes (Platlets)

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6
Q

Hematopoiesis

A

the production of blood cells and platelets, which occurs in the bone marrow.

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7
Q

How long do RBC, WBC and platelets live?

A

RBC - 120
WBC - days to years
Platelets - 7 - 10 days

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8
Q

Hemostasis

A

Balance between clotting and clot dissolution ?

the stopping of a flow of blood.

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9
Q

How much volume of blood do we normally have?

A

1.2-1.5 gallons

5 L

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10
Q

Describe the erythrocyte membrane

A

It is thin for permeability of o2 and co2

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11
Q

What do you call a mature erythrocyte with iron called

A

hemoglobin

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12
Q

What are reticulocytes?

A

immature erythrocytes

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13
Q

Erythropoiesis

A

myeloid stem cells in the bone marrow - These cells are responsible for the continual replenishment of all blood cell types in the body

the production of red blood cells.

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14
Q

Erythropoietin

A

hormone produced by kidney - stimulates red blood cell production

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15
Q

Iron - women

A

Iron is lost when females menstruate

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16
Q

Where is the majority of iron carried?

A

hemoglobin

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17
Q

What happens when there are low levels of iron in the blood?

A

hemoglobin synthesis is depressed; erythrocytes produced are small and low in hemoglobin = microcytic anemia

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18
Q

What are examples of granulocytes?

A

Eosinophils
Basophils
Neutrophils

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19
Q

What are examples of agranulocytes?

A

monocytes

lymphocytes

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20
Q

Eosinophils

A

Parasitic and allergic diseases

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21
Q

Basophils - things to remember

A

Contain heparin and histamine

Released in response to allergens

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22
Q

Neutrophils - things to remember

A

Comes from myeloid stem cell

Most abundant in body

Circulates for 6 hours then migrates into body tissues – phagocytosis (alive for 1-2 days)

Arrive within 1 hour of onset of inflammatory reaction and initiate phagocytosis

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23
Q

Things to remember about monocytes

A

Once in tissues – macrophages
Fungi and Viruses
Active in the spleen, liver, peritoneum and alveoli
— Removing debris

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24
Q

Things to remember about lymphocytes

Study These Flashcards
A

produced - lymphoid stem cells or thymus

produce antibodies and identifying other cells and organisms as foreign

25
What is platelet formation regulated by
the hormone thrombopoietin
26
Platelet - role
controls bleeding; adheres to site of injury --> platelet plug
27
Plasma: clots
remaining is serum (?)
28
Plasma protein - exampels
albumin and globulins
29
Albumin
Maintenance of fluid balance with the vascular system - produced in liver - capacity to bind substance (calcium, bilirubin, hormones)
30
Spleen - role
``` Recycling iron Pooling of platelets Blood volume regulation Filter for bacteria Can restart hematopoisis - if needed ```
31
Go look at slide 11
go
32
Gerontological considerations - hematology
Bone marrow's response is decreased Most susceptible to myelosuppressive effects of medications Anemia risk
33
What might cause anemia in the elderly?
``` Iron deficiency Calorie malnutrition Inflammation Chronic disease Cardiac and pulmonary patients cannot tolerate low blood volume ```
34
Hematocrit is what?
percent of blood consisting of erythrocytes
35
Peripheral smear - hematology dx
shape, size of leukocytes, erythrocytes, and platelets
36
False elevated hematocrit can be correlated to what
fluid volume deficit patients
37
Low hemoglobin/hematocrit - why might someone be asymptomatic
your body has compensatory mechanisms
38
What are s/s of low hemoglobin/hematocrit
fatigue, poor activity tolerance, headaches, dizziness, irritability, difficulty sleeping or concentrating, progressive fatigue, poor activity tolerance, headaches, dizziness, irritability, difficulty sleeping or concentrating, tinnitus, anorexia, dyspnea, palpitations, chest pain, indigestion, abnormal menstruation in females, impotence in males, and loss of libido Pallor – mucous membranes, nail beds, conjunctiva, palms Tachypnea and tachycardia with activity
39
Patients with severe neutropenia are at a significantly increased risk for developing what?
opportunistic infections and sepsis
40
Low while blood cell count - Skin
Check for tenderness, erythema, edema, breaks in skin integrity, moisture, drainage, lesions (especially under breasts, axillae, groin, skin folds, bony prominences, perineum, and perirectum); check all puncture sites (e.g., IV sites) and central venous access device sites for erythema, tenderness, induration, and drainage.
41
Low WBC count - oral mucosa
Check for moisture, lesions, color (check palate, tongue, buccal mucosa, gums, lips, oropharynx); assess level of pain and taste changes, which may precede objective signs of mucosal damage by 3 to 5 days.
42
Low WBC count - respiratory
Check the presence of cough, sore throat, tachypnea, pain on inspiration; auscultate breath sounds. Note color, amount, and consistency of sputum.
43
Low WBC count - gastrointestinal
Check for abdominal discomfort and distention by palpating the abdomen, assess for nausea, change in bowel pattern; auscultate bowel sounds
44
Low WBC count - genitourinary
Check for dysuria, urgency, frequency; check urine for color, clarity, and odor
45
Low WBC count - Neurologic
Ask about headache, neck stiffness, visual disturbances; assess level of consciousness, orientation, and behavior
46
Low WBC count - temp
Check for elevation (greater than 38°C [greater than 100.4°F]).
47
Absolute neutrophil count (ANC) - 1,500 to 1,000
indicates mild neutropenia
48
Absolute neutrophil count (ANC) - 999 - 500
indicates moderate neutropenia
49
Absolute neutrophil count (ANC) - less than 500
indicates severe neutropenia
50
People with a low Absolute neutrophil count (ANC), what should they do to stay safe?
avoid large crowds | avoid sick people
51
Bone marrow aspiration and biopsy: why?
Used to diagnose malignancies, benign hematologic disorders, infections and storage disorders, response to treatment
52
Bone marrow aspiration and biopsy: risk
infection and pain
53
Bone marrow aspiration and biopsy: position
prone or lateral
54
Bone marrow aspiration and biopsy: how can a nurse help during the procedure
encourage them to take deep breaths and use relaxation techniques to help with discomfort
55
Bone marrow aspiration and biopsy: post-procedure care
Patients should be instructed not to submerge in a bath for 24 hours, until the site heals. A mild analgesic (e.g., acetaminophen) may be useful. Aspirin-containing analgesics should be avoided because of the increased risk of bleeding
56
normal PTT
21-35 -- a therapeutic range is 1.5-2 times that range
57
normal INR
``` normal = below 1.6 therapeutic = 2-3 (someone on warfarin) ```
58
What tools are used to determine if someone is at risk for bleeding
through exam CBC / peripheral smeal PT and INR PTT
59
Slide 1/45 tells you about types of anemia
go look

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