Nx 102 Hematological Function Flashcards Preview

NURSING > Nx 102 Hematological Function > Flashcards

Flashcards in Nx 102 Hematological Function Deck (115):
1

hematologic system is composed of...

blood and blood forming sites

2

blood forming sites

bone marrow - primary; red; ribs; pelvis; vertebrae; and sternum
reticuloendothelial system - liver and spleen

3

3 primary types of blood cells

erythrocytes
leukocytes
thrombocytes

4

5 types of luekocytes

neutrophils (granulocyte)
basophils (granulocyte)
eosinophils (granulocyte)
monocytes
lymphocytes (T & B)

5

hematopoiesis

blood cell production

6

hematostasis

maintaining proper blood level esp when faced w/ trauma
-clot (thrombus) formation
- clot dissolution (fibrinolysis)

7

extramedullary hematopoiesis

reticuloendothelial cells of the liver and spleen

8

reticulocyte

immature erythrocyte (RBC); nucleated

9

under conditions of _____ _______, reticulocytes and other immature cells may be prematurely released into circulation

rapid erythopoiesis

10

erythopoietin

hormone produced by kidney; stimulated myeloid stem cells to produce RBCs

11

2 types of blood forming stem cells

myeloid - RBC, WBCs (most), and platelets
lymphoid - T and B lymphocytes

12

dietary requirements for erythopoiesis

iron, B12, and folic acid

13

iron is stores as

ferritin

14

average lifespan for RBC

120 days

15

old/damaged RBCs are removed by...

reticuloendothelial cells in the liver and spleen

16

most hemoglobin is _____, while small amounts are broken down to ____ and secreted in the ______

recycled, bilirubin, bile

17

normal RBC count (MALE)

4.7 - 6.1 mm3

18

normal RBC count (FEMALE)

4.2 - 5.4 mm3

19

normal Hgb (MALES)

14 - 18 g/dL

20

normal Hgb (FEMALE)

12 - 16 g/dL

21

normal Hct (MALE)

42 - 52%

22

normal Hct (FEMALE)

37 - 47%

23

mean corpuscular volume (MCV)

volume or size of the RBC

24

normocytic

normal MCV = normal size

25

microcytic

decreased MCV = small size

26

macrocytic

increased MCV = larger size

27

mean corpuscular hemoglobin concentration (MCHC)

a measure of the CONCENTRATION of hemoglobin in each cell

28

normochromic

normal MCHC = normal color
normal MCH = normal color

29

hypochromic

lower MCHC = less color
lower MCH = less color

30

mean corpuscular hemoglobin (MCH)

the AMOUNT of hemoglobin per RBC

31

risk of bone marrow aspiration and biopsy

bleeding and infection (needs signed consent)

32

common sites for bone marrow aspiration/biopsy

posterior illiac crest (sometimes sternum)

33

anemia is...

lower than normal hemoglobin and fewer circulating erythrocytes

34

anemia is not...

a specific disorder

35

hypoproliferative anema

defective RBC production due to iron, B12, or folate deficiency, decreased erythropoietin production, cancer
- iron deficiency, aplastic, or megaloblastic

36

hemolytic anemia

excessive destruction of RBCs due to altered RBC production, hypersplenism, drug, autoimmune processes, mechanical heart valves
-characterized by increased numbers of reticulocytes & hyperactive bone marrow

37

the more rapid the onset of anemia....

the more sever it is

38

pica

eating extreme "foods"; often a sign of anemia

39

"smooth tongue"

a sign of iron deficiency/anemia

40

"beefy, red tongue"

a sign of megaloplastic anemia

41

cheilosis

sores at the side of the mouth; may be a sign of anemia

42

signs of anemia

fatigue/malaise/weakness
pallor or jaundice
cardiac/resp problems (dyspnea/orthopnea)
tongues changes (beefy/smooth)
nail changes
angular cheilosis
pica

43

In anemia, the O2 carrying capacity of hemoglobin is _____, causing ____ ____ which can give rise to ____, weakness, ____ and sometimes angina

reduced, tissue hypoxia, fatigue, dyspnea

44

mild anemia Hgb levels

10 - 12 g/dL
normal male: 14 -18 g/dL
normal female: 12 - 16 g/dL

45

moderate anemia Hgb levels

6 - 10 g/dL
normal male: 14 -18 g/dL
normal female: 12 - 16 g/dL

46

severe anemia Hgb levels

< 6 g/dL
normal male: 14 - 18 g/dL
normal female: 12 - 16 g/dL

47

hemolytic anemias are often accompanied by ____ caused by increased blood levels of ____.

jaundice, bilirubin

48

reduced platelet function can cause...

aplastic anemia, petechiae, and purpura

49

the most common hematologic condition affecting elderly patients

anemia
40% of hospital admissions, 47% in long-term care

50

anemia in the elderly can result in...

increased fragility, decreased mobility and exercise, increased risk of falling, diminished cognitive function, increased risk for dementia, major depression, decrease muscle mass and bone density

51

the most common type of anemia

iron deficiency (a type of hyperproliferative anemia) - blood loss, inadequate diet, poor absorption

52

pathology of iron deficiency anemia

-microcytic, hypochromic RBCs
-fewer RBCs
-decreased Hgb & Hct
-low serm iron & ferritin levels
-decreased O2 carrying capacity

53

foods high in iron

fish, meats (esp organ), green leafy veggies, enriched breads, cereals & pasta, whole grains, dried fruits (raisins & apricots), egg yolks

54

aplastic anemia

a type of hypoproliferative anemia; rare; insidious; caused by decrease in or damage to marrow stem cells; may be congenital or acquired; most are idiopathic

55

pathology of aplastic anemia

-RBCs normocytic, normochromic
-neutropenia (low neutrophil count)
-throbocytopenia (low platelet count)
-Hgb/Hct low
-RBC count low
-prolonged bleeding time

56

normal platelet count

150000 - 450000/uL

57

normal prothrombin (bleeding) time

11 - 14 seconds

58

signs of iron deficiency anemia

waxy pallor, fatigue, dyspnea, tachycardia, brittle hair and ridged nails, smooth tongue, cheilosis, pica, neurologic manifestations in children

59

signs of aplastic anemia

(often insidious) weakness, fatigue, pallor, dyspnea, signs of infection, purpura, altered level of consciousness, bleeding from the retina

60

megaloblastic anemia

B12 or folic acid deficiency leading to impaired erythopoiesis; characterized by megaloblastic RBCs; brought on by deficiency of B12 or folic acid

61

pathology of folic acid deficiency anemia

-megaloblastic RBCs
-low serum folate levels

62

signs of folic acid deficiency anemia

weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur

63

signs of B12 deficiency (pernicious)

weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur

64

pathology of B12 deficiency anemia (pernicious)

-decreased stomach HCL and intrinsic factor
-fatal if not treated
-lack of B12 inhibits myelin formation

65

Schilling test

the definitive test for B12 (pernicious) anemia, measures exrection of radiolabled B12 (24 hour urine collection)

66

In the majority of hemolytic anemias, the premature destruction occurs in the ____

spleen

67

sickle cell anemia

-a type of hemolytic anemia
-chronic disorder resulting in anemia, pain, and organ failure
-RBCs sickle when hypoxic

68

sickle cell hypoxic threshold

-varies between patients
-illness, cold, stress, infection, dehydration

69

lifespan of a sickle cell

10 - 12 days

70

Hgb level of sickle cell patient

7 - 10 g/dL

71

polycythemia

an abnormal high RBC count with a Hct>50% in females, 55% in males

72

relative polycythemia

-Hct rises due to loss of plasma volume without RBC loss
-dehydration, diuretics, diarrhea

73

absolute polycythemia

Hct rises due to increase in total RBCs and is classified as primary or secondary

74

polycythemia vera

increased levels of all blood cells due to uncontrolled and rapid cell reproduction, maturation, and proliferation or hyperplasia of the myeloid stem cells

75

signs of polycythemia vera

ruddy cyanosis (flushed) nose, prurititis, headache, dizziness, fatigue, blurred vision, increased BP, erythromyalgia, splenogemaly, gout, renal stones, dyspnea

76

the most common hematologic condition affecting elderly patients

anemia
40% of hospital admissions, 47% in long-term care

77

anemia in the elderly can result in...

increased fragility, decreased mobility and exercise, increased risk of falling, diminished cognitive function, increased risk for dementia, major depression, decrease muscle mass and bone density

78

the most common type of anemia

iron deficiency (a type of hyperproliferative anemia) - blood loss, inadequate diet, poor absorption

79

pathology of iron deficiency anemia

-microcytic, hypochromic RBCs
-fewer RBCs
-decreased Hgb & Hct
-low serm iron & ferritin levels
-decreased O2 carrying capacity

80

foods high in iron

fish, meats (esp organ), green leafy veggies, enriched breads, cereals & pasta, whole grains, dried fruits (raisins & apricots), egg yolks

81

aplastic anemia

a type of hypoproliferative anemia; rare; insidious; caused by decrease in or damage to marrow stem cells; may be congenital or acquired; most are idiopathic

82

pathology of aplastic anemia

-RBCs normocytic, normochromic
-neutropenia (low neutrophil count)
-throbocytopenia (low platelet count)
-Hgb/Hct low
-RBC count low
-prolonged bleeding time

83

normal platelet count

150000 - 450000 mm3

84

normal prothrombin (bleeding) time

11 - 14 seconds

85

signs of iron deficiency anemia

waxy pallor, fatigue, dyspnea, tachycardia, brittle hair and ridged nails, smooth tongue, cheilosis, pica, neurologic manifestations in children

86

signs of aplastic anemia

(often insidious) weakness, fatigue, pallor, dyspnea, signs of infection, purpura, altered level of consciousness, bleeding from the retina

87

megaloblastic anemia

B12 or folic acid deficiency leading to impaired erythopoiesis; characterized by megaloblastic RBCs; brought on by deficiency of B12 or folic acid

88

pathology of folic acid deficiency anemia

-megaloblastic RBCs
-low serum folate levels

89

signs of folic acid deficiency anemia

weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur

90

signs of B12 deficiency (pernicious)

weakness, fatigue, smooth tongue, mild diarrhea, very pale, confused, paresthesias in extremities, balance issues, irritablility, poor memory, tachycardia, systolic murmur

91

pathology of B12 deficiency anemia (pernicious)

-decreased stomach HCL and intrinsic factor
-fatal if not treated
-lack of B12 inhibits myelin formation

92

Schilling test

the definitive test for B12 (pernicious) anemia, measures exrection of radiolabled B12 (24 hour urine collection)

93

In the majority of hemolytic anemias, the premature destruction occurs in the ____

spleen

94

sickle cell anemia

-a type of hemolytic anemia
-chronic disorder resulting in anemia, pain, and organ failure
-RBCs sickle when hypoxic

95

sickle cell hypoxic threshold

-varies between patients
-illness, cold, stress, infection, dehydration

96

lifespan of a sickle cell

10 - 12 days

97

Hgb level of sickle cell patient

7 - 10 g/dL

98

polycythemia

an abnormal high RBC count with a Hct>50% in females, 55% in males

99

relative polycythemia

-Hct rises due to loss of plasma volume without RBC loss
-dehydration, diuretics, diarrhea

100

absolute polycythemia

Hct rises due to increase in total RBCs and is classified as primary or secondary

101

polycythemia vera

increased levels of all blood cells due to uncontrolled and rapid cell reproduction, maturation, and proliferation or hyperplasia of the myeloid stem cells

102

signs of polycythemia vera

ruddy cyanosis (flushed) nose, prurititis, headache, dizziness, fatigue, blurred vision, increased BP, erythromyalgia, splenogemaly, gout, renal stones, dyspnea

103

secondary polycythemia

-excessive RBCs due to excessive erythopoietin due to hypoxia, renal tumors, heavy smoking, disease, or any condition that causes prolonged hypoxia

104

thrombocytopenia

-bleeding disorder; platelet levels <100000/uL
-caused by platelet destruction or consumption

105

pathology of throbocytopenia

-platelets <100000/uL
-prolonged bleeding time
-megakaryocytes in bone marrow
-clumping on blood smear

106

idiopathic thrombocytopenic purpura

-platelet deficiency
-immune system destroys platelets
-acute (children) or chronic (adults)

107

normal lifespan of platelets

7 to 10 days

108

lifespan of platelets in idiopathic thrombocytopenia purpura

1 to 3 days or less

109

signs of idiopathic thrombocytopenia purpura

-easy bruising (wet or dry)
-heavy menses
-petechiae on extremities and trunk
-nose bleeds

110

pathology of idiopathic thrombocytopenia purpura

-platelet count <20000/uL
-prolonged bleeding time
-abnormal platelets
-increased numbers of megakaryocytes in bone marrow
-possible H. pylori infection

111

hemophilia

x-linked, recessive bleeding disorder; prolonged coagulation time
-primarily affects males

112

pathology of hemophila

-platelet plug forms at bleeding site but clotting factor deficiency impairs stable clot formation

113

signs of hemophilia

-hemorrhages (75% in joints)
-spontaneous GI bleed and hematuria
-intracranial or extracranial hemorrhages dangerous
-excessive bleeding w/ surgery or dentistry

114

hemophilia A (classic)

no to low clotting factor VIII

115

hemophilia B (christmas)

no to low clotting factor IX