Flashcards in Screening 5 Deck (37):
1
Leukocyte disorders are recognized as the body's reaction to
- disease
- foreign invaders
2
What are the two leukocyte disorders we discussed?
- leukocytosis
- leukopenia
3
leukocytosis =
increased neutrophils
4
leukopenia =
too few leukocytes
5
Too few leukocytes (leukopenia) is related to
- bone marrow failure
- never a beneficial condition
6
s/s of leukocytosis
- fever
- sx of localized or systemic infection
- inflammation
- tissue trauma
7
s/s of leukopenia
- sore throat
- cough
- high fever/chills
- ulcerations
- persistent infections
- frequent/painful urination
8
When is leukopenia commonly seen?
- following chemotherapy
- consider nadir
9
What is the nadir?
WBC count is at lowest level as a result of cancer tx
10
Important considerations for a pt at a nadir
If we know they will reach the nadir, must remember that they are more susceptible to infections during this time
11
Leukopenia: When does the nadir generally occur after cancer tx?
Usually between 7-14 days
12
What are the platelet disorders we discussed?
- thrombocytosis
- thrombocytopenia
13
Thrombocytosis is an increase in
platelet count
14
Why/when does thrombocytosis usually occur?
usually compensatory and temporary after surgery
15
What factors can influence platelet count?
- diet
- exercise
- liver disease
- radiation
- chemotherapy
16
What are two nutritional factors that influence platelet count?
- lecithin
- vitamin K
17
Lecithin (prevents/promotes) coagulation
prevents
18
Vitamin K (prevents/promotes) coagulation
promotes
19
How does exercise impact coagulation?
helps destroy clots
20
clinical s/s of thrombocytosis
- easy bruising
- splenomegaly
- thrombosis
21
Why does splenomegaly occur with thrombocytosis?
It becomes enlarged because it has to work much harder
22
What is thrombocytopenia?
decreased platelet count
23
What can thrombocytopenia result from?
decreased or defective platelet production
24
What causes thrombocytopenia?
- bone marrow failure
- leukemia
- medications
25
Which medications can cause thrombocytopenia?
- NSAIDs
- methotrexate
- gold
- coumadin
26
clinical s/s of thrombocytopenia
- bleeding after minor trauma
- spontaneous bleeding
- gingival bleeding
27
Where might you see idiopathic thrombocytopenia?
children
28
PT must be on alert for obvious sx of thrombocytopenia: Why?
- exercise that involves straining could precipitate a hemorrhage
- esp. of eyes or brain
29
undiagnosed clients with sx of thrombocytopenia
need immediate physician referral
30
Why is COX so important for platelets?
COX is an enzyme needed for thromboxane A2
»»» platelet aggregation and arterial smooth muscle constrictor «««
31
These two drugs activate platelet COX
- Aspirin (ASA)
- NSAIDs
32
A single dose of this can suppress normal platelet aggregation for 48 hours up to a week
ASA
33
Why is ASA problematic for platelet aggregation?
- irreversibly inhibits COX
- platelets are inactivated for the rest of their lifespan
34
How long do platelets live?
about 8 days
34
NSAIDs effects on COX are ________
reversible
36
Effects of NSAIDs on platelets
milder than ASA
- bruising
- skin bleeding
37