Screening for Hematologic Disease

Question 1

What are RBC count norms for men?

Answer 1

4.5-6.2

HGB- 37-49%

HCT- 14-17

Question 2

What are RBC count norms for women?

Answer 2

4-5.5

HGB 36-46%

HCT- 12-15

Question 3

What are WBC norms?

Answer 3

4,500-11,000

Question 4

What are platelet norms?

Answer 4

150-400 K

Question 5

What is worse thick or thin plasma?

Answer 5

thick due to too much clotting could cause DVT

Question 6

What are common symptoms associated with RBC?

Answer 6

fatigue, dyspnea, dizziness- lack of O2

post op anemia- 8 weeks till normal aerobic capacity

Question 7

What are common symptoms associated with WBC?

Answer 7

fevers, chill, persistent infections

Question 8

What are common symptoms with platelet dysfunction?

Answer 8

easy bruising or bleeding

cramping, pain

Question 9

Who should be screened for hematology issues?

Answer 9

hx of chemo/radiation, chronic NSAID use, spontaneous bleeding, recent surgery,

has rapid onset of dyspnea, chest pain, weakness, fatigue with palpations

fingernail changes (cyanosis or spooning)

Question 10

What is anemia?

Answer 10

too few RBC, loss of iron from GI bleed?, chemo related?

Question 11

What are sx of anemia?

Answer 11

chest pain, DOE, decreased DBP, increased HR, HA, drowsiness, depression

Question 12

What are skin changes in anemia?

Answer 12

pale skin, pale or yellow eyes and mouth

Question 13

What is polycythemia?

Answer 13

too many RBC more of a med emergency as blood is sticky and could clot

Question 14

What are sx of polycythemia?

Answer 14

fatigue, SOB, pruitis, HA

Question 15

What are common characteristics of sickle cell anemia?

Answer 15

AVN, CVA, pain

less HGB and less ability to change shape

Question 16

Why do pts with sickle cell have enlarged spleen or livers?

Answer 16

they are being overworked trying to remove old/bad RBC

will be tender on palpation

Question 17

What is leukocytosis?

Answer 17

too many WBC usually as a response to infection but could also be from cancer, hemorrhage, appendicitis, splenectomy

Question 18

What is leukopenia?

Answer 18

too few, possibly from bone marrow failure

Question 19

When is WBC count lowest after chemo?

Answer 19

7-14 days post chemo

Question 20

What are sx of leukopenia?

Answer 20

sore throat, high fever, chills, mouth ulcerations, dysuria, persistent infection

Question 21

What is leukemia?

Answer 21

production of lots of immature WBC

Question 22

What are 4 types of leukemia?

Answer 22

ALL- young and old people good prognosis

AML- poor prognosis

CLL- 25-60

CML

Question 23

What are risk factors for leukemia?

Answer 23

radiation exposure, prior chemo, downs syndrome

Question 24

What are sx of leukemia?

Answer 24

infection, fever, bruising, epitaxis (nosebleed), hematuria, fatigue, enlarged lymph nodes, weight loss, enlarged spleen

Question 25

What is thrombocytosis?

Answer 25

too many can be after hemorrhage, cancer related, splenomegaly

Question 26

What are sx of too many?

Answer 26

pain, clotting, bruising

Question 27

What is thrombocytopenia?

Answer 27

too few, from BM failure, leukemia, cancer, ASA or NSAIDS

Question 28

What are sx of too few?

Answer 28

bleeding, bruising, epitaxis, menorrhagia, gum bleeding, melena, joint swelling, throwing up blood

Question 29

What are petechiae?

Answer 29

small lesions less than 2 mm

Question 30

What are purpura?

Answer 30

2mm to 1 cm size lesions

Question 31

What is ecchymoses?

Answer 31

larger lesions

Question 32

What are signs and symptoms of hemophilia?

Answer 32

hot sore jt with loss of motion, muscles hemorrhages feels like muscle pulls, GI bleed

Question 33

What should be sent out immediately?

Answer 33

thrombocytopenia? rebound belly tenderness

Question 34

When should you hold PT for blood glucose?

Answer 34

under 50 or over 240

Question 35

When should you for K?

Answer 35

under 3 over 6

Question 36

When should you hold for Na?

Answer 36

under 125 or over 150

Question 37

What is absolute neutrophil count?

Answer 37

WBC x neutrophils

Question 38

What are WBC count precautions?

Answer 38

1000-1500 neutropenic precautions may ambulate in hall with MD permission 500-1000 patient needs mask to leave room under 500 room isolation

Question 39

What is Hct cut off?

Answer 39

30% - 32% Resistive exercise to tolerance < 25% No exercise permitted > 25% Light exercise permitted < 20% patient may have SOB, tachycardia

Question 40

What is Hgb cutoff?

Answer 40

< 7 g/dL No exercise permitted or ROM only 8-10 g/dl Light exercise permitted > 10 g/dL Resistive exercise to tolerance

Question 41

What is platelet cut off?

Answer 41

≥ 50,000 – progressive resistive exercises ≤50,000 – no deep tissue massage etc, no percussion, no MMT 30,000 – 50,000 – moderate exercise 20,000 – 30,000 – light exercise no bicycle or treadmill Less than 20,000 – AROM and necessary ADL’s only watch for bleeding.

Question 42

What is INR cutoff?

Answer 42

over 4 ok over 5 no exercise