T4 Blueprint - Hematology and Blood Disorders (Josh) Flashcards Preview

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Flashcards in T4 Blueprint - Hematology and Blood Disorders (Josh) Deck (69)
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1
Q

Which organ produces prothrombin and clotting factors?

A

Liver

2
Q

Which organ regulates the growth of blood cell and stores platelets?

A

Spleen

3
Q

How many RBCs are normal?

A

4.2-6.1 million/mm3

4
Q

RBCs:

What products are needed to form Hgb and RBCs?

A

Iron

Vit B12

Folic Acid

Copper

Pyroxidine

Cobalt

Nickel

5
Q

RBCs:

What is the lifespan of an RBC?

A

120 days

6
Q

A bright red tongue is a sign of —

A

anemia

7
Q

Tenderness of pain in sternum is a sign of —

A

leukemia

8
Q

Lab Values:

RBCs

A

4.2-6.1 million/mm3

9
Q

Lab Values:

WBCs

A

5,000-10,000

10
Q

Lab Values:

Hgb

A

Female: 12-16

Male: 14-18

11
Q

Lab Values:

Iron

A

Female: 60-160

Male: 80-180

12
Q

Lab Values:

Platelets

A

150,000 - 450,000

13
Q

Lab Values:

PT

A

11-12.5 secs

14
Q

Lab Values:

If PT is high, it means –

If PT is low, it means –

A

clotting deciciency

vit K excess

15
Q

Lab Values:

aPTT measures —

A

Heparin

16
Q

Lab Values:

aPTT

A

1.5-2 x’s normal range of 30-40 secs

17
Q

Lab Values:

INR measures —

A

warfarin

18
Q

Lab Values:

INR

A

1 (normal)

2-3 (warfarin)

19
Q

Lab Values:

D-dimer measures —

A

hypercoagulability of blood

20
Q

Lab Values:

D-dimer

A

0.43-2.33 mcg/mL

or

0-250 ng/mL

21
Q

Lab Values:

What does a high D-dimer indicate?

A

clot formation has occured

22
Q

Lab Values:

Fibrinogen

A

170-340

23
Q

Lab Values:

Fibrin Degradation Products

A

less than 10 mcg/mL

24
Q

Lab Values:

Waht does Fibrin Degradation Products measure?

A

efficiency of meds for DCI

***tells us when clot dissolving activity is occurring

25
Q

Bone Marrow Aspiration:

What position do we want client in?

A

side lying or prone position

26
Q

Bone Marrow Aspiration:

Nursing care postop?

A

Monitor for signs of infection

Apply ice to biopsy site if prescribed

Mild analgesics for pain

Avoid ASA and other meds that affect clotting

27
Q

Bone Marrow Aspiratoin:

How often should client inspect site postop?

A

daily

28
Q

Anemia:

Signs and Symptoms

A

Pallor

Fatigue

Numbness of extremities

DOE

Sensitivity to cold

Tachycardia

Dizziness

Orthostatic Hypotension

Bright red tongue

29
Q

Anemia:

Risk Factors

A

Blood Loss (ex: GI ulcer)

Inadequate RBC production

Increased RBC destruction

Deficiency in components of RBCs

Bone Marrow Suppression

30
Q

CBC:

— measure the size of RBCs

— measures the amount of Hgb per RBC

A

MCV (Mean Corpuscular Vol.)

MCH (Mean Corpuscular Hgb)

31
Q

CBC:

What will MCV be with Sickle Cell?

What will MCH be with Sickle Cell?

A

MCV = Normocytic

MCH = Normochromic

32
Q

CBC:

What will MCV be with Iron Deficiency Anemia?

What will MCH be with Iron Deficiency Anemia?

A

MCV = Microcytic

MCH = Hyochromic

33
Q

Anemia:

If MCV are Macrocytic, what do we suspect?

A

Folic Acid Deficiency

Vit B12 Deficiency

34
Q

CBC:

What does MCHC measure?

A

Mean Corpuscular Hgb Concentration

  • indication of Hgb amount in relation to size of cell
35
Q

What is TIBC?

A

Total Iron Binding Capacity

  • measure serum transferrin, a protein that binds with iron and transports it for storage
36
Q

Which test detects Sickle Cell?

A

Hgb Electrophoresis

37
Q

Which test measures ability to absorb B12?

A

Schilling Test

38
Q

Anemia:

What type of foods should we encourage?

A

Red Meat

Organ Meat

Egg yolks

Kidney beans

Green leafy veggies

Nuts

Dairy products

Citrus fruits

39
Q

Anemia:

When should Hgb be checked if taking iron?

A

4-6 wks to determine efficacy

40
Q

Anemia:

What route should Iron Dextran be given?

A

IM (Z-track)

41
Q

Anemia:

Nursing considerations for Erythropoietin?

A

Monitor for increased BP

Monitor Hgb and HCT twice a week

Moniotor for cardiovascular event if Hgb rises more than 1g/dL in 2 wks

42
Q

Anemia:

If they take B12 shots, how often do they get them?

A

monthly

43
Q

Anemia:

If they take B12 shots, how should they be given?

A

IM or deep SQ to prevent irritation

44
Q

Anemia:

What will large doses of Folic Acid do?

A

Mask Vit B12 deficiency

Turn urine dark yellow

45
Q

Leukemia:

What are the signs and symptoms?

A

Bone pain

Joint swelling

Enlarged Liver/Spleen

Weight loss

Fever

Poor wound healing

Fatigue, Pallor, Tachycardia, DOE

Bleeding / Bruising

46
Q

Leukemia:

Is radiation used?

A

not typically

47
Q

Leukemia:

Following BM Transplant, what is client at risk of?

A

infection and bleeding until the transfused stem cells being producing WBCs again

48
Q

Leukemia:

What are the types of BM Transplantation?

A

Autologous (own cells)

Syngenec (identical twins)

Allogenec (close match)

49
Q

Leukemia:

Why are we concerned with bleeding and injury postop?

A

they will have a low platelet count for a while

50
Q

Lymphoma:

— is usually younger clients

— is usually after age 50.

A

Hodgkin’s

Non-Hodgkin’s

51
Q

Lymphoma:

Is Chemo used?

A

may or may not be

52
Q

Lymphoma:

What is primary form of treatment for HL?

A

Radiation

53
Q

Lymphoma:

What are s/s?

A

Enlarged, PAINLESS lymph nodes

Fever

Night Sweats

Weight Loss

Fatigue

Infection

54
Q

Sickle Cell:

What are s/s?

A

Pain

Cardiac Issues

Priapism

Skin changes

Organ damage (liver, kidney, CNS)

Joint damage

55
Q

Sickle Cell:

What is treatment plan order of importance?

A

HOP

Hydration
Oxygenation
Pain Control

56
Q

Sickle Cell:

What meds can be used but what are we concerned about

A

Hydroxyurea

***increases risk of leukemia

57
Q

Blood Transfusion:

How often are new cross match samples obtained?

A

q 72 hrs

58
Q

Blood Transfusion:

What can we premedicate with?

A

Diphenhydramine

Acetaminophen

59
Q

Blood Transfusion:

What electrolyte issue do we monitor for?

A

hyperkalemia

60
Q

Blood Transfusion:

How often do we check VS?

A

q 15 mins, 30 mins, then hourly

61
Q

Blood Transfusion:

If they have no reaction, what rate do we want to administer?

A

1 unit every 1-2 hrs

62
Q

Blood Transfusion:

T/F: Rh+ can receive from Rh- but cannot give to Rh-

A

True

63
Q

Blood Transfusion:

What are s/s of an acute hemolytic reaction?

A

Chills

Fever

Low Back Pain

Tachycardia

Tachypnea

Hemoglobinuria

64
Q

Blood Transfusion:

When would we see a Febrile reaction?

A

30 mins to 6 hrs after transfusion

65
Q

Blood Transfusion:

What are s/s of Febrile Reaction to transfusion?

A

Chills

Fever

Flushing

HA

Anxiety

66
Q

Blood Transfusion:

In the first 24 hrs, we may see a mild reaction to transfusion. What are the s/s?

A

Itching

Urticaria (Hives)

Flushing

67
Q

Blood Transfusion:

What are Anaphylactic S/S of transfusion reaction?

A

Wheezing

Dyspnea

Chest Tightness

Cyanosis

Hypotension

68
Q

Blood Transfusion:

If we overload the CV system, what s/s would we see?

A

HTN

Tachycardia

Tachypnea

JVD

Pulmonary Edema

69
Q

Blood Transfusion:

Nursing action if they have a reaction?

A

Stop

NS in separate line

Save blood for testing