UNIT 9 HEMATOLOGIC DISORDERS Flashcards by &$& Yong

What Blood type is the Universal Recipient?
A. AB+
B. AB-
C. AB
D. O-

A. AB+

How well did you know this?

Not at all

Perfectly

What Blood type is the Universal Donor?
A. O-
B. AB+
C. D
D.B

A. O-

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type A-?

A- O-

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type O-?

O-

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type O+?

O- O+

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type A+?

O+ A+ A- O-

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type AB-?

A- B- AB- O-

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type AB+?

A+ A- B+ B- AB+ AB- O+ O-

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type B-?

O- B-

How well did you know this?

Not at all

Perfectly

What blood type is compatible for Blood type B+?

B+ B- O+ O-

How well did you know this?

Not at all

Perfectly

Blood transfusion

Blood transfusions used to treat various diseases

 Verify identity of recipient and donor’s blood group
 Monitor vital signs
 Use appropriate filter
 Use blood within 30 minutes of arrival
 Infuse over 4 hours maximum

How well did you know this?

Not at all

Perfectly

A patient has been prescribed a b blood transfusion. You noticed the new grad nurse received the blood pack 5 hours ago at 1300 it is currently 1800. What is the priority nurse intervention?

A. Intervene and request that she get a new blood pack from the blood bank due to the blood 4-hour shelf life.
B. Administer the blood pack without her supervision.
C. Instruct her that she will not be able to administer the blood after 1900 due to shelf life.
D. Assist the new grad nurse with the blood transfusion.

A. Intervene and request that she get a new blood pack from the blood bank due to the blood 4-hour shelf life.

 Use blood within 30 minutes of arrival
 Infuse over 4 hours maximum

How well did you know this?

Not at all

Perfectly

Which of the following is a symptom of Anemia?

A. Hypertension
B. Hyportension
C. HGB of 16
D. bradycardia

A. Hypertension

RBC or Hgb concentration below normal range

 Characterized by etiology (depletion) or
morphology (size & shape)

 Anemia causes increased cardiac workload; may
cause murmur

How well did you know this?

Not at all

Perfectly

RED BLOOD CELL LAB VALUE

4.5-4.5 millon

How well did you know this?

Not at all

Perfectly

HEMOGLOBIN LAB VALUE

11.5- 15.5

How well did you know this?

Not at all

Perfectly

HEMATOCRT LAB VALUE

35-45

How well did you know this?

Not at all

Perfectly

Is Reb blood cells increased or decreased with a patient diagnosed with anemia?

decreased

S/S of Anemia

Pallor
Fatigue
Tachycardia
Murmurs
Growth retardation
Activity intolerance
slight jaundice if red blood cell destruc-
tion occurs
Shortness of breath
Dysrhythmias
Chest pain
Cool extremities

Management of Anemia

Treat underlying cause

Transfusions,
nutritional
interventions

*Supportive care: IVF,rest,
*decrease O2 demands (keep child calm), *O2 as PRN

What foods would you recommend for a child with anemia

Encourage the client to eat foods rich in folic
acid,
such as green leafy vegetables, meat, liver, fish, legumes, peanuts, orange juice, and avocado.
Administer folic acid as prescribed.

What is the cause of iron deficiency Anemia?

Most prevalent and preventable nutritional disorder in US
 Most often caused by nutritional deficiency
 Children 12-36 months at risk

poor diet increase intake of calcium rich foods
2. Commonly results from blood loss, increased metabolic demands, syndromes of gastrointestinal malabsorption, and dietary inadequacy.

How can you treat iron deficiency anemia? What foods would you recommend

 Iron rich foods and supplements

Dried beans
Dried fruits
Egg yolks
Iron-fortied cereals
Liver
Meat (especially lean red meat, poultry) Oysters
Salmon
Tuna
Whole grains

Iron Supplement teachings for Patient/ Parent education

Liquid preparations of iron may temporarily stain the teeth. If possible, the medication should be taken through a straw or given through a syringe or medicine dropper placed toward the back of the mouth. Brushing the teeth after administration of the drug lessens the discoloration.

Cow’s milk contains substances that bind the iron and interfere with absorp- tion. Iron supplements should not be administered with milk or milk products

. Oral iron should be given as prescribed in two di- vided doses between meals, when the presence of free hydrochloric acid is greatest, because more iron is absorbed in the acidic environ- ment of the upper gastrointestinal (GI) tract. A citrus fruit or juice taken with the medication aids in absorption.

Give supplements on empty stomach

 Black/green tarry stools normal with supplements

 Give to exclusively breast-fed babies by 4 months

Is sickle cell anemia a congenital disorder?

A. No
B. Yes

B. Yes

Hereditary presence of HbS; an autosomal recessive trait

 Pathophysiology

 Sickling causes obstruction of vessels, vascular inflammation, RBC destruction

S/S of Sickle cell disorder

Effects of Sickle cell

Hemolysis CVA (stroke) Paralysis Death Retinopathy Blindness Hemorrhage Avascular necrosis (shoulder) Hepatomegaly Gallstones Splenomegaly Splenic sequestration Autosplenectomy Hematuria Hyposthenuria (dilute urine) Avascular necrosis (hip) Abdominal pain Dactylitis (hand-foot syndrome) Priapism Anemia Pain Osteomyelitis Chronic ulcers (rare in children)

What are the risk factors of Sicle cell crisis

*infection, *stress, *dehydration, *trauma

Types of crises

Types of crises  Vaso-occlusive- “painful episode”  Splenic sequestration - pooling of blood in the spleen  Aplastic - decreased production of RBCs

 Focus: Prevent sickling and treat crisis  Oral/IV hydration  Enuresis possible  Decrease O2 demands  O2 use?  Pain management  Prevent infection  Immunizations, PCN prophylaxis, hydroxyurea  Splenectomy  Blood transfusions  Stem cell transplant  Considered curative  Teaching: S/S of infection, Acute Chest Syndrome, CVA

What is Hemophilia

Bleeding disorder resulting from deficiency o dysfunction of factors (proteins) needed for clotting

What are patient deficient in when they've been diagnosed with hemophilia

Factor 8 Pathophysiology  Deficiency of factor VIII, produced by liver

S/S OF Hemophilia?

 Prolonged bleeding  Hemorrhage  Bruising  Hemarthrosis(swelling of blood in joints)  Spontaneous hematuria

 Diagnostics  History of bleeding episodes  Evidence of inheritance  Labs: clotting factors, DNA  Treatment  Prevent bleeding  Replace clotting factor  Meds  Corticosteroids  NSAIDS- used cautiously!  DDAVP  Regular exercise and Physical Therapy  Control bleeding  RICE Rest, Ice, Compression, and Elevation  Support/educate family

Are patients diagnosed with hemophilia susceptible to nose bleeds A. Yes B. No

A. Yes

Does a patient with Hemophilia has an increase bleeding time a. yes b. no

a. yes normal range PTT Both Sexes: 20-30 sec normal range INR 0.9-1.2 sec normal range pt 11-12.5sec

The nurse is preparing home care instructions for the parents of a 10-year-old child with hemophilia. Which sport activity would the nurse suggest for this child? 1. Soccer 2. Basketball 3. Swimming 4. Field hockey

3. Swimming

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors re- lated to sickle cell crisis. Which, if identied by the parents as a precipitating factor, indicates the need for further instruction? 1. Stress 2. Trauma 3. Infection 4. Fluid overload

4. Fluid overload

A 10-year-old child with hemophilia A has slipped on the ice and bumped the knee. The nurse would prepare to administer which prescription? 1. Injection of factor X 2. Intravenous infusion of iron 3. Intravenous infusion of factor VIII 4. Intramuscular injection of iron using the Z-track method

3. Intravenous infusion of factor VIII

The nurse is preparing to instruct the parents of a child with iron-deciency anemia regarding the administration of a liquid oral iron supplement. Which instruction would the nurse give the parents? 1. Administer the iron in-between mealtimes. 2. Administer the iron through a straw. 3. Mix the iron with cereal to administer. 4. Add the iron to formula for easy administration.

1. Administer the iron in-between mealtimes.

8. Laboratory studies are performed for a child sus- pected to have iron-deciency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? 1. Elevated hemoglobin level 2. Decreased reticulocyte count 3. Elevated red blood cell count 4. Red blood cells that are microcytic and hypochromic

4. Red blood cells that are microcytic and hypochromic

The nurse is reviewing a pediatrician’s prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vase-occlusive crisis. Which prescriptions documented in the child’s record would the nurse question? Select all that apply. 1. Restrict fluid intake. 2. Position for comfort. 3. Avoid strain on painful joints. 4. Apply nasal oxygen at 2 L/minute. 5. Provide a high-calorie, high-protein diet. 6. Give meperidine, 25 mg intravenously, every 4 hours for pain.

1. Restrict fluid intake. 6. Give meperidine, 25 mg intravenously, every 4 hours for pain.