4/6 Flashcards
Watch Hgb
Symptoms poor oxygenation and perfusion
Blood transfusion if possible
Correct the prob - blood transfusion - esp if HGB LOW
Give Fe - if iron issue
Non functional or low functioning RBCs with Hgb - big deal:
SCD with plenty of RBCs - need blood transfusions - RBCs misshaped - go into clots and pool up - RBCs ineffective with proper amount of O2 - pain: treat the pain: C-shaped and clump together and clog off circulation - experience ischemia, swelling, inflammation - real pain - at risk of embolism - infarc kidney, lungs, heart, head; any organ - big ones - micro vascular - mouth, eyes, fingertips
SCD crisis - curl up - instruct them unclam up - causes clots and results in more pain and ischemia - few bends as possible
Support pt through SCD crisis - fluids - help as pass clots
Avoid triggers
Anemia - priority assessment
High altitudes
Extreme cold
HEAVY exercise - active but nothing over stressing
Not good oxygen
Anything deprives those cells - round red cells of O2 - changes shape - blast with O2 after started crisis - some cells may go back
Medication - RBCs stay in round shape - hydroxyurea - can cause birth defects
Avoid triggers
not kink too much - do clump - not jam together like SCD - push
Polychythemia -
Excess antibodies come out in cell
Antibodies come out and come together and ram into organs causing end-organ damage
Excess of cytokines - spiny things all over - want to attack bones - munch on that bone - expect Ca go up; they are angry and eating
Overproduction of gamma globulins
Usually help heal (cytokines) - instead angry - attacking bone - breaking it down and letting serum Ca out into the blood
Multiple myeloma
Ca comes into area - parathyroid glands come into play
Thyroidectomy
Chevvstick’s
Trousseau’s
Neither 100% conclusive - need assess for low Ca
Numbness and tingling around mouth
S/S LOW CA post-thyroidectomy
Not want do for people who are at high risk for bleeding
High risk for bleeding - want to: look to see if their bleeding
Look for severe headache
Look for neuro changes
Not want do invasive
Not want do aspirin
Not do steel wire brush
Not floss really hard
Not shave with straight razor
Not try prevent constipation and strain really hard - hemorrhoids
IV in and on warfarin - pull IV - hard pressure
Environment as safe as possible
These precautions not place at automatic risk for falls - experience fall treat them expanded - lot times - CT head
Can be on this and neutropenic precautions
Thrombocytopenic precautions
No idea why it happens
Autoimmune
Making antibodies against own platelets
Macrophages each platelet - “chew up platelet”
Trigger: viral infection
Immune sys - hungry and wants platelets
ITP
Immune disorder
Platelets all clump together - do abnormally - body runs out of platelets
Microcirculation clots - runs out of platelets - when cut - not platelets to try heal and seal off cut
Same process happens in DIC (clotting factors in DIC attacked) platelets attacked this time
TTP
Replacement of factors - biggest thing - does not happen - bleed along joints - imp to ice those down
Types - know stuff on slide with types - WELL
Hemophilia
Diff types: how know type: BM biopsy - know what role as RN in conjunction to BM aspiration
Leukemia
Educate what actually
What expect
How to follow-up care after the procedure - bleeding
How avoid law-suit
BM aspiration
CURABLE
Stem cell transplant/BM transplant
1 single lymph node - neck, under arm, under chest - infects slowly as goes along
CM
REMEBER B TYPE SYMPTOMS
Pain in node after alcohol intake
External radiation and chemo
Hodgkin’s
Multiple sites of lymphadenopathy
By time found - spread to organs
Chronic disease
NOT CURABLE
Long-term
Lot chemo
Monoclomal antibodies
Radiation treatment
Non-Hodgkin’s
T3 and T4 - too much
TSH - low
Negative feedback
Cannot handle heat
Hyperthyroidism
