ch 30 hematologic disorders Flashcards
what is the lifespan of RBCs in the body
120 days
Hg range for male and female
M: 14-18
F: 12-16
Hct range for male and female
M: 42-52
F: 37-47
with what hemoglobin level should someone get a blood transfuion
below or equal to 8
what does dehydration do to hematocrit levels
increases Hct
S+S anemia (6)
- tachycardia
- cool pale skin/mucous membranes
- SOB
- activity intolerance
- fatigue
- pika (eating a lot of ice)
what is MCV
how big is RBC (microcytic or macrocytic)
what is MCH
what color is RBC (hypochromic, normochromic)
where are RBCs produced
in bone marrow (stimulated by erythropoeitin from kidneys)
causes of iron deficiency anemia (6)
- malabsorption
- bowel surgery
- gastric bypass surgery
- long term use PPIs
- blood loss
- cancer
where is iron absorbed
stomach/small bowel
what is MCV and MCH of iron deficiency anemia
microcytic, hypochromic
diagnostic of iron deficiency anemia
decreased ferritin level in CBC
treatment iron deficiency anemia (2)
iron supplements (PO or parenteral) blood transfusion with PRBCs (if Hgb <8)
side effects iron supplements (2)
- constipation
- black tarry stools
how should pt take PO iron supplement
with empty stomach
with orange juice
how should pt take liquid iron supplement
through straw (stains teeth)
treatment vit b12 anemia
parenteral admin vit b12
causes folic acid deficiency (3)
- chronic alcohol abuse
- malabsorption syndromes
- lost during hemodialysis
most common cause of anemia of chronic disease
end stage renal disease
treatment anemia of chronic disease
epoeitin alpha (parenteral injection)
what blood level should you check before admin of epoeitin alpha
hemoglobin
what causes aplastic anemia
pancytopenia
-can be congenital or acquired through radiation
treatment aplastic anemia (2)
epoeitin alpha
blood transfusions
causes blood loss anemia (3)
ACUTE -trauma -surgery -GI bleeds CHRONIC -colon cancer -IBS -heavy/long periods
causes sickle cell anemia
inherited from both parents
what happens in sickle cell anemia crisis
RBCs change shape in response to decreased O2 levels
they stick together and get stuck in capillaries, causing blood clotting throughout body and sickle cell crisis
S+S sickle cell anemia crisis (3)
- pain
- fatigue
- pallor
complications of sickle cell anemia crisis (3)
- kidney failure
- death
- infections (pneumonia)
who is screened for sickle cell anemia
all women during pregnancy (DNA testing)
triggers of vasoactive crisis in sickle cell anemia (3)
- high altitude
- dehydration
- infections (especially resp illness)
how to prevent vasoactive crisis of sickle cell anemia (4)
- daily folic acid supplement
- hydroxyurea
- adequate hydration
- flu vaccine
treatment of vasoactive crisis of sickle cell anemia (4)
- hydrate
- O2
- monitor ABGs for metabolic acidosis
- pain meds (IV opioids)
cause of hemochromatosis
inherited from both parents
what is hemochromatosis
increased absorption of iron in intestines and increased deposits of iron in tissues (liver)
complication of hemochromatosis
liver failure
treatment hemochromatosis
-remove excess iron from body (donate blood or dialysis)
what is polycythemia
increased production of RBCs
causes of polycythemia (4)
- epoeitin alpha side effect
- testosterone supplement side effect
- COPD
- smoking
what are pts with polycythemia at high risk for developing
DVTs and PEs (because of hypercoagulable state)
treatment polycythemia
donate blood
what are pts with thrombocytopenia at risk for
increased bleeding
causes thrombocytopenia (2)
- aplastic anemia
- heparin side effect
what gender is more likely to have hemophilia
men
causes hemophilia
inherited blood disorder
what is hemophilia
affects clotting cascade
treatment hemophilia (2)
- give missing clotting factor
- give pooled platelets
nursing considerations hemophilia (3)
- avoid injury
- avoid meds that increase bleeding (NSAIDs/ASA)
- watch for prolonged nosebleed, tarry stools, hematuria, coffee ground emesis
cause of neutropenia
chemotherapy
what are pts with neutropenia at increased risk for
infection
treatment neutropenia (2)
- reverse isolation (pts and nurse wear PPE)
- give filgrastim
what pt would receive pooled platelets
hemophilia
what pt would receive PRBCs
anemia
admin considerations for blood products (5)
- infuse over 2 hours
- infuse within 30 mins of receiving from blood bank
- give with normal saline
- 2 RNs required for admin
- monitor constantly for first 15 mins
causes disseminated intravascular coagulation (DIC)
- pregnancy
- side effect of certain meds
what is disseminated intravascular coagulation
massive clotting depletes body of clotting factors, resulting in massive bleeds
what can disseminated intravascular coagulation lead to (2)
- thrombocytopenia
- multi organ failure
treatment disseminated intravascular coagulation (2)
- pooled platelets or FFP
- heparin or enoxaparin
what is leukemia
prevalence of immature WBCs
disorder of bone marrow
how is leukemia classified
acute/chronic and lymphocytic/myelogenous
ALL, CLL, AML, CML
is acute or chronic leukemia more severe
acute
S+S leukemia
(ANT)
anemia
neutropenia
thrombocytopenia
treatment leukemia (2)
- chemo/radiation
- bone marrow transplant
how is lymphoma classified (2)
hodgkins or non-hodgkins
which type of lymphoma is more treatable
hodgkins
what is a risk factor for developing hodgkins lymphoma
epstein-barre virus
who is more likely to have hodgkins lymphoma (2)
- men
- immunocompromised (HIV pts)
S+S hodgkins lymphoma (5)
- enlarged lymph nodes (1st sign)
- weight loss
- fever
- fatigue
- night sweats
diagnosis of (non)hodgkins lymphoma
biopsy of infected lymph nodes
hodgkins shows reed-sternberg cells
treatment (non)hodgkins lymphoma
chemo/radiation
what race is more likely to have sickle cell anemia
african american
