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PathoPharm 2 > ch 30 hematologic disorders > Flashcards

ch 30 hematologic disorders Flashcards

1
Q

what is the lifespan of RBCs in the body

A

120 days

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2
Q

Hg range for male and female

A

M: 14-18
F: 12-16

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3
Q

Hct range for male and female

A

M: 42-52
F: 37-47

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4
Q

with what hemoglobin level should someone get a blood transfuion

A

below or equal to 8

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5
Q

what does dehydration do to hematocrit levels

A

increases Hct

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6
Q

S+S anemia (6)

A
  • tachycardia
  • cool pale skin/mucous membranes
  • SOB
  • activity intolerance
  • fatigue
  • pika (eating a lot of ice)
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7
Q

what is MCV

A

how big is RBC (microcytic or macrocytic)

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8
Q

what is MCH

A

what color is RBC (hypochromic, normochromic)

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9
Q

where are RBCs produced

A

in bone marrow (stimulated by erythropoeitin from kidneys)

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10
Q

causes of iron deficiency anemia (6)

A
  • malabsorption
  • bowel surgery
  • gastric bypass surgery
  • long term use PPIs
  • blood loss
  • cancer
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11
Q

where is iron absorbed

A

stomach/small bowel

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12
Q

what is MCV and MCH of iron deficiency anemia

A

microcytic, hypochromic

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13
Q

diagnostic of iron deficiency anemia

A

decreased ferritin level in CBC

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14
Q

treatment iron deficiency anemia (2)

A 
iron supplements (PO or parenteral)
blood transfusion with PRBCs (if Hgb <8)
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15
Q

side effects iron supplements (2)

A
  • constipation

- black tarry stools

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16
Q

how should pt take PO iron supplement

A

with empty stomach

with orange juice

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17
Q

how should pt take liquid iron supplement

A

through straw (stains teeth)

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18
Q

treatment vit b12 anemia

A

parenteral admin vit b12

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19
Q

causes folic acid deficiency (3)

A
  • chronic alcohol abuse
  • malabsorption syndromes
  • lost during hemodialysis
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20
Q

most common cause of anemia of chronic disease

A

end stage renal disease

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21
Q

treatment anemia of chronic disease

A

epoeitin alpha (parenteral injection)

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22
Q

what blood level should you check before admin of epoeitin alpha

A

hemoglobin

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23
Q

what causes aplastic anemia

A

pancytopenia

-can be congenital or acquired through radiation

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24
Q

treatment aplastic anemia (2)

A

epoeitin alpha

blood transfusions

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25
Q

causes blood loss anemia (3)

A 
ACUTE
-trauma
-surgery
-GI bleeds
CHRONIC
-colon cancer
-IBS
-heavy/long periods
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26
Q

causes sickle cell anemia

A

inherited from both parents

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27
Q

what happens in sickle cell anemia crisis

A

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

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28
Q

S+S sickle cell anemia crisis (3)

A
  • pain
  • fatigue
  • pallor
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29
Q

complications of sickle cell anemia crisis (3)

A
  • kidney failure
  • death
  • infections (pneumonia)
30
Q

who is screened for sickle cell anemia

A

all women during pregnancy (DNA testing)

31
Q

triggers of vasoactive crisis in sickle cell anemia (3)

A
  • high altitude
  • dehydration
  • infections (especially resp illness)
32
Q

how to prevent vasoactive crisis of sickle cell anemia (4)

A
  • daily folic acid supplement
  • hydroxyurea
  • adequate hydration
  • flu vaccine
33
Q

treatment of vasoactive crisis of sickle cell anemia (4)

A
  • hydrate
  • O2
  • monitor ABGs for metabolic acidosis
  • pain meds (IV opioids)
34
Q

cause of hemochromatosis

A

inherited from both parents

35
Q

what is hemochromatosis

A

increased absorption of iron in intestines and increased deposits of iron in tissues (liver)

36
Q

complication of hemochromatosis

A

liver failure

37
Q

treatment hemochromatosis

A

-remove excess iron from body (donate blood or dialysis)

38
Q

what is polycythemia

A

increased production of RBCs

39
Q

causes of polycythemia (4)

A
  • epoeitin alpha side effect
  • testosterone supplement side effect
  • COPD
  • smoking
40
Q

what are pts with polycythemia at high risk for developing

A

DVTs and PEs (because of hypercoagulable state)

41
Q

treatment polycythemia

A

donate blood

42
Q

what are pts with thrombocytopenia at risk for

A

increased bleeding

43
Q

causes thrombocytopenia (2)

A
  • aplastic anemia

- heparin side effect

44
Q

what gender is more likely to have hemophilia

A

men

45
Q

causes hemophilia

A

inherited blood disorder

46
Q

what is hemophilia

A

affects clotting cascade

47
Q

treatment hemophilia (2)

A
  • give missing clotting factor

- give pooled platelets

48
Q

nursing considerations hemophilia (3)

A
  • avoid injury
  • avoid meds that increase bleeding (NSAIDs/ASA)
  • watch for prolonged nosebleed, tarry stools, hematuria, coffee ground emesis
49
Q

cause of neutropenia

A

chemotherapy

50
Q

what are pts with neutropenia at increased risk for

A

infection

51
Q

treatment neutropenia (2)

A
  • reverse isolation (pts and nurse wear PPE)

- give filgrastim

52
Q

what pt would receive pooled platelets

A

hemophilia

53
Q

what pt would receive PRBCs

A

anemia

54
Q

admin considerations for blood products (5)

A
  • 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
55
Q

causes disseminated intravascular coagulation (DIC)

A
  • pregnancy

- side effect of certain meds

56
Q

what is disseminated intravascular coagulation

A

massive clotting depletes body of clotting factors, resulting in massive bleeds

57
Q

what can disseminated intravascular coagulation lead to (2)

A
  • thrombocytopenia

- multi organ failure

58
Q

treatment disseminated intravascular coagulation (2)

A
  • pooled platelets or FFP

- heparin or enoxaparin

59
Q

what is leukemia

A

prevalence of immature WBCs

disorder of bone marrow

60
Q

how is leukemia classified

A

acute/chronic and lymphocytic/myelogenous

ALL, CLL, AML, CML

61
Q

is acute or chronic leukemia more severe

A

acute

62
Q

S+S leukemia

A

(ANT)
anemia
neutropenia
thrombocytopenia

63
Q

treatment leukemia (2)

A
  • chemo/radiation

- bone marrow transplant

64
Q

how is lymphoma classified (2)

A

hodgkins or non-hodgkins

65
Q

which type of lymphoma is more treatable

A

hodgkins

66
Q

what is a risk factor for developing hodgkins lymphoma

A

epstein-barre virus

67
Q

who is more likely to have hodgkins lymphoma (2)

A
  • men

- immunocompromised (HIV pts)

68
Q

S+S hodgkins lymphoma (5)

A
  • enlarged lymph nodes (1st sign)
  • weight loss
  • fever
  • fatigue
  • night sweats
69
Q

diagnosis of (non)hodgkins lymphoma

A

biopsy of infected lymph nodes

hodgkins shows reed-sternberg cells

70
Q

treatment (non)hodgkins lymphoma

A

chemo/radiation

71
Q

what race is more likely to have sickle cell anemia

A

african american

PathoPharm 2 (33 decks)

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