Chapter 24 Hematology and Renal Emergencies Flashcards

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1
Q

Key Terms

lack of a normal of red blood cells in the circulation

A

Anemia

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2
Q

Key Terms

loss of the normal ability to form a blood clot with internal or external bleeding

A

Coagulopathy

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3
Q

Key Terms

a gravity exchange process for peritoneal dialysis in which a bag of dialysis fluid is raised above the level of an abdominal catheter to fill the abdominal catheter to fill the abdominal cavity and lowered below the level of the abdominal catheter to drain the fluid out

A

Continuous Ambulatory Peritoneal Dialysis (CAPD)

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4
Q

Key Terms

a mechanical process for peritoneal dialysis in which a machine fills and empties the abdominal cavity of dialysis solution

A

Continuous Cycler-Assisted Peritoneal Dialysis (CCPD)

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5
Q

Key Terms

the process by which toxins and excess fluid are removed from the body by a medical system independent of the kidneys

A

Dialysis

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6
Q

Key Terms

irreversible renal failure to the extent that the kidneys can no longer provide adequate filtration and fluid balance to sustain life; survival with ____ usually requires dialysis

A

End-Stage Renal Disease (ESRD)

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7
Q

Key Terms

one cycle of filling and draining the peritoneal cavity in peritoneal dialysis

A

Exchange

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8
Q

Key Terms

bacterial infection within the peritoneal cavity

A

Peritonitis

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9
Q

Key Terms

an infection that begins in the urinary tract and ascends up the ureter into the kidney

A

Pyelonephritis

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10
Q

Key Terms

loss of the kidneys’ ability to filter the blood and remove toxins and excess fluid from the body

A

Renal Failure

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11
Q

Key Terms

an inherited disease in which a genetic defect in the hemoglobin results in abdominal structure of the red blood cells

A

Sickle Cell Anemia (SCA)

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12
Q

Key Terms

a vibration felt on gentle palpation, such as that which typically occurs within an arterial-venous fistula

A

Thrill

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13
Q

Key Terms

a drainage tube placed into the urinary system to allow the flow of urine out of the body

A

Urinary Catheter

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14
Q

Critical Decision Making

DETERMINE IF YOU WOULD REQUEST ADVANCED LIFE SUPPORT FOR THE FOLLOWING PATIENTS AND, IF SO, WHY.

A twenty-nine-year-old patient with sickle cell anemia who has severe pain in his arms and chest.

A

A twenty-nine-year-old patient with sickle cell anemia and severe pain in his arms and chest could be suffering from acute chest syndrome. Chest syndrome is characterized by shortness of breath and chest pain associated with hypoxia when blood vessels in the lungs become blocked. This patient will benefit from an ALS transport.

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15
Q

Critical Decision Making

DETERMINE IF YOU WOULD REQUEST ADVANCED LIFE SUPPORT FOR THE FOLLOWING PATIENTS AND, IF SO, WHY.

A forty-two-year-old patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement.

A

A forty-two-year-old patient who recently completed his peritoneal dialysis and complains of severe abdominal pain that is worsened by movement likely does not require an ALS transport unless he develops priority signs and symptoms. He may have developed an infection or infiltration of his peritoneum or catheter. He still requires transport and evaluation in the emergency department.

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16
Q

Critical Decision Making

DETERMINE IF YOU WOULD REQUEST ADVANCED LIFE SUPPORT FOR THE FOLLOWING PATIENTS AND, IF SO, WHY.

A fifty-five-year-old female who refused to leave her house to go to her hemodialysis appointments and now complains of severe difficulty breathing, has a rapid pulse, and is anxious.

A

A fifty-five-year-old female who refused to leave her house to go to her hemodialysis appointments and now complains of severe difficulty breathing, tachycardia, and anxiety definitely needs ALS intervention because of her priority signs and symptoms. She may be suffering from an electrolyte imbalance or kidney failure; the patient could even go into ventricular fibrillation or other lethal rhythm.

17
Q

Critical Decision Making

DETERMINE IF YOU WOULD REQUEST ADVANCED LIFE SUPPORT FOR THE FOLLOWING PATIENTS AND, IF SO, WHY.

A thirty-seven-year-old sickle cell anemia patient who complains of extreme fatigue.

A

A thirty-seven-year-old sickle cell anemia patient complaining of extreme fatigue likely does not develop signs of acute chest syndrome, high fever, hypoperfusion, or stroke.

18
Q

Short Answer

What is sickle cell anemia?

A

Sickle cell anemia is an inherited disease in which patients have a genetic defect in their hemoglobin that results in an abnormal structure of the red blood cells.

19
Q

Short Answer

What is “sludging” in a patient with sickle cell anemia?

A

Patients with sickle cell disease have red blood cells composed of defective hemoglobin that causes them to lose their ability to have a normal shape and compressibility. Instead of normal, doughnut-shaped red blood cells, sickle cell patients have red blood cells that resemble a sickle, or crescent, when observed under a microscope. When these misshapen red blood cells move throughout the bloodstream, they can become clogged in capillaries and organs because of their shape and lack of compressibility. This is known as “sludging”.

20
Q

Short Answer

What is a “thrill”?

A

Chronic renal failure patients on hemodialysis must have specialized intravascular access sites established to allow for their frequent dialysis treatments. These sites are the surgical connection between an artery and a vein, known as a fistula. Because arteries maintain a much higher pressure than veins, the site will create turbulent blood flow is known as a “thrill”.

21
Q

Short Answer

What is the difference between “hemodialysis” and “peritoneal dialysis”?

A

In hemodialysis, a patient is connected to a dialysis machine that pumps his blood through specialized filter to remove toxins and excess fluid. This is almost always completed in a local or regional dialysis center. Peritoneal dialysis, in contrast, is typically completed at home. The patient has a permanent catheter implanted through the abdominal wall and into the peritoneal cavity. Several liters of a specially formulated dialysis solution are run into the abdominal cavity and left in place for several hours, where it absorbs waste material and excess fluid; then the fluid is drained back out into the bag and discarded.

22
Q

Short Answer

What are the complications that may be seen if a patient misses a dialysis appointment?

A

A patient who misses a dialysis appointment is at risk for fluid and toxin buildup in his system. This can manifest with symptoms similar to heart failure. The patient may develop shortness of breath, peripheral and pulmonary edema, and even cardiac rhythm disturbances.