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MS exam 3 > Chapter 29 > Flashcards

Chapter 29 Flashcards

1
Q

Lower than normal hemoglobin and fewer than normal circulating erythrocytes is known as?
**this is a sign if an underlying disorder

A

Anemia

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2
Q

_____ is a defect in production of RBCs.
*Caused by trauma, bleeding ulcers, GI bleeding, liver disease, or ruptured aneurysm

A

Hypoproliferative anemia

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3
Q

____ is excess destruction of RBCs.
**Caused by altered erythropoiesis, hypersplenism, drug-induced, autoimmune processes, mechanical heart valves, sickle cell

A

Hemolytic anemia

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4
Q

_____ is a protein in red blood cells that helps carry oxygen throughout the body.

A

Hemoglobin

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5
Q

What are some clinical manifestations of anemia?

A

fatigue, jaundice, SOB, dyspnea, tachycardia, chest pain, tongue (beefy red) and nail changes (brittle), PICA, angular cheilosis, forgetfulness, paresthesia, extremity numbness, memory loss

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6
Q

What diagnostic tests can be used to diagnose anemia?

A

H&H
RBC indices
iron studies
vitamin b12
folate
erythropoietin levels
bone marrow aspiration

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7
Q

What assessments should the nurse complete in a patient with anemia?

A

Health hx
labs
S/S
nutritional assessment
meds
cardiac and GI assessments
assess blood loss (period, GI)
neuro assessment

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8
Q

Medical management of a patient with anemia:
Correct or control the ____
_____ of packed RBC
treatment ____ to type of anemia
_____ therapy
____ or vitamin supplements

A

cause
tranfusion
specific
dietary
iron

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9
Q

What are some collaborative problems and potential complications for a patient with anemia?

A

heart failure
angina
paresthesia
confusion
injury related to falls
depressed mood

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10
Q

____ ____ are more likely to develop depressed mood, confusion, or experience falls with injury.

A

older adults

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11
Q

Patients with underlying ____ ____ are more likely to develop cardiac complications.

A

heart disease

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12
Q

Major treatment goals for a patient with anemia include:
- decreased ____
- ______ nutrition
- maintain of adequate ___ perfusion
- adherence to ____ plan
- ______ of complications

A

fatigue
adequate
tissue
treatment
absence

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13
Q

What is the MOST common symptom associated with anemia?

A

Fatigue
**encourage balance to rest and activity

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14
Q

What type of food should be encouraged in a patient with anemia?

A

Iron rich foods and limit alcohol

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15
Q

What is the most common type of anemia in ALL age groups?

A

Iron deficiency

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16
Q

What type of anemia occurs in chronic renal failure?

A

Anemia in renal disease

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17
Q

What type of anemia is common during cancer treatment, chronic infections, and autoimmune diseases?

A

Anemia of inflammation

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18
Q

What type of anemia is caused by bone marrow suppression?

A

Aplastic anemia

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19
Q

What type of anemia is caused by folic acid and vitamin B12 deficiency that leads to abnormally large erythrocytes?

A

megaloblastic anemia

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20
Q

TRUE OR FALSE.
We should assume the cause of iron deficiency anemia is bleeding until proven otherwise.

A

TRUE

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21
Q

What are some clinical manifestations of iron deficiency anemia?

A

dizziness, fatigue, weakness, pallor, dyspnea on exertion, swollen beefy red tongue, brittle nails

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22
Q

What is the definitive diagnosis for iron deficiency anemia?

A

Bone marrow aspiration

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23
Q

What is the mainstay treatment of iron deficiency anemia?

A

Oral iron supplements

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24
Q

what can inhibit the absorption of iron supplements?

A

Coffee, tea, soda, dairy products, and antacids

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25
Q

What drugs are associated with causing iron deficiency anemia due to GI bleeding?

A

NSAIDS, steroids, alcohol

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26
Q

What drugs are associated with causing iron deficiency anemia due to malabsorption of iron?

A

PPIs (Prilosec), H2 receptor blockers (Pepsid), antacids (tums, pepto)

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27
Q

Why does anemia in renal disease occur in patients with kidney failure?

A

Because kidneys produce EPO

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28
Q

What are S/S of anemia in renal disease?

A
  • reduced O2 utilization
    -decreased cognitive function
    -impaired memory
    -reduced immune response
    -decreased libido
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29
Q

What are S/S of megaloblastic anemia?

A

-dyspnea
-jaundice
-fatigue
-neurological issues

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30
Q

What population is vitamin b12 deficiency common among?

A

vegans

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31
Q

What is the most common symptom of vitamin b12 deficiency?

A

neurological problems/disorders

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32
Q

What are some causes of a folic acid deficiency?

A

Alcoholism, oral contraceptives, meds that act as a folic acid antagonist, low dietary intake, old age, pregnancy

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33
Q

___ ____ conditions are when the erythrocytes have shortened lifespan, therefore their number in circulation is reduced.

A

hemolytic anemias

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34
Q

What will be released into systemic circulation in a patient with hemolytic anemia?

A

reticulocytes (immature RBCs)

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35
Q

What are the different types of hemolytic anemias?

A

-sickle cell disease
-thalassemia
-glucose 6 phosphate dehydrogenase deficiency

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36
Q

___ ___ ____ is an inherited condition that results in oddly shaped erythrocytes that can adhere to the wall of small vessels causing a thrombus and tissue ischemia.
*More common among African Americans

A

sickle cell disease

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37
Q

What is the inherited gene that causes sickle cell disease?

A

HbS gene

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38
Q

Sickle-shaped cells has a ____ lifespan, resulting in anemia.

A

shortened

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39
Q

What assessments should be done on a patient with sickle cell disease?

A

health hx
physical exam
pain assessment
labs
S/S
sickle cell crisis assessment
blood loss (period, GI)
Cardiovascular assessment
neuro assessment

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40
Q

Symptoms will vary in sickle cell disease based on the amount of ___ ____.

A

HbS gene

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41
Q

What are the clinical manifestations of sickle cell disease?

A

primary symptom is pain due to ischemic tissue, anemia, fever, swelling, tenderness, hypertension, tachycardia, N/V, ulcerations of lower legs

42
Q

What usually triggers a sickling episode?

A

low O2 tension in the blood

43
Q

____ is the most common precipitating factor of a sickling episode.

A

infection

44
Q

Initially, sickling is reversible with ______.

A

re-oxygenation

45
Q

_____ ____ is extremely painful and caused by sickle cells getting trapped in small vessels preventing blood flow.

A

Vaso-occlusive crisis

46
Q

____ ___ is caused by infection from HPV.
*hemoglobin fail rapidly and bone marrow cannot compensate

A

Aplastic crisis

47
Q

____ ___ happens when organs pool sickled cells.
*commonly seen in spleen, liver, and lungs

A

Sequestration crisis

48
Q

What are potential complications of sickle cell disease?

A

hypoxia, ischemia, infection, dehydration, CVA, anemia, kidney disease, heart failure, impotence, substance abuse, acute chest syndrome

49
Q

___ ____ ___ is a term used to convert conditions characterized by chest pain, cough, fever, hypoxia, and lung infiltrates.

A

Acute chest syndrome

50
Q

What is the main cause of death in young adults with sickle cell disease?

A

Thromboembolism

51
Q

What is the only chemotherapy agent that is FDA approved to treat a sickle cell crisis?

A

Hydroxyurea

52
Q

Management of sickle cell disease:
____ used for hypoxia
____ used for dehydration

A

oxygen
IV fluids

53
Q

____ ____ ____ ___ may CURE disease.
BUT
there is a small donor pool and failure a risk in its with preexisting organ damage

A

Hematopoietic stem cell transplant

54
Q

What is polycythemia?

A

increased volume of RBCs

55
Q

___ ___ is caused by a congenital gene mutation.

A

Primary polycythemia

56
Q

____ ____ is caused by an excessive production of erythropoietin from reduced amounts of oxygen, cyanotic heart disease, non-pathologic conditions or neoplasms

A

secondary polycythemia

57
Q

What is the medical management of polycythemia?

A

**treatment NOT NEEDED if condition is mild
treat underlying cause
therapeutic phlebotomy

58
Q

In order to be diagnosed with polycythemia, a females hematocrit must be ___, and male ____.

A

50%
55%
**dehydration is NOT A CAUSE

59
Q

___ ____ ____ is a calculation of the total number of circulating neutrophils.

A

absolute neutrophil count

60
Q

___ is uncontrolled proliferation of WBCs, often immature

A

Leukemia

61
Q

___ is lower than normal number of neutrophils. (<2000/mm3)

A

neutropenia

62
Q

____ is a lower than normal platelet count.

A

thrombocytopenia

63
Q

____ is an abnormal decrease in WBCs, RBCs, and platelets

A

Pancytopenia

64
Q

____ is a lymphocyte count less than 1500/mm3.

A

Lymphopenia

65
Q

___ is a higher than normal platelet count.

A

thrombocytosis

66
Q

___ is tiny capillary hemorrhages.

A

Petechiae

67
Q

TRUE or FALSE.
A patient with neutropenia will have clinical manifestations before they develop an infection.

A

FALSE
they DO NOT have S/S until infection has developed

68
Q

What type of patient is at an increased risk for infection and needs to be monitored closely?

A

Neutropenic

69
Q

What are some causes of lymphopenia?

A

-exposure to radiation
-long-term use of corticosteroids
-infections
-neoplasms
-alcohol abuse

70
Q

Most blood coagulation factors are synthesized in the ____.

A

liver

71
Q

___ liver disease and ___ can negatively impact clotting.

A

Alcoholic
Hepatitis

72
Q

_____ is a fat-soluble vitamin that effect production of clotting factors in the liver.

A

Vitamin K

73
Q

What kind of foods are rich in vitamin K?

A

Leafy greens, broccoli, soybeans, pumpkin, smaller amounts of meats and cheese.

74
Q

Who is more likely to be deficient in vitamin K?

A

pts who had bariatric surgery, bowel diseases, or malabsorption disorders

75
Q

What mediations impact clotting factors?

A

Coumadin (warfarin)
heparin

76
Q

What is a normal platelet count?

A

140,000-400,000

77
Q

___ ___ is failure of hemostatic mechanisms, blood cannot clot properly.

A

bleeding disorders

78
Q

What are some common causes of bleeding disorders?

A

trauma, platelet abnormality, coagulation factor abnormality

79
Q

What is medical management of bleeding disorders?

A

specific blood products

80
Q

What is nursing management of bleeding disorders?

A

limit injury, asses for bleeding, bleeding precautions

81
Q

What are some common bleeding disorders?

A

-secondary thrombocytosis
-thrombocytopenia
-immune thrombocytopenia purpura
-platelet defects
-hemophillia
-von willebrand disease

82
Q

What are clinical manifestations of thrombocytopenia?

A

**usually DO NOT occur until count <50,00
petechiae, nosebleeds, bleeding gums, excessive menstrual flow, surgery, hemorrhage

83
Q

What is the treatment for thrombocytopenia?

A

*treat underlying cause
corticosteroids, platelet transfusion, IVIG

84
Q

True or False.
A patient with thrombocytopenia should notify provider or dentist prior to any procedures or taking any new meds

A

TRUE

85
Q

Nurses should ensure they do patient teaching concerning ___ ___ to a patient with thrombocytopenia.

A

Bleeding precautions

86
Q

_____ ___ is caused by a genetic defect making person deficient in clotting factor VIII. Most common effects 1 in 5000 births.

A

Hemophilia A

87
Q

____ __ is a genetic defect that makes person deficient in clotting factor IX. Most commonly effects males and occurs in all ethnic groups.

A

Hemophilia B

88
Q

TRUE OR FALSE.
75% of all bleeding In hemophilia patients occurs in joints. Commonly affected are knees, ankles, shoulders, wrists, and hips.

A

TRUE

89
Q

What is the most common sign of hemophilia?

A

BLEEDING, anytime and anywhere

90
Q

Medical management of hemophilia consists of?

A

transfusion of factor VIII and IX concentrates or FFP

91
Q

What is nursing management for a patient with hemophilia?

A

education, avoid using aspirin and NSAIDS, don’t take warm baths, encourage excellent oral hygiene

92
Q

What are some acquired coagulation disorders?

A

liver disease, vitamin K deficiency, DIC, thrombotic disorders, hyperhomocysteinemia, antithrombin deficiency, protein C & S deficiency, thrombophilia

93
Q

DIC is NOT a ____ but a sign of an underlying disorder.

A

disease

94
Q

What are triggers of DIC?

A

sepsis, trauma, shock, cancer, abruption placentae, toxins, allergic reactions

95
Q

What is the treatment for DIC?

A

**treat underlying cause
correct tissue ischemia
replace fluids and electrolytes
maintain BP
replace coagulation factors
use heparin or LMWH

96
Q

What are potential nursing diagnoses for a patient with DIC?

A

fluid volume deficiency, impaired skin integrity, imbalanced fluid volume, ineffective tissue perfusion, risk for injury, death anxiety

97
Q

What are some potential complications of DIC?

A

-kidney injury
-gangrene
-pulmonary embolism or hemorrhage
-acute respiratory distress syndrome
-stroke

98
Q

TRUE OR FALSE.
In a patient with DIC, the nurse should avoid trauma and procedures that increase risk fo bleeding, including activities that would increase ICP.

A

TRUE

99
Q

What is the anecdote to heparin?

A

Protamine sulfate

100
Q

What is the anecdote to Warfarin?

A

Vitamin K

MS exam 3 (3 decks)

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