Chapter 41 and 42 Hematology Flashcards
Fibrinolytics
Selectively degrade fibrin threads in the formed blood clot
Platelet Inhibitors
prevent platelets from becoming active or activated platelets from clumping together
Anemia
Reduction in RBC’s, hemoglobin, or hematocrit
Sickle cell disease
Genetic
chronic anemia, pain, disability, organ damage, increased risk for infection, and early death
Sickle Cell Disease: Pathophysiology
Formation of abnormal hemoglobin chains
Iron Deficiency Anemia cause
blood loss, poor intestinal absorption, or inadequate diet
Iron Deficiency Anemia sx
weakness and pallor
abnormal bleeding, especially from the GI tract
Causes of Vitamin B12 Deficiency Anemia
small bowel resection, tapeworm, overgrowth of intestinal bacteria
Result of Vitamin B12 Deficiency Anemia
improper DNA synthesis of RBCs.
Pernicious Anemia
failure to absorb vitamin B12
Caused by a deficiency of intrinsic factor
Aplastic Anemia
Deficiency of circulating RBCs
failure of the bone marrow to produce RBC’s
Aplastic Anemia tx
Blood transfusions
Immunosuppressive therapy
Splenectomy
Polycythemia Vera
Cancer of the RBCs
Increase in blood hemoglobin or hematocrit
Over production of red blood cells, leukocytes and platelets
Polycythemia Vera tx
Phlebotomy
Hydration
Anticoagulants
Myelodysplastic Syndromes
caused by the formation of abnormal cells in the bone marrow
Drugs for iron overload
deferasirox and deferoxamine mesylate
Leukemia
of cancer with uncontrolled production of immature white blood cells in the bone marrow
Laboratory assessment of leukemia
Decreased H&H
Low platelets
Abnormal WBC (high)
Hodgkin’s Lymphoma: Interventions
One of the most treatable types of cancer
External radiation
Chemotherapy
Hodgkin’s Lymphoma marker
Reed-Sternberg cell
Spreads to different lymph nodes in an orderly fashion
Hodgkin’s Lymphoma sx
Large, painless lymph node, usually in the neck, becomes painful when alcohol ingested; fever, drenching night sweats, and unexplained weight loss
Non-Hodgkin’s Lymphoma
more than 12 types
do not have Reed-Sternberg cell
Not orderly
Multiple Myeloma
White blood cell cancer that involves a more mature lymphocyte called a plasma cell
Multiple Myeloma interventions
Chemotherapy
Autologous stem cell transplant
Analgesics
Bisphosphonates
Autoimmune Thrombocytopenic Purpura
Total number of circulating platelets is greatly reduced even though production in the bone marrow is normal.
Patients make an antibody directed against the surface of their own platelets.
Autoimmune Thrombocytopenic Purpura drug therapy
corticosteroids, azathioprine, IV immunoglobulin, IV anti-Rho, or low doses of chemotherapy
Platelet transfusions`
Thrombotic Thrombocytopenic Purpura (TTP)
Rare
platelets clump together abnormally in the capillaries, and too few platelets remain in circulation
Thrombotic Thrombocytopenic Purpura (TTP) tx
plasmapheresis, aspirin, alprostadil, plicamycin, and immunosuppressive therapy
Types of Transfusions
Red blood cell Platelet Plasma—fresh frozen plasma Cryoprecipitate Granulocyte (white cell)
Function of albumin in the blood
increases osmotic pressure of the blood, preventing the plasma from leaking into the tissues
Functions of globulins in the blood
transport substances, protect the body from infections, and are the main protein of antibodies
Components of plasma
albumin, globulins, and fibrinogen
RBC’s
Majority of blood cells
4.2-6.1 million
Live 120 days
produce hemoglobin
Function of hemoglobin
carries O2
Needs iron to function
Function of the spleen in blood
balances blood cell production with blood cell destruction and assists with immunity. It destroys old or imperfect RBC’s, breaks down the hemoglobin , stores platelets, and filters antigens
Trigger of blood clotting
formation of a platelet plug
Most common sx of anemia
fatigue
Most common cause of anemia
GI bleed
Sickle cell anemia sx
pain #1 may be asymptomatic Jaundice SOB, fatigue Murmur, poor tissue perfusion tachycardia, priaprism pallor
Labs seen in sickle cell anemia
low hematocrit
high reticulate count (due to release of immature blood cells)
high bilirubin
increased WBC
Sickle cell anemia interventions
pain related to hypoxia to tissues: tx w/ O2 and opioids
hydrate
promote venus return
RBC transfusion
Polycythemia Vera sx
dark flushed skin itching caused by dilated blood vessels and poor tissue perfusion HTN Distended veins sluggish blood flow
Chelation
chemical binding of iron and its removal from the body
Leukemia without tx
PT will die of infection of hemorrhage
Acute leukemia sx
echymosis, petechiae, open infected lesions, pallor, bleding gums, anorexia, weiht loss, enlarged liver and spleen, hematuria, tachycardia, orthostatic hypotension, palpitations, dyspnea on exertion, fatigue, h/a, fever, bone pain, joint swelling and pain
Chronic leukemia sx
murmurs, bruits, slow cap refill, respiratory changes, chronic repeated infections, pallor, coolness of extremities, petechia, easy bleeding, weight loss, nausea, anorexia
Bone marrow transplant
typical tx for luekemia
Graft vs host disease (GVHD)
cells of the donated marrow recognize the patients cells as foreign and start an attack
Drugs are given to suppress the immune function
Oprevlakin (Neumega)
given to leukemia PT’s to induce platelet growth after chemo
Autoimmune Thrombocytopenic Purpura sx
o Ecchymosis, petechial rash on the arms, legs, upper chest, and neck, musosal bleeding, anemia and low H&H if bleeding episodes have happened
Autoimmune Thrombocytopenic Purpura complication
Rare: intracranial bleed-induced stroke
Hemophilia transmission
• X linked recessive trait passed from women to their daughters who will be carriers and to their sons who will have the disease
Hemophilia A
deficiency of factor VIII and accounts for 80% of cases
Hemophilia B
deficiency of factor IX- accounts for 20% of cases
Platelet count to qualify for transfusion
<10,000
