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Respiratory semester 3 > exam 2 > Flashcards

exam 2 Flashcards

1
Q

causes of thrombocytopenia

A

Commonly from ingestion of high doses of certain drugs
Autoimmune diseases
Increased platelet consumption Splenomegaly
Bone marrow suppression/failure
can be caused from heparin , quinine, sulfa abx

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2
Q

Diagnostic studies for COPD

A

H&P, spirometry, CXR, 6-min walk test, COPD assessment test, Clinical COPD questionnaire, ABGs

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3
Q

what is neutropenia

A

ANC < 1000
severe neutropenia <500
Patient has little or no ability to fight infection

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4
Q

moderate anemia

A

Hgb: 6-10
Cardiopulmonary s/sx at rest

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5
Q

what is sickle cell anemia

A

autosomal recessive disorder
abnormal hgb = Hgb S
Hgb S causes erythrocyte to stiffen and elongate taking on sickle shape in response to low O2 levels

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6
Q

Thrombocytopenia diagnostics

A

↓ Platelet count
Prolonged bleeding < 50,000
Hemorrhage < 20,000
Peripheral blood smear
Medical history
Clinical examination
Lab parameter comparisons
increased LDH
PT, INR

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7
Q

An autosomal recessive, disorder
altered transport of sodium and chloride ions in and out of epithelial cells
Affects primarily lungs, skin, GI tract (pancreas/biliary tract) , repro tract.

A

Cystic fibrosis

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8
Q

what is Hodgkins lymphoma

A

malignant neoplasm that originates in bone marrow , goes to lymphatic structures resulting in proliferation of lymphocytes

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9
Q

what does a peripheral blood smear show in sickle cell disease

A

may reveal sickled cells and increased abnormal reticulocytes

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10
Q

iron rich foods

A

liver, dried fruits, legumes, dark greens, whole grains, beans, cereals

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11
Q

acute asthma exacerbation symptoms

A

tripod position, prominent wheezing, RR >30, pulse > 120, accessory muscles to the neck, agitation

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12
Q

What education should be provided for patients with sickle cell disease

A
  1. Avoiding exposure to crowds to prevent infection
  2. severe exercise could cause hypoxia and causes changes in permeability
  3. Remove any constrictive clothes
  4. avoid anything that can trigger crisis
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13
Q

symptoms of DIC

A

bleeding from venipuncture sites, hemoptysis, hypotension, tachycardia, bloody stools, hematuria

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14
Q

shape of RBCs in sickle cell

A

rigid, elongated, crescent shape

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15
Q

asthma drug triggers

A

beta blockers: propranolol, metoprolol, timolol
Ace inhibitors: lisinopril, trigger dry cough

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16
Q

How is sickle cell disease diagnosed

A

Peripheral blood smear
Sickling test
Electrophoresis of hemoglobin
Skeletal x-rays
Magnetic resonance imaging (MRI)
Doppler studies
X-rays

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17
Q

Defective DNA synthesis in RBCs

A

Megaloblastic Anemia

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18
Q

progressive disease associated with an enhanced chronic inflammatory response in the airways and lungs, primarily caused by cigarette smoking that results in persistent airflow limitation. .

A

COPD

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19
Q

PEFR yellow zone

A

50-80% of personal best
indicates caution, something triggering asthma

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20
Q

asthma exacerbation assessment

A

RR/HR, accessory muscle use, lung auscultation, PEFR to monitor airflow obstruction, pulse ox, ABGs

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21
Q

purpose of peak expiratory flow rate

A

measures the maximum speed of expiration, can help predict an asthma attack or monitor severity of disease, measures degree of obstruction

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22
Q

stages of Hodgkins lymphoma

A

Stage 1 is one lymphnodes
2 – is two or more
3 – lymph nodes affected above and below diaphragm
4 – even on sides of diaphragm

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23
Q

COPD patho

A

Chronic inflammation of airways, lung parenchyma (bronchioles and alveoli), and pulmonary blood vessels
Airflow limitation, air trapping, gas exchange is abnormal, mucous hypersecretion

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24
Q

mild anemia

A

Hgb: 10-12
Palpitations, dypnea, fatigue

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25
Q

3rd leading cause of death in US

A

COPD

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26
Q

what other symptoms accompany pain during sickle cell crisis

A

Fever , swelling , tenderness, tachypnea, HTN, N/V

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27
Q

severe anemia

A

Hgb: <6
Pallor, Jaundice, Pruritus
Elevated HR, systolic murmurs, angina pectoris, MI, HF, cardiomegaly, congestion, ascites, edema

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28
Q

Peak flow results: green zone

A

80-100% , remain on meds

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29
Q

what is polycythemia

A

increased number of RBCs, causes hyperviscosity and hypervolemia

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30
Q

Diminished availability of erythrocyte precursors

A

Aplastic Anemia

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31
Q

what is an immunologic transfusion reaction

A

reaction when donor blood and recipient blood weren’t compatible

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32
Q

drug/food additive triggers of asthma

A

aspirin, NSAIDs, salicylic acid,

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33
Q

chronic long-term condition, intermittent inflammation that narrows airways in lungs, causes limitations of bronchiole responsiveness

A

asthma

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34
Q

abnormal lymph node assessment

A

tender = inflammation
enlarged > 1 cm
hard/fixed = malignancy

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35
Q

what meds can be used to treat neutropenia

A

Neupogen and filgastrim

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36
Q

Treatment for DIC

A

stabilize pt, oxygen, volume replacement , control bleeding, might need blood, vitamin k

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37
Q

COPD symptoms

A

chronic intermittent cough/sputum production
dyspnea
difficulty breathing
wheezing/chest tightness
underweight with anorexia
chronic fatigue
paroxysmal nocturnal dyspnea

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38
Q

How is polycythemia diagnosed

A

lab and bone marrow aspiration

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39
Q

Inadequate production of Hgb.
Autosomal recessive genetic disorder

A

Thalassemia

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40
Q

what is thrombocytopenia

A

reduction of platelets < 100, results in prolonged or spontaneous bleeding

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41
Q

COPD risk factors

A

Cigarette smoking
occupation chemicals and dusts
air pollution
infection
genetics
aging
asthma
gender

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42
Q

mild allergic transfusion reaction

A

hives
pruritis
facial flushing

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43
Q

Symptoms of Cobalamin deficiency (pernicious anemia)

A

palpations
fatigue
dyspnea
pallor
sore red, beefy, shiny tongue
anorexia
N/V
abdominal pain
weakness, paresthesias
decreased senses
ataxia, muscle weakness
impaire thoughts

44
Q

Treatment of pernicious anemia

A

parenteral or intranasal admin of cobalamin
most common is 1000 mg of B12 IM , everyday for 2 weeks, then once a week until Hgb is normal , then once a month for life

45
Q

management o f neutropenia

A

Put pt in isolation to protect pt.
remove fresh plants
monitor labs
any s/s of infection (fever = early sign)
keep eye on IV for infection
teach personal hygiene
instruct to take all meds especially antibiotics
check temp q4h

46
Q

what is an acute transfusion reaction

A

reaction occurs during the transfusion

47
Q

extra info about Hodgkins lymphoma

A

If begins above diaphragm,it will have slow progress, if below diaphragm itll spread quick
A is for pts with no symptoms
B is for pts with symptoms

48
Q

causes of aplastic anemia

A

can be autoimmune but also caused by alcohol , radiation, viral or bacterial infection

49
Q

symptoms of Hodgkins lymphoma

A

Enlargement of cervical, axillary, or inguinal lymph nodes, mediastinal nodes
Painless unless: Exert pressure on nerves, Alcohol

50
Q

what is aplastic anemia (idiopathic)

A

pancytopenia with hypo cellular bone marrow
low bc, low rbc, low platelets

51
Q

triggers of sickle cell

A

low o2 in blood
hypoxia or low oxygen in blood can be cause by infection, high altitude , stress, surgery, blood loss, dehydration, acidosis, lowered body temp

52
Q

thalassemia major treatment

A

blood transfusions with chelating agents
meds
splenectomy
monitor hepatic, cardiac, pulmonary function
hematopoietic stem cell transplant

53
Q

asthma triad

A

nasal polyps, asthma, sensitivity to aspirin and NSAIDs

54
Q

anemia due to Decreased Hgb synthesis

A

Iron-Deficiency Anemia
Thalassemia

55
Q

how does aging cause COPD

A

lung loses recoil or stiffness of chest wall causing alteration in gas exchange, lungs become rounder and smaller, decreased number of alveoli and happens due to loss of tissue in airway

56
Q

what causes polycythemia

A

due to gene mutation but not inherited
can be caused by radiation or exposure to toxic substances

57
Q

what causes an increase in Hgb

A

polycythemia and dehydration

58
Q

What is DIC

A

Serious bleeding and thrombotic disorder that results from abnormally initiated and accelerated clotting
DIC is not a disease, abnormal response of normal clotting cascade caused by a disease process or disorder

59
Q

COPD patient presentation

A

prolonged expiratory phase
wheezes
decreased breath sounds
barrel chest
tripod position
pursed lip breathing

60
Q

Megaloblastic anemias

A

folic acid and cobalamin (vitamin b12) anemias

61
Q

asthma risk factors

A

genetic factors
environmental factors
male gender before puberty
obesity

62
Q

Late COPD manifestations?

A

polycythemia and cyanosis
hypoxemia
increased production of RBCs
bluish-red color of skin
Hgb concentration may reach 20 g/dL or more

63
Q

hemolytic transfusion reaction

A

low back pain
hypotension
tachycardia
fever and chills
chest pain
tachypnea
hemoglobinuria

64
Q

causes of pernicious anemia

A

absence of intrinsic factor
GI surgery (small bowel resection )
chronic GI disease (celiac or crohns)
excessive alcohol or hot tea ingestion (decreases acidity)
smoking
long term use of H2 blockers and PPIs
strict vegetarians

65
Q

Treatment for transfusion reactions

A

antihistamines
antipyretics
stop transfusion
keep iv line open with normal salin e
monitor VS q15 min
post transfusion blood sample
treat s/sx

66
Q

symptoms of aplastic anemia

A

fatigue
dypsnea
will have neutropenia (infection risk)
will have thrombocytopenia (bleeding risk)

67
Q

the presence of cough and sputum production for at least 3 months in each of 2 consecutive years, is an independent disease that may precede or follow the development of airflow limitation.

A

Chronic Bronchitis

68
Q

why are iron and TIBC elevated in aplastic anemia

A

iron is floating in blood

69
Q

asthma diagnostic studies

A

history and physical, spirometry, peak expiratory flow rate, chest x-ray, oximetry, allergy testing, blood levels of eosinophils

70
Q

Symptoms of polycythemia

A

headache, vertigo, dizziness, tinnitus, visual disturbances, pruritis, paresthesias, erythromyalgia, angina, intermittent claudication , thrombophlebitis

71
Q

cystic fibrosis treatment

A

antibiotics for infections
pulmozyme, inhaled hypertonic saline, and CPT to clear secretions
digestive enzymes replacement to provide adequate nutrition
high calorie, high fat, high protein diet
supplemental fat soluble vitamins (A, d, e, K)

72
Q

what causes pain in sickle cell

A

pain from vessel occlusion (tissue ischemia)
RBCs have hard time passing cuz of shape

73
Q

what is a delayed transfusion reaction

A

reaction can happen days or weeks after transfusion

74
Q

symptoms of salicylic/NSAID use

A

wheezing in 2 hrs, rhinorrhea, congestion, tearing, angioedema

75
Q

treatment of intermittent and persistent asthma

A

avoid triggers of acute attacks
pre-mediate befor exercising
short medication (rescue med)
long term or controller med

76
Q

Iron deficiency Anemia: S/sx

A

pallor
glossitis
cheilitis
headache
paresthesias
burning sensation

77
Q

Cystic fibrosis symptoms

A

fatigue
chronic cough w/ thick/sticky mucus
recurrent URIs
chronic hypoxia
clubbing, barrel chest
decreased absorption of vitamins and enzymes
abdominal distention
decreased digestive enzymes
greasy, smelly stools (steatorrhea)
meconium ileus in newborn
rectal prolapse

78
Q

How does electrophoresis of hgb diagnose sickle cell disease

A

determines amount of hgb s and scd from other variants

79
Q

what does a “shift to the left” indicate

A

bone marrow releases more immature neutrophils during an infection when the body cannot keep up with WBC production , levels being to normalize when infection is gettin better or body can keep up

80
Q

what are indications for a bone marrow biopsy

A

Used to diagnose disease
determine stage of progression of disease
check iron levels
monitor treatment of disease
check for anemia
check for cancer such as leukemia, lymphoma, multiple myeloma
sometimes to investigate fevers

81
Q

symptoms of thrombocytopenia

A

Patients are often asymptomatic
Mucosal bleeding (nose or gingival bleeding)
Petechiae
Purpura
Ecchymoses
heavy menstrual flow in women
LOC changes
internal bleeding signs

82
Q

asthma symptoms

A

prolonged expiration, expiratory wheezing, air trapping, lung hyperinflation, chest tightness, dyspnea, cough, accessory muscle use

83
Q

spirometry use

A

assess lung function, measures how much air pt can inhale/exhale, diagnoses asthma and COPD, can be used to monitor treatment for chronic lung disease

84
Q

Nursing interventions for bone marrow biopsy

A

apply pressure with sterile dressing
assess for bleeding and lay on site for 30-60 min
monitor VS
educate that area will be sore for 3 days

85
Q

anaphylactic transfusion reaction

A

SOB
bronchospasm
anxiety
hives
pruritis

86
Q

diagnosis of Hodgkins lymphoma

A

Peripheral blood analysis
CBC abnormalities are variable and not diagnostic
Excisional lymph node biopsy
Bone marrow examination
Radiologic evaluation

87
Q

Thalassemia major

A

Thalassemia major = life threatening
Physical and mental delay
Jaundice
Splenomegaly
Hepatomegaly
Cardiomyopathy
Bone marrow hyperplasia

88
Q

Treatment of thrombocytopenia

A

Prevent or control hemorrhage
Any bleeding needs evaluation and treatment
Watch for bleeding that can be difficult to detect
Avoid IM injections
Closely monitor platelet count, coagulation studies, Hgb, and Hct
Platelet Transfusions
Manage blood loss from excessive menstrual bleeding
Avoid SQ injections if possible , apply pressure and ice packs right after if given
soft toothbrush

89
Q

febrile reaction symptoms

A

chills
fever
headache
flushing
tachycardia
anxiety

90
Q

asthma triggers

A

cockroaches, furry animals, fungi, pollen, molds, cigarette or wood smoke, vehicle exhaust, concentrated pollution, physical exertion

91
Q

why are fluids given during a sickle cell crisis

A

to reduce blood viscosity and prevent dehydration , maintain kidney function

92
Q

Symptoms of sickle cell disease

A

asymptomatic except during sicking episodes

Symptoms:
pain from tissue hypoxia and damage
pallor of mucus membranes
jaundice from hemolysis
prone to gallstones
skin may have gray cast

93
Q

systematic symptoms of lymphoma

A

Weight loss, fatigue/weakness, fever/chills, tachycardia, night sweats, itching

Advanced pts: hepatomegaly, splenomegaly, anemia

94
Q

how do you treat an exacerbation of polycythemia

A

aspirin, ambulation, lukewarm bath

95
Q

which pts may have high risk of acquiring DIC

A

pts with sepsis, notify HCP if septic and starts bleeding

96
Q

complications of polycythemia

A

scurrying of bone marrow cuz it is overworked and can lead to leukemia, feeling full due to splenomegaly, splenectomy may be needed

97
Q

COPD treatment

A

smoking cessation
evaluate for environmental or occupational irritants
breathing retraining (pursed lip, diaphragmatic breathing)
airway clearance
CPT
vaccines
drug therapy similar to asthma

98
Q

what is nonimmunologic reaction

A

due to blood being damaged during transportation

99
Q

what is included in a CBC with differential

A

Neutrophils, lymphocytes, eosinophils, basophils, monocytes

100
Q

what is the treatment for polycythemia

A

reduce blood volume and viscosity by removing blood through phlebotomy

101
Q

causes of Hodgkins lymphoma

A

Epstein Barr Virus (EPV)
Genetic predisposition,
Occupational toxins
HIV

102
Q

treatment of aplastic anemia

A

hematopoietic stem cell transplant and immunosuppressive therapy with cyclosporine

will have ongoing blood transfusion , iron binding agent to prevent iron overload

103
Q

iron deficiency anemia diagnostics

A

CBC
Low Hgb/Hct
Low serum iron
High TIBC
Low ferritin
Stool Occult blood test
Endoscopy/Colonoscopy
Bone Marrow Biopsy

104
Q

the destruction of the alveoli and is a pathologic term that explains only one of several structural abnormalities in COPD patients

A

emphysema

105
Q

diagnosis of aplastic anemia

A

Low Hgb, WBC, and platelet values
Low reticulocyte count
Elevated serum iron and TIBC
Hypocellular bone marrow with increased fat content (yellow marrow)

106
Q

PEFR red zone

A

50% or less of personal best
indicates serious problem, action must be taken with HCP

107
Q

Normal lymph node assessment

A

not palpable, < 1 cm, firm, contender

Respiratory semester 3 (2 decks)

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