Exam 3 Flashcards
Buerger’s Disease
A disease that causes obstruction of the blood vessels of the hands and feet. Caused by vasculitis or inflammation of the blood vessels. Inflammation is irritation with presence of extra immune cells. Blood flow to the hands and feet can become completely blocked and cause tissue damage and lead to gangrene. Worse at night, causes ischemia (restriction of blood supply in tissues) and fibrosis (thickening or scarring of tissues) of vessels in extremities with increased sensitivity to cold; cause unknown but is associated with smoking.
Raynaud’s Disease
A general term to describe a condition in which there is an increased or unusual sensitivity to cold or emotional factors, occurring primarily in the hands. Occurs between ages 17 and 50. Painful vasospasms of arteries and arterioles in extremities, especially digits, causes red-white-blue skin color changes on exposure to cold or stress.
Lymphatic Nodes
Filter debris from the lymph and produces lymphocytes
Lymphedema
Accumulation of lymph in soft tissue
Lymphangitis/Lymphadentitis
Inflammation of lymphatic channels that usually result from acute staph or strep infection in an extremity. Symptoms: generalized edema, systemic infection, fever, chills, localized pain. Treatment: PCN, warm soak.
Varicose veins
distended protruding veins that appear darkened and torturous
Thrombophlebitis
refers to a thrombus that is associated with inflammation
- occurs in deep veins of the lower extremities
Chronic venous insufficency
the result of prolonged venous hypertension that stretches the veins and damages the valves
Venous stasis ulcers
results in people with long-term venous insufficiency which causes edema or minor injury to a limb
- occurs over the malleolus, inner and outer ankle
Thrombocytopenia
low (reduction) blood platelet count
Anemia
- RBC, Hemoglobin, and hematocrit levels below normal
- May be see decreased serum iron, decreased total iron binding capacity and serum ferritin.
- Insufficient oxygen supply to tissues
Symptoms of Anemia
Results from decreased oxygen carrying capacity
- Fatigue
- Pallor
- Dyspnea-short of breath
- Tachycardia
- Vertigo-dizzy
- Headache
- Cardiac dilation
- Disorientation
Hypovalemic Anemia-Early Signs
“Blood loss anemia”
- Anemia secondary to hemorrhage or blood loss
- Decreased blood volume
- Decreased amount of oxygen to tissues
- Usually due to an acute blood loss
- May see symptoms of hypovolemic shock
- Urine output decreases
Treatment Hypovolemic Anemia
- First priority is control bleeding
- Treat for shock
- Replace lost fluid volume
- Administer oxygen to correct hypoxemia
- Change position-lay them down and elevate legs
Pernicious Anemia
*Absence of intrinsic factor secreted by gastric mucosa
*Without the intrinsic factor, cannot absorb vitamin B12
It is a megaloblastic anemia-large red blood cells
Pernicious Anemia (Etiology)
- Elderly- gastric mucosal atrophy-cells become smaller
- Autoimmune Component-body is fighting
- Gastric surgery/gastrectomy
- Malabsorption
Treatment for Aplastic Anemia
- Find and treat underlying cause
- Platelet transfusions (HLA matched)
- Avoid all blood transfusions if possible to minimize risk of tissue rejection*
- Prepare for possible bone marrow transplant
- If untreated, aplastic anemia is fatal 75% of the time
Types of hemophilia
- A: (classic) deficiency of factor VIII and accounts for 80% of hemophilia cases
- B: (christmas disease) deficiency of factor IX and accounts for 20% of cases
Symptoms of Pernicious Anemia
- Red, swollen, sore tongue
- Impaired position sense (proprioception)
- Numbness and tingling of hands and feet (paresthesia)
- Disorientation
Treatment for Pernicious Anemia
- Monthly B12 injections for life
* If severe, may also require blood transfusions, folic acid supplements, and iron
Aplastic Anemia
- condition of decreased bone marrow function
* results in decreased erythrocytes, leukopenia, thrombocytopenia, pantocytopenia (all 3 blood elements reduced)
Aplastic Anemia Etiology
- Congenital
- Autoimmune
- Viral
- Medications
- Chemicals-arsenic, benzene, alcohol, insecticides
- Radiation
- Chemotherapy-kills all rapidly increasing cells
Treatment for Aplastic Anemia
- Find and treat underlying cause
- Platelet transfusions (HLA matched)
- Avoid all blood transfusions if possible to minimize risk of tissue rejection*
- Prepare for possible bone marrow transplant
Iron Deficiency Anemia
RBCs contain decreased concentration of hemoglobin
Possible causes:
*Acute or chronic blood loss (menstrual bleeding or GI bleeding)
*Poor iron absorption from GI tract
*Poor dietary iron intake
*alcoholism
Symptoms of iron deficiency
- Pallor
- Glossitis-tongue is red, smooth, painful
- Fatigue
- Weakness
- Shortness of breath
- spoon shaped fingernails
- tachycardia
Diagnostic findings with Iron deficiency anemia
- Low serum iron
- decreased RBC count
- decreased hemoglobin
- decreased hematocrit
Treatment for iron deficiency
Oral iron-Ferrous sulfate
- Administered in 5 daily doses
- OJ enhances absorption of iron
- May cause abdominal discomfort and constipation
- Use z-tract method-seals medication in to muscle
- Use colase-stool softener
Thalassemia
Inherited blood disorder where the body produces an inadequate amount of hemoglobin(rbc that carries oxygen)
Hemophilia A
affects mostly males
S & S of hemophilia
- abnormal bleeding
- excessive bleeding
- Bruising easily
- joint and muscle hemorrhages
Sickle Cell Anemia
- Most common genetic disorder in US
- Most predominant in African-American
- Recessive gene
- If heterozygous for gene, results in sickle cell trait
- Development of abnormal hemoglobin S in place of normal hemoglobin A
- Hemoglobin becomes crescent or sickle shaped when person is deprived of oxygen.
- Red blood cells clump and are trapped in small vessels causing PAIN
- Blood circulation is viscous and sluggish
- Abnormal cells recognized and hemolyzed
- Spleen functions to remove the RBC debris from circulation
Sickle Cell Crisis
Happens due to:
- Increased sickling and deoxygenation
- Sickled cell clog small capillaries
- Local hypoxia, thrombosis
- Occurs due to anything causing hypoxia!! (dehydration, infections, altitudes, emotional/physical stress)
SYMPTOMS of CRISIS:
- Jaundice from excessive hemolysis (cell burst-breakdown of RBCs)
- Splenic enlargement
- Pain in various parts of the body
- Fatigue
Nursing interventions for Sickle Cell Crisis
- Bedrest
- Hydration to thin blood
- Blood transfusions
- Analgesics
- Drug-Hydroxyurea-increases fetal hemoglobin levels and reduce hemolysis
Polycythemia Vera
Abnormal increase in the circulating number of red blood cells.
- Blood is vicous
- RBC, Hemoglobin, and hematocrit counts are elevated
Two Types:
Primary-all bone marrow elements are increased
Secondary-due to hypoxia; only RBCs are increased
Treatment:
- Adequate oxygenation to prevent hypoxia.
- Repeated phlebotomy to decrease blood viscosity
- Myelosuppressive agents to slow bone marrow production
