Exam 6 Flashcards
Thalassemia treatment:
Blood transfusion
Which anemia is associated with macrocyclic and misshapen RBCs w/ thin membranes?
Vitamin B 12 deficiency
Snape of RBCs with iron deficiency anemia?
Misshapen and pale
Manifestations of Vit B 12 deficiency?
Pallor Jaundice Weakness Beef, smooth red tongue Paresthesias
Polycythemia
Abnormally high RBC count
Who is at high risk for developing vitamin B12 deficiency
Strict vegans
High risk for aplastic anemia?
Farmers with regular exposure to pesticides
Bronze colored skin is associated with which type of anemia?
Thalassemia
Aplastic anemia treatment
Stem cell transplant
Requires blood transfusion for life is associated with which type of anemia?
Thalassemia
Ferrous Sulfate:
Dosage
Side effects
Teaching
Daily dose of 150-200 mg
Constipation, dark stools, stains teeth
Acidic environment, no milk or antacids, calcium
Iv drug name for Iron
Iron dextran (INFed)
Aplastic anemia clinical therapies:
Blood transfusion
Bone marrow transplant
Thrombocytopenia:
Decreased platelet count, less than 100000
Danger of spontaneous hemorrhage
Leukemia:
Chronic malignant disorders of WBCs
Decreased WBC count
Thalassemia clinical therapies:
Regular blood transfusions
Folic acid supplementation
Possible splenectomy
Genetic counseling
Sickle cell crisis clinical therapies:
Rest Oxygen Narcotic analgesia Hydration Treatment of precipitating factors
Priority for anemia:
Adequate tissue oxygenation
Thrombocytosis:
Danger of excessive clotting
Neutropenic:
Neutrophils less than 1000?
Immature WBCs
Leukopenia:
WBC count less than 4000
G-6PD caused by:
Hereditary defect in RBC metabolism
What occurs in aplastic anemia?
Bone marrow fails to produce all 3 types of blood cells
Pancytopenia
Pancytopenia:
Decrease in all three (WBC count, RBC count, and platelets)
What causes aplastic anemia?
Most cases are unknown
Toxins
Radiation
Infection
G6PD affects which gender more often?
Men due to being located on the X chromosome
What can trigger G6PD?
Stressors
Hemolytic Anemia is characterized by?
Premature destruction (lysis) of RBCs
Folic Acid deficiency anemia manifestation
Pallor
Progressive weakness and fatigue
SON, palpitations
Glossitis, cheilosis, diarrhea
Folic Acid Deficiency is common in who:
Older adults
Patients with TPN
Alcohol or drug addicts
Where is Vitamin B12 absorbed
Ileum
Dietary deficiency of Vit B12 commonly occur among who?
Strict vegans
Pernicious anemia is the lack of what?
Lack of the intrinsic factor
Vit B12 is found in what types of food:
Those derived from animals
Cheilosis:
Cracks on the lips and at the corners of the mouth
Chronic iron deficiency can lead to:
Brittle, spoon shaped nails
Cheilosis
Smooth sore tongue
Pica
Erythopoiesis means:
RBC development (in bone marrow)
Hypochromic:
RBCs are pale
Micro trim:
Small RBCs
Microcytic RBCs associated with:
Thalassemia
Iron def. anemia
Macrocyclic RBCs are associated with:
Vit B12 or folate def.
Liver disease
Chemo
Hypochromic:
Pale RBCs
Seizures:
Periods of abnormal electrical discharges in the brain that may cause involuntary movement and or behavior and sensory alterations
Epilepsy:
When seizure activity becomes chronic with recurrent episodes secondary to a CNS disorder
Focal seizures:
When abnormal electrical activity is contained to a limited/specific area of the brain
Normally one side of the brain
Focal seizures (AKA)
Partial seizures
Types of focal seizures
Focal aware
Focal impaired
Focal aware seizures:
Do not affect memory or awareness
Focal impaired seizures:
Can affect behavior, awareness, or memory before, during, or after the seizure episode
Generalized seizures:
Both hemispheres of the brain
Focal seizures can sometimes turn into ____ seizures
Generalized
Generalized seizures may also manifest as what:
Blank stares
Brief muscle twitches
Muscle stiffening
Clinic phase:
Alternating muscle contraction and relaxation
Postictal period:
Following the seizure activity
Aura:
Early sign of seizure
Diagnostic test of seizures
CBC Blood chemistry Urine culture Lumbar puncture Serum drug level EEG Lead level Toxicology screening CT MRI Angiography
Intractable seizures:
Those that cannot be controlled
Status Epilepticus:
Continuous seizure that last for more than 30 minutes or a seizure during which time of consciousness is not regained
What can be admin. To prevent hypoglycemia:
50% dextrose
What can be admin to stop seizure activity
Diazepam
Lorazepam
What medication is admin IV for longer term control of seizures
Phenytoin
Nursing diagnosis for seizures
Breathing pattern Raise for trauma Chronic low self esteem Impaired verbal communication Acute confusion
Implementation for seizures:
Provide patient safety
Maintain the airway
Support home management
Risk factors for SCD:
Genetics
African Americans
SCD needs inheritance of which two genes
Two Hbs
Priapism:
Painful, prolonged penile erection
SCD: hot or cold compresses
Neither
Sickle cell crisis AKA
Vaso-occlusive crisis
Sickle cell crisis:
Term used to describe the painful periods resulting from ischemia due to vascular occlusion
Most common type of SCD:
Sickle cell anemia
Suckling:
RBCs that are crescent or sickle shaped
Diagnostic Tests for SCD:
Newborn screening Heel sticks Amniocentesis Venous blood sample Ultrasound scanning of head
Surgery for SCD:
Bone marrow transplant
Hematopoietic stem cell transplant
Blood transfusion
Splenectomy
Hydroxyurea:
Decreased production of abnormal blood cells and leads to less amounts of pain being experienced
Hemosiderosis:
Iron stored in tissues and organs
Implementation for SCD:
Oxygenation Circulation Fluid volume balance Manage pain Manage and prevent infection Risk for caregiver role strain
SCD:
Pain is due to
Vascular occlusion by RBCs
SCD
Risk for infection due to
Impaired circulation
SCD
Impaired circulation due to
Impaired flow of suckled RBCs
SCD:
Many children undergo:
Splenectomy
This compromises immunity: risk for infection
Early destruction of RBCs can lead to ____
Anemia
Hydroxyuera side effects:
Bone marrow suppression, headaches, dizziness, and n+v
Complication of multiple blood transfusions:
An overload of iron in the body
Deferoxamine:
Treats iron overload due to multiple blood transfusion
Splenic sequestration:
Life threatening
Yes can cause death within hours
Splenic sequestration:
Manifestations
Shock
Hypovolemia
Profound anemia
Ketogenic diet for seizures:
High fat, low carb, adequate protein
Most common type of seizure:
Tonic clinic
Tonic clonic:
Body stiffens
Cry out
Relaxation then spasm
Lose consciousness
Absence:
Most common in peds Daydreaming Goes unnoticed Won’t respond to you Very very shot...seconds long Won’t remember it
What is the hallmark of absence seizures
Daydreaming
How long do tonic clonic seizures last:
1-3 mins
Which seizures can go unnoticed
Absence
Focal onset aware: (simple partial)
Patient aware Auras Short less than 2 mins Conscious Recurrent muscle contractions
Focal Impaired Awareness:
Unaware
Automations
Temporal lobe location is the most common
Automatism:
Lip smacking, aimless walking, or picking and clothing (unaware while doing this)
Atonic:
W/o muscle tone
Great risk for head injury
Wear a helmet
Not aware during the event
Atonic is at great risk for:
Head injury due to no muscle tone
Medication for status epilepticus:
Diazepam or lorazepam
Phenytoin (Dilantin)
Assess what
Gums for bleeding and increase visits to the dentist
Increase Vit D intake
Can cause gingival hyperplasia
Hyperhemolytic:
Increase death of RBCs
What is often the cause of a crisis:
Hypoxia
Neurtrophenia
WBC is decreased High risk for infection Reverse isolation Carefully monitor temp Restrict ill visitors No plants or flowers Dedicated equipment for the patient only
Patient teaching for neutropenia
Report temp above 100 Above crowds and sick people No raw foods Avoid yard work or gardening Wash dishes in hot water Wash toothbrush in bleach or hot water
Anemia
Decreased RBC counts
Medication of Anemia
Ferrous sulfate
Educate
Intake of B12 and iron
Rest periods
Thrombocytopenia
Decreased platelet count
High risk for bleeding
Monitor for blood
Avoid IV injection
Hold prolonged pressure on area
Teaching for thrombocytopenia
Soft toothbrush Avoid blowing nose Avoid NSAIDs Electric razors Implement safety precautions