Hematologic and Immune systems Flashcards
Exam 4 (Final)
Human Immunodeficiency Virus Infection:
What is it ?
Impaired cellular immunity is a consequence of AIDS.
Human Immunodeficiency Virus Infection:
What is AIDS caused by?
AIDS is caused by HIV.
Human Immunodeficiency Virus Infection:
What is it defined as?
Now defined as a chronic illness
Human Immunodeficiency Virus Infection
Epidemiology: How many people with 1.2 million? How many people are living with it unaware? What pop is it higher in?
CDC estimated more than 1.2 million people with AIDS.
1 in 7 living with HIV but unaware
Higher in African Americans/Blacks
Higher in men who have sex with men
Stages of HIV Infection
Stage 1: CD4 T-cells count > 500 mcL
Stage 2: CD4: 200-499
Stage 3: AIDS with CD4 < 200 mcL
Stages of HIV Infection
What is management?
Control of opportunistic infection
Antiretroviral therapy
Human Immunodeficiency Virus Infection
Pathogenesis:
CD4 binding site
Anemias:
Broad anemia groups:
Blood loss anemia
Hemolytic anemias
Deficiency anemias
Chronic anemia
Aplastic anemia
Anemias:
Hemolytic anemias include
Congenital hemolytic anemia
Acquired hemolytic anemia
Anemias:
Deficiency anemias include:
Iron deficiency anemia
Megaloblastic anemias
Anemias:
Aplastic anemias: what to know?
bone marrow is generating new cells.. 70% mortality rate w/i one year if not treated w blood transfusions
Anemias Assessment:
What should you assess for?
Assess for blood loss.
Anemias Assessment:
What mind problems to assess?
Weakness, depressed mood, impaired cognitive function, and easy fatigability
Anemias Assessment:
What body problems to assess?
At risk for impaired tissue oxygenation, impaired organ function, impaired susceptibility to thrombocytopenic bleeding, increased risk of postoperative mortality, increased probability of transfusion, and decreased survival
Anemias:
Physical Examination and management
Pallor, tachycardia, hypotension
Splenomegaly, jaundice, and dark urine
Intake and output
Stool guaiac test
Low serum iron
Stool guiac test:
detects hidden blood in stool samples.
bluish color says there is blood
Anemias: Physical Examination and management
Management: What two things to do?
Parenteral iron sulfate
Blood transfusion
Anemias:
Physical Examination and management:
Blood transfusion: When is this done?
When risks of decreased oxygen-carrying capacity outweigh the risks of transfusion
Nursing Care of the Patient With Anemia:
What are you assessing for?
Assess for adverse effects of replacement therapy.
Assess signs and symptoms indicative of decreased perfusion.
Nursing Care of the Patient With Anemia:
What should you identify?
Identify the correct patient and ensure ABO compatibility.
Nursing Care of the Patient With Anemia:
What should you decrease?
Decrease metabolic needs and reduce oxygen demand.
Nursing Care of the Patient With Anemia:
What kind of strategies should you implement?
Implement strategies to reduce phlebotomy blood loss.
Disorders of Hemostasis:
What are they?
Platelet disorders
Disorders of Hemostasis:
Platelet disorders
Types of thrombocytopenia- What are they?
Drug-induced thrombocytopenia
Heparin-induced thrombocytopenia
Thrombotic thrombocytopenic purpura (TTP)
Immune thrombocytopenic purpura (ITP)
Disorders of Hemostasis:
Assessment and Management:
What are you assessing for (symptom-association)
Assessment of symptoms associated with any of the risk factors or associated disorders
Disorders of Hemostasis:
Assessment and Management:
What are you assessing for (symptoms)
Fatigue, fever, weight loss, or night sweats
Disorders of Hemostasis:
Assessment and Management:
What history are you collecting?
Accurate medication and alcohol history
Disorders of Hemostasis:
Assessment and Management:
Management: When should you hold drugs? What drugs to avoid?
Hold any drugs that may induce thrombocytopenia such as anticonvulsants, penicillin.
Avoid aspirin, antiplatelet agents, and NSAIDs.
Disorders of Hemostasis:
Assessment and Management:
Management: What else should you avoid?
Avoid trauma.
Disorders of Hemostasis:
Assessment and Management:
Management: What kind of transfusions should you get?
Platelet transfusions
Disorders of Hemostasis:
Assessment and Management:
Management: What should you do daily?
Daily labs
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
What is it?
Imbalance between the natural procoagulant and anticoagulant systems
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
What occurs in this
Unregulated thrombin activity, microvasculature thrombi, platelet consumption, and microangiopathic hemolytic anemia
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Etiology: What kind of complication is it?
DIC is a secondary complication.
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Etiology: What is extrinsic pathway activated by?
Extrinsic pathway is activated by damage to the endothelial lining of blood vessels.
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Etiology: What is intrinsic pathway activated by?
Intrinsic pathway is activated when subendothelial tissue is exposed to the bloodstream and circulating factor XII comes in contact with the exposed tissue.
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Assessment
Clinical presentation
Systemic ischemia from the thrombi formation
Minor or major hemorrhage
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Assessment: What do you collect?
Complete history
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Assessment: How is presentation?
Acute or chronic presentation
Low-grade bleeding
Bleeding from the nose, gums, lungs, gastrointestinal tract, surgical sites, injection sites, and intravascular access sites; hematuria; petechial rashes; and purpura fulminans
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Assessment: How is presentation?
Unexpected thrombotic events
Signs and symptoms of inappropriate clotting
Demarcation cyanosis
Disorders of Hemostasis:
Disseminated Intravascular Coagulation:
Management:
What to eliminate? What to treat sepsis? What kind of therapy? What else?
Eliminate the causative agent.
Antibiotic or antifungal therapy for sepsis
Fluid replacement
Oxygen
Heparin therapy
Replacement therapy- Fresh Frozen Plasma (FFP,) RBC
