Hematologic and Immunologic Ch24+25

Question 1

normal RBC last…

Answer 1

4 months (120 days)

Question 2

sickled RBC last…

Answer 2

15 days

Question 3

sickle cell anemia

Answer 3

Hgb becomes elongated in RBC
autosomal recessive disorder (need both genes from both parents)
causes chronic anemia
sickled cells clump together and obstruct capillary blood flow
sickle cell crises occur

Question 4

sickle cell crisis

Answer 4

obstructions lead to hypoxia and tissue ischemia, causes pain in hands feet and joints
triggered by anything that increases need for oxygen (sports, recess, winter time/hypothermia, trauma, fever, infection, emotional stress, high altitude, hypoventilation, poorly pressurized airplanes, dehydration/increased blood viscosity)

Question 5

complication of sickle cell

Answer 5

splenic sequestration/splenic crisis
occurs as the spleen becomes swelled with sickled RBC
medical emergency
dx: ultrasound
treat: fluids, PCA, O2

Question 6

long term management of sickle cell

Answer 6

prevention and treatment of pain
avoid infections/get vaccinated

Question 7

pts with sickle cell are at increased risk for…

Answer 7

bacterial infections
strokes

Question 8

iron deficiency anemia

Answer 8

low number of RBC due to lake of dietary iron
acute symptoms: fatigue, cyanosis, low H/H
chronic symptoms: growth retardation
treat: supplements, transfusion, IVF to replace intravascular space, bedrest, O2

Question 9

iron deficiency anemia is predictable for…

Answer 9

infants (breastfed new iron supplements)
females during menstruation
at 12-36mo r/t ingestion of lots of cow milk
in adolescents r/t poor eating habits and rapid growth

Question 10

hemophilia

Answer 10

a group of hereditary clotting disorders
A, B, C, VWD
all causing increased clotting time
treat: desmopressin, Amicar, blood transfusions in emergencies

Question 11

RN considerations for hemophilia

Answer 11

monitor for bleeding (especially with incisions, taking out IVs)
increased risk for bruising and epistasis

Question 12

hemoarthrosis

Answer 12

bleeding into joint spaces of the knees, ankles, or elbows leading to impaired mobility
CM: limited ROM, swelling

Question 13

lupus

Answer 13

chronic autoimmune disorder
goal= stay in remission
CM: joint pain, butterfly rash, mouth sores, depression, seizures, fatigue, fever, weight loss, anemia, easy bruising
treat: corticosteroids to suppress immune system, avoid exposure for flareups