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NP 4- TOP 8 > HEMATOLOGIC DISEASES > Flashcards

HEMATOLOGIC DISEASES Flashcards

1
Q

Blood Components

A
  1. RBC/ Erythrocytes: ↓ RBC= ANEMIA
  2. WBC/ Leukocytes: ↓EBC= LEUKOPENIA
  3. Platelet/ Thrombocytes: ↓platelets:
    Thrombocytopenia
    4.Plasma: Liquid Portion of Blood
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2
Q

↓RBC, ↓WBC, ↓PLATELET

A

APLASTIC ANEMIA

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3
Q

2 types of Plasma

A

-Serum Plasma
-Protein Plasma

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4
Q

type of plasma which is the Liquid portion of blood

A

SERUM PLASMA

↑PLASMA
-Hemodillution
-↓ blood viscosity

↓PLASMA
-Hemoconcentration
-↑blood viscosity
-Risk for thrombus (clot formation)

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5
Q

type of plasma that is Produced by the liver

A

PLASMA PROTEIN

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6
Q

Types of plasma protein

A

-ALBUMIN
-FIBRIN
-GLOBULINS

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7
Q

Type of protein plasma that is abundant and (+) oncotic pressure, stays in the intravascular

A

ALBUMIN

↓Albumin
-Hypoalbuminemia
- (-) oncotic pressure
-Edema & Ascites

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8
Q

Type of protein plasma that is the clotting factor
Risk for: Bleeding & ecchymosis

A

FIBRIN

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9
Q

3 Types of Globulin

A

AH- BI- GA
-Alphaglobulin: transport Hormones
-Betaglobulin: transport Iron
-Gammaglobulin: transport Antibodies
:Produces in WBC (B-cells)
but scattered in plasma

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10
Q

Antibodies attack its own cells/body

A

Autoimmune disease

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11
Q

Treatment & Drug of choice for autoimmune diseases

A

Tx: Plasmapheresis: removal of antibodies on plasma

DOC: Steroids (Prednisone)

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12
Q

Complications of Plasmapheresis

A
  1. Immunosuppression
  2. Hypovolemia (Hypotension)
  3. Allergic Reaction
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13
Q

BLOOD PREPARATION

A

-Whole blood
-Packed RBC
-Platelet Concentrate
-FFP (Fresh Frozen Plasma)

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14
Q

Whole Blood

A

-Massive blood loss
-Hypovolemic shock
-Surgery: amputation

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15
Q

Packed RBC

A

-Anemia
-Fluid overload
-CHF
-Pulmonary Edema
-Renal Failure

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16
Q

Platelet concentrate

A

-Bleeding disorders
-Dengue
-Thrombocytopenia
-Hemophilia
-ITP (Idiopathic Thrombocytopenia Purpura)

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17
Q

FFP (FRESH FROZEN PLASMA)

A

-↑Blood Viscosity
-Burns: ↑hematocrit
-Polycythemia Vera

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18
Q

Whole Blood & Packed RBC must be transfused within:

A

2-4 hours; Maximum of 6 hours

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19
Q

Platelet concentrate & FFP must be transfused within:

A

10-20 minutes

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20
Q

Nursing Safety during Blood Tranfusion:

A

Blood typing, cross, matching, and transfusion orders must be checked by
“2 NURSES”

If there is only 1 available nurse
“GO TO THE NEAREST NURSING STATION”

If 2 units is received:
“TRANSFUSE ONLY 1 UNIT AND SEND THE 1 UNIT IN THE LABORATORY”

If there is an error notice in the blood details:
“RETURN TO THE BLOOD BANK”

What must be done prior to transfusion:
“CARDIOPULMONARY (CP) CLEARANCE”
-To adjust rate

Monitor for complication of blood transfusion

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21
Q

What to prepare for Blood Transfusion

A

-Blood set
-Large-Bore needle (Gauge 18)
-PNSS (Saline solution): NO D5
CONTAINING, CAUSES HEMOLYSIS
-Alternative line: For emergency meds.

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22
Q

Blood Tranfusion Complications:

A

-Pulmonary Edema
-Tranfusion Reaction

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23
Q

Blood Tranfusion Complications: Cause of Pulmonary edema

A

Rapid Infusion

Manifestation:
-Dyspnea
-(+)Rales or Crackles

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24
Q

Management for Pulmonary edema

A

-↓ Infusion Rate: don’t stop since its compatible
-POC: High backrest
-DOC: Diuretics : Eliminate excess fluid

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25
Blood Tranfusion Complications: Cause transfusion reaction
Incompatible blood Manifestations: -SOB -Tightness of throat -Wheezing
26
Plan of care for Transfusion Reaction:
-Stop the infusion -Infuse Saline solution (NSS) -POC: High backrest -DOC: Epinephrine (Rapid acting Bronchodilator)
27
Blood type , Destroys, Tranfuse
BLOOD TYPE DESTROYS TRANSFUSE A B, AB A,O B A, AB B,O AB X A, B, AB, O O AB O
28
Universal Recipient
AB
29
Universal Donor
O
30
Cross matching
"+" : Impure; Presence of Antigen "-": Pure A+ = A+ A-= A-
31
-Microcytic Anemia -Hypochromic Anemia
Iron Defeciency Anemia (IDA)
32
Manifestations of IDA
4F's -Fatigue (Tiredness) -Fainting -Forgetfulness -Fallor (Pallor) + -Dyspnea & Tachycardia -Pale White Tongue
33
Early sign of IDA
Dyspnea & Tachycardia -Compensatory Mechanism ↓ O2
34
Late S/sx of Anemia
Concave Fingernails or Spoon Nails
35
PLAN OF CARE FOR IDA:
Diet: ↑Iron Diet -Organ Meat: Liver =↑abundant in Iron -Lean Meat: No fat, Full meat -Green Leafy Vegetables: Easy Access Iron supplement -When: Before meal -How: w/Orange juice or w/Vitamin C -Black Stool: Normal, Document -Constipation: ↑fiber diet & fluid intake -Staining of teeth (yellow): Should be taken w/ straw
36
When is the best time to give Iron Supplement?
Before Meals -↑hcl
37
How will you give Iron Supplement?
With Orange Juice With Vitamin C
38
Iron IM is given via?
-Given via Z-track Technique or zigzag technique R: Prevent Leakage in subq tissue, prevent staining
39
Contraindication of Iron
Dont's of Iron: CA-TS-MI-EG- A CApe( Coffee) TSaa (Tea) MIlk: Breastfeeding EGg Antacids: ↓Iron absorption; ↓Hcl -Coffee & Tea= Stimulants -Milk & Egg= Calcium ↓Iron absorption
40
Why Iron must not be given along with Antacids?
Antacids: ↓Iron absorption; ↓Hcl
41
↓Folic Acid or B9 ↓B12
Megaloblastic Anemia
42
Common Cause of Megaloblastic Anemia
-Overcooking of Green Leafy Vegetables: ↓B9 -Alcoholism
43
Complications of Megaloblastic Anemia:
-Neural Tube defects -Macrocystic anemia -Hyperchromic anemia -Large RBC: Malabsoprtion Syndrome
44
Manifestation of Megaloblastic Anemia
-IDA + "Sore Tongue" -4F+ dyspnea & tachycardia
45
PLAN OF CARE FOR MEGALOBLASTIC ANEMIA:
-Encourage Green Leafy Vegetables Broccoli Spinach Asparagus Broad Beans -Folic Acid Supplement: 1mg/Day PO
46
Lack of intrinsic Factor that absorbs Vitamin B12 (Cyanocobalamine)
PERNICIOUS ANEMIA
47
Common Cause of Pernicious Anemia
Gastric Surgery -Gastrectomy -Antrectomy Billroth 1: Gastroduodenostomy; Gastric Ulcer Billroth 2: Gastrojuojenostomy; Duodenal Ulcer Antrum: base of stomach ---> Parietal Cell: Produces HCL & Intrinsic Factor which absorbs Vit. b12
48
Manifestation of Pernicious aNEMIA
IDA +"Beefy Red tongue" + "Peripheral Neuritis"
49
Function of Vitamin B12
RBC production= IDA Myelin Sheath Formation = Peripheral Neuritis
50
Diagnostic Test for Pernicious Anemia
Schilling's Test -Radioactive Vit. B12 (Oral -24 hour urine collection ↑ 40% Vit B12 (urine) = (+) Pernicious Anemia
51
Management for Pernicious Anemia
1. Given Vit. B12 (IM): IM Injection every month for life **Uncompliance: Death within 2-3 years 2. Give Hcl solution 10ml mix with water for 1 week after vitamin B12 Administration.
52
PERNICIOUS ANEMIA (↓ B9) IS PART OF MEGALOBLASTIC ANEMIA (↓B12)
SKL
53
Sickling or Clamping of RBC Crescent Shaped RBC
Sickle-cell anemia
54
Normal shape of RBC
Spherical
55
Shape of RBC with Sickle cell anemia
Crescent Shape
56
Predisposing Factors of Sickle Cell Anemia
-Dehydration -Stress -Surgery -↑ Altitude -Infection ***Causes clamping of RBC Not Rigid: Reversible Rigid: Irreversible
57
Sickle cell can't enter the Vessel because of obstruction -Microcirculation is obstructed by sickled RBC, causing ischemic injury to organ and resultant pain.
Vaso-Occlusive Crisis
58
Manifestation of sickle-cell anemia
Splenomegaly Anemia Hypovolemic Shock Joint pain Erectile Dysfunction
59
Pooling of blood in the spleen
Hypovolemic Shock
60
Sequestration of blood in spleen
Splenomegaly
61
Destruction of RBC, by the spleen that results to ↓ RBC
ANEMIA
62
Plan of Care for Sickle-Cell:
1) PRIORITY: H-O-P -Hydration: Oral; IV =To inflate cells -Oxygen Administration -Pain Management: DOC: Morphine Sulfate (Opiod/Narcotics) 2) Blood Transfusion: Due to Anemia 3) Diet: ↑ Calories: Provide Energy ↓ Iron: Destroyed RBC leaves Iron = Iron Toxicity ↑Folic Acid: Replacement for IRON 4. IRON TOXICITY: DOC: Deferoxamine
63
What is replacement of Iron for Sickle Cell Anemia?
Folic Acid
64
Diagnostic Test for Sickle Cell Anemia:
1) Sickle-Turbidity Test/ Sickledex -Blood is mix in sickledex solution Result: Cloudy = (+) Sickle Cell Anemia 2) Hgb Electrophoresis -Introduction of electricity in the blood that causes clamping
65
Vit B1
Thiamine
66
Vit B2
Riboflavin
67
Vit B3
Niacin
68
Vit B5
Pantothenic Acid
69
Vit B6
Pyridoxine
70
Vit B7
Biotin
71
Vit B9
Folic Acid
72
Vit B12
Cobalomin/ Cyanocobalamin
73
-Hypoplasia of bone marrow -↓Bone marrow activity -↓RBC: Anemia; fatigue & Dyspnea -↓WBC: Leukopenia; Prone to infection -↓Platelet: Thrombocytopenia; Bleeding
Aplastic Anemia/ Pancytopenia
74
Immature WBC (↑Bands)
Leukemia ↓RBC: Anemia ↑WBC (immature): Prone to infection ↓Platelet: Bleeding
75
Two types of WBC
-Bands: Immature WBC -Segs: (Segmentor) Mature WBC
76
Diagnostic Test for Leukemia
Bone Marrow Aspiration
77
Site of Bone Marrow Aspiration for Pediatric:
Posterior TIBIA
78
Site of Bone Marrow Aspiration for ADULT:
Iliac Crest
79
Types of Leukemia
AML (Acute Myelogenous Leukemia) -AMatandaL (Matanda) -Common in adult -Life threatening: Poor prognosis -Myelogenous: all WBC comes from ALL (Acute Lymphocytic Leukemia) -Common in Pedia
80
PLAN OF CARE LEUKEMIA
-Bone Marrow Transplant: Precaution similar with B.T. -Chemotherapy -Stem cell therapy
81
Hyperplasia of Bone Marrow ↑ Bone Marrow Activity
Polycythemia Vera ↑RBC; ↑WBC;↑PLATELET ↑RBC 1.↑ Blood viscosity: Prone to Thrombus Thrombus: MI- Chestpain & Dyspnea CVA- Ischemic, ↓LOC, Confusion, Disorientation 2.Organ Infiltration -Hepatomegaly -Splenomegaly -Joint Pain 3. Rudy Complexion -Reddish Skin 4. ↑ RBC -Activates immune response; (+) Pruritis ↑WBC -No signs of Infection ↑Platelet -Overdistention of platelet -Ruptured platelet ---> Bleeding
82
Diagnostic test Polycythemia Vera
CBC -reveals that all is ↑
83
PLAN OF CARE
1. ↑Viscosity -Hydrate (↑ fluids) -Avoid ↑ altitude -Monitor s/sx of thromboembolism 2. (+) Joint Pain -DOC: Low dose Aspirin 3. (+) Pruritis -Well-ventilated room: Sweating ↑ Itchiness -Starch Bath -Calamine Lotion (for itching) 4. (+) Bleeding -monitor s/sx bleeding -avoid anti-coagulants
84
Compensatory due to chronic hypoxia
Polycythemia
85
Polycythemia Complications:
1. Shock 2. Blood Loss 3. Tetralogy of Fallot: Tet Spell ↓ O2 deprivation ↓ ↑ Bone Marrow Activity ↓ ↑RBC ↓ Prone to thrombus formation
86
Goal of polycythemia
Reverse the Hypoxia
87
Plan of Care for Polycythemia:
-O2 Administration -Blood transfusion
88
Whose nurse is ↑ risk for HIV
Hemodialysis Nurse: Handling Needle
89
Common Causes of HIV/AIDS
Cause: HIV (Retrovirus) Common: -Heterosexual/Homosexual: Anal Sex -Unprotected Sex -Blood Transfusion: Needle -Transmitted in pregnancy Precaution: Universal Precaution
90
AIDS
HIV + Immunocompromise = AIDS -TB -Pneumonia
91
Manifestation of AIDS:
EARLY SIGNS -Fever -Sore Throat -Malaise -Fatigue -weight loss -Night sweats -Diarrhea -Persistent Generalized Lymph Nodes RASHES: Kaposis Sarcoma PNEUMONIA IN AIDS: Pneumonystis Carini (Immunosuppression)
92
Diagnostic Test for HIV/AIDS
CDT4 Cells - <200 counts: Indicates AIDS -<100 counts: Immunosuppression ELISA TEST -(+) HIV infection -False (+) : Frequent or Multiple Blood Transfusion : Pregnancy -False (-) : Within few weeks to <3 months ***Best time for ELISA: After 3 months WESTERN BLOT -confirmatory test
93
DRUG OF CHOICE FOR HIV/AIDS: DOC
AZT (Azidothymidine/ Zidovodine) -Prevent HIV cells replication, Not cure
94
Platelet is destroyed by own Platelet/ Antibody
ITP (Idiopathic Thrombocytopenic Purpura)
95
Cause of ITP:
-Unknown -R/t viral infection in children
96
Lifespan of platelet with ITP:
1-3 Days normal lifespan: 7-10 days
97
Bleeding Manifestation
-Menorrhagia (Heavy Menstruation) -Bruising -Bleeding Nares & Gums -Ecchymosis -Purpura (purple skin)
98
Plan of Care
Platelet Transfusion DOC: ↑ Dose Steroids (Prednisone) : Immunosuppressant (Immuvan) Test Viral Infection -IVIG (IV Immunoglobulin) Chemotherapy DOC: Plant alkaloids (Oncovin) Plant Poison Splenectomy -Removal of spleen which is potential site of platelet DESTRUCTION Plasmapheresis
99
Lifespan of normal Platelet
7-10 days
100

NP 4- TOP 8 (3 decks)

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