Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AHII > Hematologic Disorders > Flashcards

Hematologic Disorders Flashcards

1
Q

Look at Gas Exchange and Tissue Perfusion
Blood (RBC) oxygen delivery system to body
RBC contain Hemoglobin which exchanges Oxygen and Carbon Dioxide at the cellular level so cells can make ATP and energy
Any interruption of this process creates disease/disorder

A

Hematologic disorders: direct concepts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Heme needs iron to transport oxygen
Four molecules of oxygen can attach to one Heme
Globin carries carbon dioxide; carbon dioxide/carbon monoxide more affinity to heme and will kick O2 out - if in a fire - not go off SpO2 because looking at number molecules attached to heme

A

RBC contain Hemoglobin which exchanges Oxygen and Carbon Dioxide at the cellular level so cells can make ATP and energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anemia
Types of anemia
Symptoms of anemia

A

Hematologic disorders: RBC disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Shown by Reduction of RBC, Hgb, and/or Hct
Clinical sign – not a specific disease
Classifications look at
Blood loss
Hemolytic - lysis of RBC
Impaired RBC production

A

Anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Iron-deficiency (microcytic - small blood cell)
Hemolytic - lysis of the blood cells
Megaloblastic (macrocytic - large blood cell)
Aplastic anemia (bone marrow depression)
Chronic disease anemias

A

Types of anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Due to Blood loss; poor nutrition

A

Iron-deficiency (microcytic - small blood cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Immune, due to mech. Trauma - broken open the blood cells, sickle cell

A

Hemolytic - lysis of the blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Vitamin B12 (Cobalamin) deficiency
Pernicious anemia-lack intrinsic factor
Folic acid deficiency

A

Megaloblastic (macrocytic - large blood cell)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ex: Chronic renal failure - kidneys can no longer produce EPO and stops production of RBC - given Epogen - leading to anemia

A

Chronic disease anemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fatigue
Dizziness
Fainting - lack oxygen carrying capacity
Low BP - hypotension
Hypovolemia
Heart palpitations - rapid HR
Chest pain due to low O2 delivering capacity
angina/chest pain - due to low O2 delivering capacity
Heart attack - due to low O2 delivering capacity
Muscular weakness
SOB
Persons of color - notice - yellowing in the eyes for anemia

A

Symptoms of anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Genetic disorder of hemoglobin (HgbS) causing distortion of RBC shape (sickle) in response to decrease O2 - make sickle shape - make C-shaped RBC
Autosomal recessive
Anemia due to abnormal Hgb - cannot carry O2
Vaso-occlusive events - Cs clump together easily
Sickle cells: sticky/fragile; clump together; occlude blood vessels
Leads to anoxia, ischemic infarctions, end-organ damage - looking at PE, MI, stroke; lodging in renal artery = kidney disease

A

Patho - Hematologic disorders: sickle cell anemia (SCD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cerebral infarts/strokes
Pulmonary infarts/PE
Splenomegaly - blood cells build up in the speen causing it to not work causing autosplenectomy - cause from disease - damage to spleen and organ shrinks and non-functional
Renal infarts
CHF
Bone marrow hyperplasia
Vascular occlusions - ulcers and extremity infartions
Severity varies - depending on what going on
Periodic crises - usually recovers
Precipitating Conditions (triggers):

A

Clinical Manifestations and Triggers - Hematologic disorders: sickle cell anemia (SCD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hypoxia states - low O2
High altitudes
Dehydration
Venous stasis - blood not moving around; sickle cells can clump together
Physical/emotional stress
Anesthesia
Diff types of Infections
Low or high environmental or body temperatures

A

Precipitating Conditions (triggers): - Hematologic disorders: sickle cell anemia (SCD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pain management - opioids (look out for constipation)
Oxygen - caused sickling of cells in first place
Hydration - prevent sticking together and clumping
Body positioning - not bend pts at any pt - bending pts allow cells to clump
Prevent infection
Blood transfusion - esp if pt is having major symp: SOB not tolerable or Hgb less than 7.5
Hydroxyurea (Reduces sickling of cells) - antimetabolite; can increase risk of cancer within infants; make sure not get pregnant
Teaching
Emotional Support
Supportive care

A

Med-surg - Hematologic disorders: sickle cell anemia (SCD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

To prevent crisis - staying well hydrated; not go and get into position where lack O2; infected need to come to doc to prevent this
Manage drugs
Women BCP with Hydroxyurea
Heredity aspects

A

Teaching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Good
Have disease for rest of live
Lot lose hope

A

Emotional Support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Available
Understanding what happening with pt
Lot hospitals have sickle cell clinics that understand these pts

A

Supportive care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acute Pain - cells clotting off and causing ischemic areas; lack tissue perfusion
Ineffective peripheral tissue perfusion
Deficient Fluid volume - give additional fluids
Activity intolerance
Risk for decreased Cardiac tissue perfusion - MI, chest pain
Risk for Infection
Risk for ineffective cerebral Tissue perfusion - stroke

A

N. diagnosis - Hematologic disorders: sickle cell anemia (SCD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Administer oxygen
Administer pain medications
Do not bend the client to allow for non-constricted blood flow
Check circulation of peripheral extremities
Assess for signs of central claudication - chest pain, lack of LOC, suspect PE
Keep patient warm - NOT HOT; no heating pads; warm clothing
Administer IVF or PO fluids

A

N. interventions - Hematologic disorders: sickle cell anemia (SCD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Doing Complete Blood Count with differential and RBC indices (indices good at whether saying large/small RBC)
Reticulocyte Count - look at how fast RBC made by bone marrow
Iron Studies - ferritin iron, transferritin, total iron binding capacity
Coomb’s Test - hemolytic anemia - look at antibodies on surface of RBCs
Bone marrow aspiration - tell us if anything in bone marrow or stimulation of bone marrow that is preventing blood cells from being made

A

Diagnostics review - Hematologic disorders: anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Red blood cells
Hemoglobin
Hematocrit
RBC indices

A

Anemia labs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

4.2-6.1
Decreased: anemia/bleeding
Increased: severely dehydrated/PV

A

Red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

12-18 g/dL
Decreased: anemia/bleeding/fluid overload
Increased: severely dehydrated; PV

A

Hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

37-52%
Decreased: anemia/bleeding/fluid overload
Increased: severely dehydrated; PV

A

Hematocrit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Good look at these to see what is going
Relate measurements of RBC, hematocrit, and hemoglobin; provides information on types of anemia

A

RBC indices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Determine underlying cause
Iron deficiency
Vitamin B
Blood loss
Immune
Chronic Disease

A

Med-surg: - Hematologic disorders: anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Mild: Oral ferrous sulfate (iron) - give with some food since taste horrible and hard on belly
Vitamin C enhances absorption; take between meals
Hgb should rise 2 g in 4 weeks
Severe: IV or IM iron dextran (IM use the Z track method - not leak back out); IV - esp on initiation - had be on tele and BP checked frequently because high rate rxn

A

Iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diet changes (high in liver, chicken, beef, tuna, or eggs), oral supplements, injections

A

Vitamin B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Stop bleeding; transfusions - mass trauma

A

Blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Immunosuppressive therapies (incredibly high risk for infection - pushing down immune sys so not go into autoimmune state and attack), transfusions, BM transplant

A

Immune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

(Chronic Kidney Disease/cancers)
Erythropoietin (Procrit/Epogen) injections - stim EPO

A

Chronic Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Gather history (past of assessment), diet, meds (chemo or something that may drive down blood production), menstrual flow (what like), any symptoms/manifestations
Assess for:

A

Assessment - Hematologic disorders: anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Fatigue, pallor, cyanosis, jaundice (good sign of hemolytic anemia - heme outside blood causing skin turn yellow, bleeding, dry skin,
Mouth ulcers or fissures, smooth tongue (glossitis)
Lymph nodes involvement (infection/cancer), resp. rate and rhythm - low blood volume/inability care O2, tachycardia - low blood volume/inability care O2
VS, O2 sat - not always exactly right - if change CO2 or carbon monoxide poisoning, gen review labs

A

Assess for:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Activity intolerance
Fatigue
Any type Altered tissue perfusion
Impaired gas exchange - low Hgb
Anxiety
Impaired comfort
Risk for Bleeding
Risk for injury
Impaired Memory

A

N. diagnosis - Hematologic disorders: anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Apply Oxygen
Oral or IM or IV iron
Supplements (Vit B, Folic acid)
Epoetin (Procrit) SQ weekly - after dialysis session often
RBC transfusion (Hemoglobin < 7.5, transfuse higher Hgb if pt extremely symptomatic: not able breathe, confused, lack O2 getting to periphery)

A

Interdisciplinary interventions - Hematologic disorders: anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Energy conservation
Good Supportive care - taking care what going on with pt
Correction of the anemia
EX: Diet changes
Teaching pt good self-care

A

N. interventions - Hematologic disorders: anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Loss of cellular regulation; proliferation of RBCs, WBC, Platelets
Also known as pan - means all
Blood hyper viscous (thick) blood
Clinical Manifestations:
Complications (thick blood)
Medical
N. interventions
Contact doctor first sign of infection or occlusion
Exercise slowly
Interdisciplinary
N. diagnosis

A

Hematologic disorders: primary polycythemia vera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Causes Poor oxygenation of tissues due to poor circulation; cell destruction
RBC >16.5g/dl; Hgb > 18g/dl; Hct >55%; high K (norm 3.5 -5 mEq/L); high uric acid; high Hgb, Hct, K, uric acid

A

Blood hyper viscous (thick) blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Hypertension (beat and push hard to get stuff out into circ - lot pressure in vessels); headaches (thick blood pushed through brain, HTN); dizziness (lack O2); purple/gray color (lack O2); itching, dyspnea

A

Clinical Manifestations:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Angina/chest pain, claudication (stopping of O2 - clotting areas of body), thromboses; infarctions: MI, intracranial bleeds/CVA - ischemic

A

Complications (thick blood)

41
Q

Repeated apheresis 2 to 5 times week - actual bleeding, medications: Hydroxyurea - keep sickle cell shape norm, anticoagulants - thin blood so circ normally

A

Medical

42
Q

Prevent clots - give anticoags, wear SCDs, get up and move as much as possible
Hydration (3 L day) - 2-4 L qday
Stop smoking = causes venous stasus
Promote venous return
Elevate feet or SCDs worn; esp if have varicose veins - push blood back up
Avoid tight clothing
Support hose - help muscles of legs push blood up
Thrombocytopenia precautions - bleeding precautions - on anticoags; bleeding risk - Use electric razor, soft toothbrush
Neutropenic precautions - higher risk for infection

A

N. interventions

43
Q

Stop activity at first sign of chest pain (call 911) or dizziness

A

Exercise slowly

44
Q

Anticoagulants
Chemotherapy - stop overproduction

A

Interdisciplinary

45
Q

Ineffective protection
Risk for bleeding and infection
Risk ineffective tissue perfusion

A

N. diagnosis

46
Q

Precancerous state
Abnormal cell formation in bone marrow; once out into body and released completely destroyed by body after release; decrease in all blood cell types (aka pancytopenia)
30% risk develop acute leukemia
Risk Factors:
Diagnosis:
Medial Treatment

A

Hematologic disorders: myelodysplastic syndrome (MDS)

47
Q

> 65 yrs, exposure to chemicals (esp pesticides, benzene), tobacco smoke, chemotherapy/radiation

A

Risk Factors:

48
Q

Cytogenetic testing - looks at chromosomes that id’d abnormal
Peripheral blood smears - look at cell abnormalities

A

Diagnosis:

49
Q

Supportive care
Blood/platelet transfusions; Epogen (Procrit) injections
Allogeneic hematopoietic stem cell transplant only curative treatment issue for MDS
Immunomodulatory agents
Medication: immuran

A

Medial Treatment

50
Q

Local bleeding - petechiae
Easier to control
EX: idiopathic thrombocytopenic purpura (ITP) - immune system destroys platelets, thrombotic thrombocytopenic purpura (TTP) - platelets clump abnormally - causing clots - then body runs out

A

Platelet disorders: - Hematologic disorders: Platelet and clotting disorders

51
Q

Occurs deeper in body: joint spaces: SQ; deep bleeds difficult to control and often restarts
EX: hemophilia, heparin induced thrombocytopenia

A

Clotting factors disorders - Hematologic disorders: Platelet and clotting disorders

52
Q

Normal platelets: 150,000-400,000/mm3
Decreased production
Increased destruction
Increased consumption

A

Reasons - Hematologic disorders: platelet disorders

53
Q

Happen because Cancers and treatment - common with chemo; aplastic anemias; toxins; meds; alcohol decreases production

A

Decreased production

54
Q

Autoimmune issue
Infections; meds; spleen disorder; cancers

A

Increased destruction

55
Q

Body make enough but body chewing them up and decreasing them
Disseminating intravascular coagulation (DIC) - making microvascular clots and running out of platelets

A

Increased consumption

56
Q

Too few
Diff levels
40,000-80,000 /mm3: Risk for bleeding with mild trauma
<20,000: Risk for spontaneous bleeding
<5000/mm3 risk for fatal bleed in CNS or GI hemorrhage - have someone who suddenly becomes confused - worry about bleeding in brain
Exemplar
Idiopathic Thrombocytopenic Purpura (ITP)

A

Thrombocytopenia - Hematologic disorders: platelet disorders

57
Q

Too many
Platelet count above normal > 600,000/mm3
HIGH Risk for clotting
Exemplar
Thrombotic Thrombocytopenic Purpura

A

Thrombocytosis - Hematologic disorders: platelet disorders

58
Q

Autoimmune Disorder
Patients make antibodies against own platelets; macrophages destroy - chewing up platelets
Diagnosis: serial low platelets levels & BM biopsy - BM putting out norm rate but body chewing them up
Treatment:

A

Hematologic disorders: idiopathic thrombocytopenic purpura (ITP)

59
Q

Triggers: Viral infections thought to trigger condition
Most common in women 20-40 yrs

A

Patients make antibodies against own platelets; macrophages destroy - chewing up platelets

60
Q

Immunosuppressive drugs (prednisone - INFECTION), platelet transfusion, splenectomy (last resort - destroyed pieces of platelet stored in spleen and going to swell and could rupture)

A

Treatment:

61
Q

Platelets to clump together abnormally in capillaries and too few available in circulation
Inappropriate clotting but also fails to clot when trauma occurs - not necessary but then when need it not available
Tissue becomes ischemic may lead to kidney failure, MI, CVA; untreated fatal in 3 months

A

Autoimmune disease: - Hematologic disorders: thrombotic thrombocytopenia purpura

62
Q

Plasmapheresis, fresh frozen plasma to provide platelet aggregation inhibitors; platelet inhibitor drugs

A

Treatment: - Hematologic disorders: thrombotic thrombocytopenia purpura

63
Q

X linked recessive trait;
Women carrier (50% chance of passing gene to offspring)

A

Genetic disorder 1 in 10,000 - Hematologic disorders: hemophilia

64
Q

Type A- factor VIII (8) deficiency (80% of cases)
Type B –factor IX (9) deficiency (20% of cases)

A

Types - Hematologic disorders: hemophilia

65
Q

Abnormal bleeding to any type of trauma, specifically in the joints
Bleed longer than normal
Problem forming stable fibrin clot - allow for extensive bleeding

A

Symptoms: - Hematologic disorders: hemophilia

66
Q

Complication most common
Joint problems from repeated episodes of bleeding
Diagnosis
PTT prolonged
Treatment
Replace missing factor with infusion of synthetic factors

A

Medical management - Hematologic disorders: hemophilia

67
Q

Minimize trauma and other causes of bleeding
Assess for signs and symptoms of bleeding - esp in joints
Interdisciplinary

A

N. management - Hematologic disorders: hemophilia

68
Q

Thrombocytopenia/bleeding Precautions
Risk assessment- Protect patient from injuries - padding side rails; not up by self

A

Minimize trauma and other causes of bleeding

69
Q

Prepare to administer platelet transfusions for counts below < 10,000 mm3
Replace missing clotting factors with infusion of synthetic factors
Educate patient and family: risk for bleeding and how reduce risk for trauma

A

Interdisciplinary

70
Q

PT
INR
PTT

A

Clotting time

71
Q

Ref range: 11-12.5 sec
Significance: prolonged: warfarin therapy; clotting factor deficient; liver failure
Most stacked with INR
Looks at clotting factors II, V, VII, X
WARFARIN THERAPY; LIVER FAILURE

A

PT

72
Q

Ref range: 0.8-1.1
Significance: standard measure for PT
WARFARIN THERAPY; LIVER FAILURE
Most stacked with PT

A

INR

73
Q

Ref range: 60-70 sec
Significance: prolonged: heparin therapy; clotting factor deficient (hemophilia); autoimmune: ab attack clotting factors
HEPARIN THERAPY; HEMOPHILIA; AUTOIMMUNE DISORDERS
Looks at clotting factors II, V, VIII, IX, XI, XII

A

PTT

74
Q

Leukemia
Lymphoma
Multiple myeloma

A

Hematologic disorders: cancers of the blood

75
Q

Uncontrolled cell production
Cancer occurs in stem cells of bone marrow; overcrowded with nonfunctional blood cells - lot of them but not functional
Overproduction of blasts cells (immature WBC - called blasts)
Exact cause unknown; many/may be genetic and enviornmental factors involved
50% of pts have abnormal chromosomes
Normal cell production decreased result in:
Infiltration tissues/organs
Norm cell production increased
Classifications
Type
Risk factors
Diagnosis
CM
Diagnosis: bone marrow aspiration - for leukemia
Medical treatment

A

Leukemia

76
Q

Pancytopenia
Neutropenia
Anemia
Thrombocytopenia

A

Normal cell production decreased result in:

77
Q

Acute:
Sudden onset abnormal blood cells
Chronic:
Abnormal cells replicate slowly
Classified by Cell type
Lymphoid cells: Lymphocytic
Myeloid cells: Myelogenous

A

Classifications

78
Q

Acute Lymphocytic Leukemia (ALL)
Most common type in young children
Acute Myelogenous Leukemia (AML)
Most common type of in all adults
Chronic Lymphocytic Leukemia (CLL)
Most common chronic adult leukemia
Chronic Myelogenous Leukemia (CML)
Asymptomatic for years before entering a fast growth phase

A

Type

79
Q

Prior exposure chemotherapy or ionizing radiation - previous cancer
Bone marrow hypoplasia/slow growth
Genetic factors (Down syndrome)
Immune deficiency
Virus

A

Risk factors

80
Q

CBC
Abnormal WBC count; High blast cells show poorer prognosis
Low Hgb & Hct and platelets
Bone Marrow Biopsy
Definitive test
Chromosome analysis - diff things on chromosome that can lead to pt having leukemia
Other x-rays, CAT scans, MRI

A

Diagnosis

81
Q

Weight loss
Fever
Frequent infections - no control over cells any longer
SOB - low cell production
Muscular weakness
bone/joint pain
Fatigue
Loss of appetite
spleen/liver enlargement - both/one - r/t engulfment of diff cells that need to be destroyed/cleaned
Swelling with lymph nodes
Skin: night sweats, easy bruising/bleeding, puplish patches/spots

A

CM

82
Q

Provides information to pt about what expect with procedure; blood cells and production
Nursing:
Teach patient what to expect
Position
Sedative provided
Local anesthetic injected - both needle and incision made
Follow-up Care
Look at area incised - no more bleeding
Control bleeding
Inspect site every 2 hours
Pain control
BM provide info about blood cells and production

A

Diagnosis: bone marrow aspiration - for leukemia

83
Q

Induction Therapy
Intense chemotherapy started as soon as diagnosis confirmed
Hospitalized 2-3 weeks in protective isolation - drive down and suppress bone marrow
SE: Severe bone marrow suppression, alopecia N&V, stomatitis, can cause organ toxicity - kill fast growing cells
Recovered: Consolidation Therapy:
Repeat drugs or Bone Marrow Transplant
Maintenance therapy:
Months and years to maintain remission

A

Medical treatment

84
Q

Cancer of lymphocytes
Two main types:
Many subtypes of both
Hodgkin’s lymphoma
Non-Hodgkin’s Lymphoma

A

Lymphoma

85
Q

Hodgkin’s lymphoma (HL)
Teens and adults in 50-60s
Non-Hodgkin’s lymphoma (NHL)
All other lymphomas (over 60 types)
Older adult men
Variety lymph nodes affected

A

Two main types:

86
Q

Starts in single lymph node in neck underarm or chest
Proceeds in orderly fashion to next lymph node
Fatigue, anorexia, short of breath
“B” symptoms: sweats, fever, itching, weight loss
Pain in lymph node areas after alcohol intake

A

Signs/Symptoms - Hodgkin’s lymphoma

87
Q

Viral infections; chemical exposure

A

Risk Factors: - Hodgkin’s lymphoma

88
Q

External radiation and Chemotherapy
Curable

A

Treatment - Hodgkin’s lymphoma

89
Q

Lymphadenopathy in multiple sites - swelling of lymph nodes in multiple sides
Spread to other organs at time of diagnosis most time

A

Symptoms: - Non-Hodgkin’s Lymphoma

90
Q

Autoimmune disease and immunosuppressive disorders, viruses (HIV, EBV - ebstein barr), chemicals

A

Risk factors: - Non-Hodgkin’s Lymphoma

91
Q

Chemotherapy/monoclonal antibodies; radiation
Chronic disease/not curable

A

Treat: - Non-Hodgkin’s Lymphoma

92
Q

Overgrowth of plasma cells (PC)
PC overproduce gamma globulin (gammopathy) - excess in antibodies in blood clog blood vessels of kidneys and other organs - clog in blood vessels and infect organ
Produce excess cytokines - increase cancer growth rate and destroy bone - destroy higher level of calcium
Diagnostic tests - serum electrophoresis test detects monoclonal immunoglobulin; bone marrow biopsy: greater than 10% infiltrated plasma cells; X-ray: osteolytic bone lesions
CM
Treatment
Nursing

A

Multiple myeloma

93
Q

Early signs
Fatigue
Anemia
Easy bruising
Bone pain
Infections
Later
Bone fractures
Kidney dysfunction due to cells going in and infection
HTN
Rare: hypercalcemia, hyperviscosity syndrome - can happen - Leads to progressive bone destruction, bleeding, kidney failure, immunosuppression, and death

A

CM

94
Q

Chemotherapy agents
Bone marrow transplant
Incurable

A

Treatment

95
Q

Care of immunocompromised patient
Pain control

A

Nursing

96
Q

Infection protection
Thrombocytopenic precautions - bleeding
Energy conservation
Teach good self care
Stay out crowds or to HCP if look like have an infeciton
Good Psychosocial support

A

Hematologic disorders: nursing care for leukemia, lymphoma, and multiple myeloma

97
Q

Prophylactic Drugs: antiviral, antibiotic, antifungals
Neutropenic precautions
Monitor labs daily
Monitor for early manifestations of infection
Good Hygiene/skin care

A

Infection protection

98
Q

Teach risk/signs of infection/how to prevent - how reduce risk
Avoid crowd, children/ill people/wear mask
Hand hygiene/good personal hygiene/mouth care
Avoid constipation/shaving with blade –use electric shaver
Do not handle feces (clean cat litter/bird cage/dog, etc.)
No fresh flowers or plants/No gardening - dirt harbors infective process
Non invasive procedures - unless not helped
No sexual relations
Discuss food safety (No fresh fruits/vegetables/raw meat/eggs/some cheeses)
Pt should have thermometer and know how to use it
Who to notify and when (report temp greater than or equal to 100.5 degrees F, chills, signs of illness or infection)
Weekly labs
Administer growth factor as directed to stim neutrophil regeneration

A

Hematologic disorders: neutropenic precautions

99
Q

Risk for injury: Risk factors: abnormal clotting
Assess for S/S of bleedin - Bruises/nose/gums/blood in urine/blood in stool/severe headaches
Avoid IM/SQ/IV or invasive procedures
No aspirin/NSAID
Soft toothbrush; no flossing or dental procedures
No razor blades-use Electric razor
Stool softeners & laxatives to prevent straining
Hold pressure for 5 min. on venipuncture sites
Teach signs of bleeding; when to notify doctor - signs hematoma, joint bleeding
Provide Safe environment: Avoid situations where falls may occur

A

Hematologic disorders: thrombocyptopenic precautions

AHII (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions