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MedSurg > Hematologic Disorders > Flashcards

Hematologic Disorders Flashcards

1
Q

Anemia

A

Not enough cells resulting in inability to carry enough O2 to the tissues

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2
Q

Anemia S&S

A

Cold extremities, lightheadedness

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3
Q

WBC levels

A

4,500 - 10,500

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4
Q

Hgb levels

A

M: 13.5 - 17.5
F: 12 - 16

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5
Q

H&H levels

A

M: 42 - 52%
F: 37 - 47%

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6
Q

Platelet levels

A

150,000 - 450,000

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7
Q

Neutrophil infection level

A

> 67%

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8
Q

Segmented neutrophils (segs) infection level

A

> 55%

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9
Q

Neutrophil band infection level

A

> 5/6%

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10
Q

Iron deficiency anemia

A

Lack of iron so can’t make Hgb for RBC to carry O2

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11
Q

Iron deficiency anemia clinical manifestation

A
  • Fatigue, pallor
  • *Tachycardia bc lack of blood
  • *Tachypnea
  • *SOB
  • Fissures (mouth/anus)
  • Glossitis (tongue: smooth, swollen, reddened)
  • Spoon-shaped fingernails (not common in industrialized countries)
  • Brittle hair
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12
Q

Iron deficiency anemia labs

A
  • Hgb/Hct: low
  • MCV: low (indicate size of RBC)
  • MCH: low (indicate Hgb concentration)
  • MCHC: low (indicate Hgb concentration)
  • Serum ferritin: low
  • Serum iron: low
  • TIBC: high bc body trying to compensate
  • Transferrin saturation: low
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13
Q

Iron deficiency anemia nursing assess

A
  • VS: tachycardia, tachypnea
  • Fatigue, pallor
  • SOB
  • LOC
  • Change in hair, tongue (beefy red), nails (spoon)
  • Assess for blood loss: emesis, sputum, urine, stool
  • Labs: Hgb, Hct, MCV, MCH, MCHC, serum iron, ferritin, TIBC, transferrin sat
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14
Q

Sickle cell disease patho

A
  • Genetic disorder of Hgb –> RBC shape changed d/t lack of O2
  • Sickle shaped RBC causes vasoocclusion, lack of O2, hemolysis (breaks up which causes anemia)
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15
Q

Types of sickle cell crisis

A

Result of increased sickling and anything causing hypoxemia and vasoconstriction.
- Vaso-occlusive
- Aplastic
- Sequestration
- Hemolytic crisis

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16
Q

Vasoocclusive crisis

A
  • Most common
  • Vessel obstruction by clumping, tiss hypoxia, pain
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17
Q

Aplastic

A

Bone marrow ceases to make RBCs

18
Q

Sequestration

A
  • Most severe
  • Pooling of RBCs in spleen, shock, CV failure
19
Q

Hemolytic crisis

A
  • RBC hemolysis
  • Decreased Hgb
  • Jaundice
20
Q

Sickle cell disease clinical manifestations (no crisis)

A

Anemia
- Fatigue
- Pallor
- SOB

21
Q

Sickle cell disease clinical manifestations (crisis)

A

Vasoocclusive
- Pain
- Swelling

22
Q

Which areas are most affected by vasoocclusion?

A
  • Distal areas: joints, bones, chest, abdomen
  • Wound healing in the extremities
23
Q

What happens if ischemic organ damage in SS?

A
  • Cerebrovascular, pulmonary, and splenic infarcts
  • Priapism: painful erection that doesn’t go away
  • Liver and kidney damage
24
Q

Sickle cell anemia assess

A
  • VS: tachycardia, tachypnea, fever (infection)
  • Fatigue, pallor, SOB
  • Pain and swelling in joints, jaundice (if hemolytic crisis)
  • Psychosocial: depression, anger
  • Diagnostic tests
25
Q

Sickle cell anemia diagnostic tests

A
  • Hgb, serum bilirubin
  • Serum iron, vitamin B12, folate level
  • Chest x-ray
26
Q

Sickle cell anemia nursing action

A
  • Administer O2 as ordered
  • Provide hydration/fluids esp for kidney bc need to prevent infection
  • Pain meds as ordered
  • Antipyretics as ordered
  • Blood transfusions as ordered
  • Emotional support
27
Q

Sickle cell anemia patient teaching

A
  • Avoid cold temps and restrictive clothing
  • Patho of disease
  • Infection prevention (vaccines, dental hygiene, hand washing…)
  • Avoid high-altitudes
28
Q

Leukemia

A

Uncontrolled replication of WBCs - leukemic cells/blasts

29
Q

Leukocytosis

A

uncontrolled cloning of immature abnormal cell –> fills BM –> enters circulation

30
Q

Leukemia clinical manifestations

A
  • Painful lymphadenopathy (neck, groin, armpit) d/t cells go to lymph glands
  • Anemia d/t lack of RBC
  • Infection d/t lack of neutrophil
  • Bleeding d/t thrombocytopenia
  • LUQ pain d/t splenic sequestration of blasts
31
Q

Leukemia diagnostic tests

A
  • CBC shows diff types of WBCs (neutrophils, eosinophils, basophils)
  • Biopsy
  • Lumbar puncture
32
Q

Which tests diagnose leukemia?

A
  • Biopsy and bone marrow aspirate: type of leukemia, chromosomal abnormalities
  • Lumbar puncture: CSF involvement
33
Q

Complications of pancytopenia (low levels of all three: RBC, WBC, platelet)

A
  • Infection secondary to neutropenia < 1000
  • Hemorrhage and bleeding secondary to thrombocytopenia < 150,000
  • Anemia
34
Q

Leukemia nursing action

A
  • Administer chemo as ordered
  • Neutropenic/bleeding precautions
  • Antibiotics, antivirals, antifungals (prophylactic) as ordered
  • Symptom management of N/V, diarrhea, stomatitis
  • Administer blood prods as ordered
35
Q

What’s medical emergency in neutropenic pt?

A

Fever

36
Q

Hodgekins vs Non-hodgekins lymphoma

A
  • H: better survival rate, Reed Steinburg cell present
  • N: higher in industrialized countries
37
Q

Lymphoma

A

Single stem cell in lymph develops into solid tumor and spreads to other LN or spleen

38
Q

Lymphoma diagnostic tests

A

Labs:
- CBC w diff, CMP, coagulation studies, LDH

Radiology:
- Chest x-ray
- CT scan
- PET scan
- MRI

…

39
Q

What does lymph node biopsy show

A

Presence of RS cells –> determine HL or NHL

40
Q

What does bone marrow biopsy/lumbar puncture show in lymphoma

A

Symptoms indicating involvement

MedSurg (15 decks)

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