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Hematologic Disorders Flashcards

1
Q

What is the site of RBC production?

A

Bone marrow

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2
Q

What are RBC’s responsible for?

A

Oxygen and carbon dioxide transport

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3
Q

What are platelets?

A

Cell fragments that work to stop blood flow from an injury by adhering to the walls of blood vessels and forming platelet plugs

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4
Q

The newborn has a ___ (higher or lower?) level of erythropoietin which stimulates ___ production

A

Higher; RBC production

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5
Q

Which levels are high in infants? RBC, HgB, Hct, Platelet

A

RBC, HgB, Hct

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6
Q

Which levels are low in infants? RBC, HgB, Hct, Platelet

A

Platelet

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7
Q

Anemia results from __, __, __.

A
  • Blood loss
  • Decreased production of erythrocytes or HgB
  • Hemolysis
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8
Q

Normal RBC blood value

A

Between 4 and 5

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9
Q

Normal Hct blood value

A

35 or 36

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10
Q

Normal HgB blood value

A

around 15

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11
Q

Normal WBC blood value

A

10, if it’s over then you are thinking about infection

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12
Q

Normal platelet blood value

A

200,000

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13
Q

If LOW MCV, what can be suspected?

A
  • Iron deficiency
  • Lead or toxins
  • Thalessemias
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14
Q

If HIGH MCV, what can be suspected?

A
  • Vitamin B12 deficiency
  • Aplastic anemia
  • Alcoholism
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15
Q

What is Anemia?

A

Anemia is a condition in which there is a decrease in the oxygen carrying capacity of the blood.

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16
Q

What are some general effects of anemia that stand out?

A

Being tired and concentration stand out; mental confusion and changes in appetite

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17
Q

What are early signs of Iron Deficiency Anemia?

A

Pallor, irritability, fatigue

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18
Q

What are late signs of Iron Deficiency Anemia?

A
  • Nail bed deformities (spooning)
  • Tachycardia
  • Growth retardation
  • Systolic heart murmur
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19
Q

What is the most common type of anemia in the US?

A

Iron Deficiency Anemia

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20
Q

Dietary iron is absorbed in the __.

It then passes to the bloodstream or stored in the intestinal epithelial cells as __.

A

Small intestine

Ferritin

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21
Q

3 diagnostic evaluations for Iron Deficiency Anemia

*What is reticulocyte count?

A
  • CBC (HgB is usually 6-11, decrease MCV)
  • Reticulocyte count (newly produced immature RBC)
  • Serum iron and serum ferritin (levels are low)
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22
Q

What is preferred as a replacement for iron?

A

Ferrous sulfate d/t it being absorbed the best

23
Q

What can chronic iron deficiency lead to?

A

Heart Failure

24
Q

What interferes with the absorption of iron? When should you give these items to avoid interference?

A

Fluoride, antacids, dairy products; give one hour before or two hours after

25
What increases absorption of iron?
Vitamin C
26
What does iron do to teeth?
Stains teeth; give iron with a straw, dropper or syringe
27
What is Aplastic Anemia?
Failure of the bone marrow to produce adequate numbers of circulating blood cells
28
Treatment for aplastic anemia
Stem cell transplant
29
What are some safety interventions for a patient with aplastic anemia?
- Preventing hemorrhage!! - No injections - No rectal temps - Extra soft tooth brush
30
How do we help aplastic anemia patients protect against infection?
Private room and meticulous hand washing
31
Explain what sickle cell anemia is
- Autosomal recessive condition where normal hemoglobin is partially or completely replaced by the sickle shaped HgB S
32
When do symptoms manifest in sickle cell anemia?
4-6 months
33
What do many children undergo in early childhood regarding sickle cell anemia and what does it lead to?
They undergo a splenectomy which leads to severely compromised immunity.
34
What is the reason for a splenectomy with sickle cell anemia?
Old cells get collected in the spleen
35
S/S of sickle cell anemia What ethnicities is sickle cell most common in?
Pain, pallor, hands and feet are cold, dizziness, headache, SOB African American, Mediterranean, Indian or Middle Eastern
36
Complications of sickle cell anemia: - Acute chest syndrome - Dactylitis - Priapism - CVA
- Acute chest syndrome (chest pain): acute chest pain, fever, tachycardia, dyspnea, decreased O2 sat, retractions - Dactylitis: swelling in hands and feet - Priapism (persistent painful erection) - CVA (abnormal behavior, weakness, slurred speech, severe headache)
37
Acute sequestration crisis: blood pooling in the spleen can lead to ___.
Hypovolemic shock
38
What are some triggers for sickle cell crisis?
- High altitudes - Increased blood viscosity (dehydration) - Infection, fever - Hypoxia - Hypoventilation - Vasoconstriction (cold exposure)
39
What is a transcranial doppler test used for and at what age?
Used to assess intracranial vascular flow and determine risk for CVA, done annually on children 2-16
40
What pain medication is NOT used for sickle cell anemia?
Demerol d/t side effect profile
41
Early symptoms of lead poisioning
Fatigue, headaches, irritability, metallic taste
42
Late symptoms of lead poisoning
Cognitive changes, memory problems, mentation becomes poor, kidney problems, weight loss
43
Therapeutic management for long term exposure to lead
- isolation from the source | - chelation therapy to remove lead from the body
44
Therapeutic managements for someone who potentially ate doses of lead
- Gastric lavage | - Bowel irrigation with polyethylene glycol solution
45
Hemophilia is a..
X linked recessive trait expressed almost exclusively as carrier females and affected males
46
Hemophilia A (classic hemophilia) is factor __ deficiency
Factor VIII; most common
47
Hemophilia B (Christmas Disease) is factor __ deficiency
Factor IX
48
Hemophilia lab tests results (normal or abnormal): - aPTT - Platelets and prothrombin time - Whole blood clotting time
aPTT is prolonged Platelets and prothrombin is within range Whole blood clotting time is within range or prolonged
49
Hemophilia A is a __ bleeding disorder
Hereditary
50
S/S of Hemophilia A
Spontaneous bleeding, easy bruising, nosebleeds, hematuria, bleeding after minor trauma
51
What is the biggest worry with Hemophilia A?
Hemarthrosis (joint capsule swollen with blood)
52
What is Factor VIII used for? Corticosteroids? N-SAIDS?
Factor VIII is used to prevent and treat hemorrhage Corticosteroids is used to treat hemarthrosis NSAIDS is used to treat synovitis
53
What are some nursing interventions for epistaxis?
- Sit forward with head tilted slightly forward - Apply pressure to nose for 10 minutes (ATI says 30 min) - Kleenex can be packed in nose - Swab with vaseline after it stops - May apply ice - Breath through the mouth - Seek ER is bleeding persists for more than 10 minutes

Pediatrics (3 decks)

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