Hematologic Disorders Flashcards
1
Q
What is anemia?
A
a condition that develops when the blood lacks enough healthy blood cells resulting in a lack of hemoglobin
2
Q
What does hemoglobin do?
A
binds oxygen to blood cells
3
Q
Normal Female Hemoglobin level
A
12-16 g/dL
4
Q
Normal Male Hemoglobin level
A
14-18 g/dL
5
Q
Hypoproliferative Anemia is caused by what?
A
- pernicious/vitamin B12 deficiency
- folate deficiency
- iron deficiency
- aplastic
6
Q
Which two types of anemia are chronic?
A
Hypoproliferative or Blood loss
7
Q
Blood loss anemia can also be what?
A
acute
8
Q
Blood Loss Anemia
A
losing RBC’s faster than the body can produce them
9
Q
Hypoproliferative Anemia
A
bone marrow does not produce enough RBC’s
10
Q
Hemolysis Anemia is caused by what?
A
- autoimmune disease
- thalassemia
- sickle cell
11
Q
S/S of Anemia
A
- weak/tired
- SOB
- increased risk for infection
- cold hands/feet
- pallor
- pica
12
Q
Vitamin B12 deficiency results from what?
A
- inadequate dietary intake
- malabsorption in GI tract secondary to disease state/surgery
- lack of protein that binds B12
13
Q
S/S of Vitamin B12 Deficiency
A
- fatigue/weakness
- jaundice
- sore red tongue
- neurological symptoms: secondary neuropathy, delusions
14
Q
Treatment for B12 Deficiency
A
- increase dietary intake
- B12 injection/nasal spray
- B12 supplements
- folic acid supplements
15
Q
Folate Deficiency results from what?
A
- deficient dietary intake; especially raw vegetables
- alcoholism
- pregnancy
- small bowel disease (Celiac’s)
16
Q
S/S of Folate Deficiency
A
- fatigue/weakness
- mood changes
- lacks neuro symptoms
17
Q
Treatment of Folate Deficiency
A
- increase dietary intake
- folic acid supplements
18
Q
What is the most common type of anemia?
A
Iron Deficiency Anemia
19
Q
Iron Deficiency Anemia results from what?
A
- insufficient dietary intake
- blood loss
- pregnancy/child birth
- alcoholism
20
Q
What is the most common cause of iron deficiency anemia?
A
blood loss
21
Q
S/S of Iron Deficiency Anemia
A
- extreme fatigue/weakness
- pallor
- tachycardia
- dyspnea
- pica
22
Q
Treatment for IDA
A
- take oral iron
- increase dietary intake
- vitamin C increases iron absorption
23
Q
How should oral iron be taken?
A
on an empty stomach or with orange juice
24
Q
Side effects of taking iron are?
A
- black stools
- abdominal pain
- diarrhea
25
How should you give an Iron/B12 injections?
Z track method
26
Most common Hematologic Diseases
- autoimmune diseases: Rheumatoid Arth. & Lupus
- inflammatory bowel disease (Crohn's, ulcerative colitis)
- chronic infections (HIV, AIDS)
- chronic kidney disease
27
Manifestations of Hematologic Dx
- mild-moderate
- progress slowly
- stabilize quickly
28
Acute Blood Loss
associated w/ acute GI bleed, trauma, or surgery
| menstrual cycles
29
Chronic Blood Loss
Chronic GI bleed
30
S/S of Blood Loss
-hemoglobin may be normal at first but levels will decrease as blood loss continues
31
Acute Blood Loss S/S
- hypotension
- dizziness
- tachycardia
- tachypnea
32
Chronic Blood Loss S/S
- fatigue
- pallor
- dyspnea
33
Treatment for Blood Loss
- blood transfusion
| - alternative treatments for religious purposes
34
Sickle Cell Anemia
inherited disorder that causes RBC's to become misshapen and breakdown
- become rigid and sticky
- obstruct vessels, limiting O2 to parts of body
35
Sickle Cell Anemia is most commonly seen in who?
African Americans
| Hispanics
36
S/S of Sickle Cell
- sudden severe episodes of pain
- swelling of hands and feet
- frequent infections
- vision problems
37
Complications of Sickle Cell
- stroke
- blindness
- priapism
38
Goals of Treatment for Sickle Cell
- avoid crisis
- relieve symptoms
- prevent complications
39
Treatment for Sickle Cell
- hydroxyurea
- vaccinations
- antibiotics
- pain meds
- blood transfusions
- daily folic acid
40
Hydroxyurea
anticancer drug that will stimulate the production of fetal hemoglobin
-helps reduce # of crisis's
41
What to do to help w/ fatigue?
- frequent short periods of exercise
- frequent rest periods
- prioritize activities by importance and necessity
42
What to do for imbalanced nutrition?
- balanced healthy diet
- alcohol limitation/cessation
- individualized dietary plan
- dietary supplements
43
How to manage perfusion of sickle cell?
- supplemental O2
- IV fluids
- blood transfusion
- monitor BP and hold antihypertensive when needed
44
Normal Platelet Level
150,000-400,000
45
Thrombocytopenia means what?
low platelet level
46
Thrombocytopenia is a result of what?
- decreased production of platelets
- increased destruction of platelets
- increased consumption
47
What are some causes of Thrombocytopenia?
- malignancy
- infection
- medication
- autoimmune
- disseminated intravascular coagulation
48
For thrombocytopenia caused by infection you need to what?
treat underlying cause
49
Immune thrombocytopenia Purpura is most commonly found in who?
Children and young women
50
Immune Thrombocytopenia Purpura (ITP)
- body produces antibodies against own platelets
- antibodies attach to platelets
- body destroys the platelets that carry its own platelets
51
S/S of ITP
- platelet count as low as 5000
- easy or excessive bruising
- petechia
- bleeding from gum or nose
- hematuria/Melena
- unusually heavy menstrual flow
52
1st Line Treatment for ITP w/ < 30,000 platelets or severe bleeding
-begin oral prednisone
| ITP is the result of an abnormally acting immune system and so the steroid will suppress the immune system
53
1st Line Treat for ITP w/ < 5000 platelets or internal bleeding
- pulse corticosteroids
| - IV immunoglobin
54
Pulse Corticosteroids are given how?
in large doses in intermittent infusions
55
IV Immunoglobin
overwhelms the spleen w/ antibody so that it cannot recognize the antibody coated platelets
56
2nd Line Treatment for ITP
- splenectomy
| - rituximab
57
After a splenectomy the patient is at risk for what?
- infection
| - death related to sepsis
58
If fever occurs after splenectomy you should what?
immediately administer antibiotics
59
Prior to splenectomy surgery you should?
receive all vaccinations
60
Education after Splenectomy
- call provider at first sign of sickness
- temp > 100.5
- sore throat
- cough/cold lasts longer than normal
- chills that don't go away
- malaise
61
Platelet Dysfunction
platelet numbers are WNL but function is altered
62
Medications that prevent platelets from clumping and forming clots are?
- Aspirin (lasts 7-10 days)
- NSAIDS (lasts 5-7 days)
- Plavix (lasts 2-3 days)
63
Von Willebrand Disease "Free Bleeder"
genetic disorder caused by missing or defective von Willebrand factor, a clotting protein
64
What does VWF do?
Binds w/ factor VIII, a key clotting protein, and platelets in blood vessel walls which help form a platelet plug during the clotting process at the site of vascular injury
65
Type I VWD
symptoms are mild
66
Type II VWD
symptoms are mild to moderate
67
Type III VWD
symptoms are severe
| spontaneous bleeding often occurs w/in joints and muscles
68
S/S of VWD
- severe bleeding following dental procedures, surgeries, child birth
- unusually heavy menses
- large bruises that easily appear
- nosebleeds
69
Desmopressin for Treatment of VWD
- injection/nasal spray
- stimulate release of stored VWF
- contraindicated w/ CAD (may cause MI)
- may cause hyponatremia from fluid retention
