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NCLEX prep > Hematological > Flashcards

Hematological Flashcards

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1
Q

Bleeding Time

A

1-9 mins

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2
Q

Bicarbonate

A

22-26

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3
Q

Partial Pressure Oxygen

A

80-100

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4
Q

Oxygen Sat

A

95-100&

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5
Q

aPTT

A

30-40 (1.5-2.5x higher w/ heparin)

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6
Q

Sodium

A

135-145

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7
Q

BUN

A

10-20

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8
Q

Cholesterol

A

<200

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9
Q

pH

A

7.35-7.45

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10
Q

Glucose

A

70-110

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11
Q

K+

A

3.5-5

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12
Q

Creatinine

A

0.5-1.2

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13
Q

HGB A1C

A

<6%

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14
Q

Partial Pressure Carbon Dioxide

A

35-45

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15
Q

Platelet

A

150-400

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16
Q

Hemoglobin

A

12-18

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17
Q

PT

A

11-12.5 (1.5-2.5x higher w/ coumadin)

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18
Q

PTT

A

25-35 (1.5-2.5x higher w/ heparin)

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19
Q

WBC

A

5-10

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20
Q

Hematocrit

A

37-52

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21
Q

INR

A

0.9-1.2 (2-3 on coumadin)

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22
Q

Allergic Blood Transaction S/S

A

facial flushing. hives. rash. wheezing. decreased BP

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23
Q

Febrile Blood Transaction S/S

A

headache. tachycardia. tachypnea. fever. chills.

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24
Q

Hemolytic Blood Transaction S/S

A

decreased BP. Increased RR. apprehension. low back pain. fever. tachycardia. chills. chest pain. hemogloulinuria.

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25
Q

Blood Transfusion Rules

A

only compatible with NS. need Y tubing. 2 RN verification. LPN can NOT give. type and cross 1st. know ABO complatibility and rh factor. verify informed consent, allergies, and past reaction to blood. premedicate 30 mins prior with benadryl. IV access needs to be 18 or larger (no smaller than 20g). VS: q 15x1 then q 1hr until done (stay with patient). must be hung within 30 mins or will have to return to blood bank. must be completed w/in 4 hours. if the blood has to be delivered slowly (longer than 4 hrs) due to fluid overload make sure blood bank is aware so blood is not wasted and they can give multiple bags. keep red hazard bag in room. use blood warmer if pt is hypothermic or if the blood needs to be administered extremely quickly (emergencies)

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26
Q

Iron Deficiency Anemia Patho

A

decreased iron, decreased RBC to hemoglobin, decreased O2 perfusion to body

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27
Q

Iron Deficiency Anemia Causes

A

pregnancy. poor diet. vegetarian and vegan. gastric bypass. gastric surgery. celiac disease. blood loss: GI bleeds, heavy periods, hemorrhage.

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28
Q

Iron Deficiency Anemia S/S

A

lethargic. easily overexerted. SOA. pica (weird cravings). pallor. glossitis. increased HR. reduced hgb. hypochromic (pale) and microcytic (small) RBC. koilonychias (spoon nails). neuro changes.

29
Q

Iron Deficiency Anemia Care

A

pain management. IVF. check for bleeding. give iron. give O2. possible blood transfusion.

30
Q

Iron Administration

A

give oral iron through straw (perform oral care), on empty stomach with full glass of water or vitamin c (OJ). do NOT give with antacids, milk, or calcium. will have dark black stools and can cause constipation. iron injections given using Z track method.

31
Q

Folic Acid Deficiency Patho

A

anemia caused by decrease of folate

32
Q

Folic Acid Deficiency Causes

A

decreased diet of fruits, veggies, and fortified cereals. overcooked foods. GI diseases. medications.

33
Q

Folic Acid Deficiency S/S

A

fatigue. gray hair. mouth sores. tongue swelling. growth defects. pale. SOA. irritable.

34
Q

Folic Acid Deficiency Care

A

educate about diet of green leafy veggies, liver, yeast, citrus, dried beans, and nuts. folic acid turns pee dark yellow. decrease folic acid in pregnancy can lead to tubal defects.

35
Q

Folic Acid Deficiency Treatment

A

fluids. pain management replace folate. prenatals with folic acid.

36
Q

B12 Deficiency (pernicious anemia) Patho

A

autoimmune condition where body does NOT produce intrinsic factor to help absorb vit b12

37
Q

B12 Deficiency (pernicious anemia) Causes

A

genetics. elderly. Addison’s. DM. thyroid issues.

38
Q

B12 Deficiency (pernicious anemia) S/S:

A

parasthesia. clumsy. depression. muscle weakness. HR. red beefy tongue. upset stomach. jaundice. pallor. confused. unsteady gait. SOA.

39
Q

B12 Deficiency (pernicious anemia) Care

A

Schilling Test (determines pernicious anemia vs. malnutrition). B12 injections for life. blood transfusion. educate about safety. eat foods high in iron, vitamin c, and folic acid. oral hygiene d/t red beefy tongue.

40
Q

Sickle Cell Anemia Patho

A

abnormal stiff and sticky C shaped RBC

41
Q

Sickle Cell Anemia Cause

A

genetics

42
Q

Sickle Cell Anemia Tests

A

Sickledex (dithionite). hemoglobin electrophoresis.

43
Q

Sickle Cell Anemia Crisis Triggers

A

blood loss (trauma/surgery). illness. climbing/flying high altitudes. stress. low fluid intake. dehydration. elevated temp (fever or exercising)

44
Q

Sickle Cell Anemia Crisis S/S

A

WONT HAVE UNTIL CRISIS OCCURS! vaso-occlusive: RBC stick together and decrease O2 perfusion. hyperhemolytic (increase RBC death leading to increased bilirubin). jaundice. aplastic (no RBC production). spleen not working (swelling, congested, infected). gallstones. increased risk for stroke. vision changes

45
Q

Sickle Cell Anemia Care

A

IVF. O2. pain meds. bed rest. check respiratory. elevate extremities and use warm compresses when dactylitis (swelling of hands/feet) occurs. no restrictive clothing. folic acid. blood transfusion. prevent infection/PNA. neuro checks. eye checks.

46
Q

Sickle Cell Anemia Crisis Prevention

A

vaccines. no high altitudes. hand hygiene. no sick people. hydrate. decrease stress. no smoking. do not over exercise.

47
Q

Sickle Cell Anemia Medication

A

Hydroxyurea (creasted fetal hbg to decrease sickling; decrease WBC and leads to higher risk of infection). Stem cell transplant

48
Q

Universal Doner

A

O-

49
Q

Universal Reciever

A

AB

50
Q

ITP Patho

A

autoimmune. bleeding disorder (low platelet and increased bruising)

51
Q

ITP Labs

A

decreased platelet. NORMAL CBC AND COAGS!

52
Q

ITP Care

A

corticosteroids and immunosuppressants. spleenectomy if pt does not respond to meds

53
Q

TTP Patho

A

lacking an enzyme in blood. clotting disorder in small blood vessels that leads to decreased platelets

54
Q

TTP Labs

A

decreased platelet. normal OR slightly increased CBC and coags

55
Q

TTP Care

A

glucocorticoids. vincristine. rituximab. cyclosporine A. plasmapheresis.

56
Q

HIT Patho

A

immunity mediated clotting disorder. abnormal antibodies that activate platelets to cause thrombosis

57
Q

HIT Risk

A

on heparin for longer than 1 wk

58
Q

HIT Labs

A

decreased platelet

59
Q

HIT Care

A

anticoagulants with direct thrombin inhibitors (argatroban, lepirudin, bivalirudin)

60
Q

DIC Patho

A

secondary to other complications. bleeding and clotting at the same time

61
Q

DIC Risk

A

septicemia. cardiac arrest. pulmonary arrest. trauma. OB complications. cancer

62
Q

DIC Labs

A

decreased platelets. decreased hgb. decreased fibrinogen. increase coags. increase d-dimer.

63
Q

DIC Care

A

heparin. assess and correct underlying cause. prevent organ damage by replacing clotting factor. check for microemboli.

64
Q

Expected S/S for Bleeding Disorders

A

bleeding gums. epistaxis. ozzing/trickling from incision/lacterations. petechiae. ecchymoses. hematuria. excessive bleeding from venipuncture/injection sight. tachycardia. hypotension. sweating. organ failure secondary to microemboli. respiratory distress. redness/pain/warmth/swelling in lower extremities (HIT)

65
Q

General Care for Bleeding Disorders

A

assess regularly. check for s/s organ failure or intracranial bleed (decreased LOC and oliguria). check labs for clotting factor. give fluids. give blood and blood products. avoid NSAIDs. give O2. avoid valsalva. start bleeding precautions.

66
Q

Heparin Antidote

A

protamine sulfate

67
Q

Coumadin Antidote

A

vitamin K

68
Q

Transfusion Reaction Steps

A

stop transaction. discontinue and remove tubing. replace with new tubing and flush NS. notify MD and blood bank. stay with patient.

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