Hematological Alterations Flashcards
What is the cellular portion of blood?
Erythrocytes, leukocytes, and thrombocytes
What is in plasma?
Proteins, electrolytes, clotting factors, antibodies, and anticoagulants
What is the process of making red blood cells?
Erythropoiesis
What is the primary function of blood?
To transport oxygen to tissue and carry carbon dioxide to the lungs
What part of blood actually carries oxygen?
Hemoglobin
What is the precursor to red blood cells?
Reticulocytes
How long do red blood cells live, and what destroys them?
120 days, Spleen
What disease is the reduction of red blood cells?
Anemia
What is polycythemia?
Higher than average red blood cells
What causes polycythemia?
Any condition the decreases quantity of oxygen transport to tissue
What complications can arise from polycythemia?
Increase blood viscosity which can lead to cerebral vascular accidents
Do newborns have naturally occurring anemia or polycythemia?
Polycythemia
Where are leukocyte a formed?
In the bone marrow and lymph tissue
Leukocytes are elevated in the presence of what?
Infection
What are the five types of leukocytes?
Neutrophils, eosinophils, basophils, monocytes, lymphocytes
What do you neutrophils do?
Phagocytosis
What do eosinophils do?
Act in an allergic reaction
What do basophils do?
Act in inflammatory reactions
What do monocytes do?
Phagocytosis and antigen processing
What do lymphocytes do?
Act in immunity
What is a differential blood count?
Indicates the percentage of each type of leukocytes present in the blood
What is leukopenia
A decrease in white blood cells
Leukopenia is caused by what
Immune disorders, bone marrow disorders, viral infections
Thrombocytes are what?
Cell fragments that form hemostatic plugs to aid in coagulation processes
What is thrombocytopenia?
A deficiency of platelets which can lead to bleeding disorders
What is anemia?
A reduction in the number of red blood cells, quantity of hemoglobin, and volume of packed red blood cells to below normal levels
What are the functions of blood?
To transport the hormones and oxygen, regulate body temperature, provide cellular nutrition, act as a defense against foreign antigens
What are the causes of anemia?
Increased loss or destruction of existing red blood cells, decreased rate of red cell production, or manifestations of an underlying disorder
What is the most common type of anemia?
Iron deficiency anemia
Iron is needed for what?
Hemoglobin production
Not enough iron decreases what?
The production of red blood cells
What are the causes of iron deficiency anemia?
Blood loss, malabsorption or poor nutritional intake, increased internal demands or rapid growth
How long does maternal iron stores last?
Usually 4 to 6 months
Who are at risk for anemia?
Infants older than six months who are exclusively breast-fed, infants given cows milk before one year, children with chronic blood loss
What are the results of in adequate iron supply?
Red blood cells are smaller, number of red blood cells are produced, quantity of hemoglobin is reduced, oxygen carrying capacity as of blood is decreased
What are signs and symptoms of iron deficiency anemia?
Pallor, fatigue, irritability, growth retardation, mental delays
How is iron deficiency anemia diagnosed?
Through clinical presentation and lab studies
When is screening done for iron deficiency anemia?
At 9 to 12 months, 15 to 18 months for second screening, 2 to 3 years for follow up screening, and in adolescents
What are some dietary management teaching for iron deficiency anemia?
Eat foods rich in iron, iron fortified formula or baby cereal, restripped milk intake to ensure adequate intake, take iron rich foods with vitamin C
What are some nursing interventions for ferrous sulfate?
Give on an empty stomach with orange juice, avoid calcium containing food, can cause Black stool and G.I. discomfort
What are signs of a ferrous sulfate overdose?
Abdominal pain, vomiting, and bloody diarrhea
What is sickle cell disease?
And AutoZone will recessive disorder that is a genetic condition affecting hemoglobin of red blood cells.
One third of deaths associated with sickle cell occur during what?
An acute crisis
One in how many African-American infants will have sickle cell anemia? And one in how many African-Americans will be a carrier for the trait?
One in 375,: one in 12
What happened to hemoglobin in sickle cell anemia?
The hemoglobin is partially or completely replaced with abnormal hemoglobin, hemoglobin forms by genetic mutation in which amino acid valine replaces amino acid glutamic acid
What is the homework feature of sickle cell anemia?
That’s so occlusion resulting in ischemic tissue injury to organs and chronic hemolytic anemia
Can sickle cell’s return to their normal shape, what causes this?
Yes, sickle cells can return to their normal shape when stress is relieved and patient is rehydrated and re-oxygenated
The typical red blood cell is 120 days, how long is a sickle cell lifespan?
10 to 20 days
What are some factors which can precipitate sickling?
Fever or infection, trauma, dehydration, hypoxia, poorly pressurized airplanes, vasoconstriction when cold, emotional and physical stress
What is a life-threatening complication for sickle cell disease?
Splenic sequestering
What is the leading cause of death in sickle cell anemia?
Bacterial infections
Strokes are a significant risk of sickle cell anemia, they can lead to what problems?
Mental retardation, developmental delays, and other neurological outcomes
When does sickle cell anemia usually present
4 to 6 months of age
How can newborns be diagnosed for sickle cell anemia?
Testing cord blood via hemoglobin electrophoresis
What are some clinical manifestations of sickle cell anemia?
Most common complaint is pain. Splenic sequestions, febrile illness, cerebrovascular accident, chronic complications: Anemia, delayed growth and development, jaundice, retinopathy
What is a sickle cell crisis?
An acute exacerbation of the disease that varies in severity and frequency
What is the most common type of Sickel cell crisis?
A vasso-occlusive crisis. It is very painful and caused by stasis of blood, clumping, ischemia, and infarction
What are clinical symptoms of a sickle cell crisis?
Fever, pain, tissue engorgement, severe abdominal pain
What is splenic sequestration?
A life-threatening event caused by the pulling of blood in the spleen. The spleen can hold 1/5 of the bodies blood supply at a time. Because of this it can lead to cardiovascular Collapse, profound anemia, and hypovolemic shock
In sickle cell anemia, what is an aplastic crisis?
Diminished erythropoiesis triggered by viral infection or depletion of full lick acid. Causes profound anemia, pallor, and fatigue.
What is the most common reason for hospitalization with sickle cell patients?
Pain, commonly found in the back, abdomen, chest, and joints. Intensity and duration varies. Opioid analgesics, and PCA pumps are used
What is the treatment for sickle cell anemia?
Sickle cell anemia has no cure, supportive treatment and prevention our key. Morphine is used around the clock for pain, oral and IV fluids are provided, oxygen, if needed. Daily prophylactic penicillin, the pneumococcal vaccine, transfusion of packed red blood cells
What is hemophilia?
A group of hereditary bleeding disorders resulting from deficiency and specific clotting factors
What is the most common form of hemophilia? And what is it a deficiency of?
Hemophilia A is most common, and it is a deficiency of clotting factor eight
Hemophilia B is a deficiency of what factor?
Clotting factor nine
Which form of hemophilia is most common?
Hemophilia A, which accounts for 80% of the cases in the United States. Hemophilia B has approximately 15% of cases
What is treatment for hemophilia?
Factory replacement therapy, caregivers learn to start IVs and administer the factor, this keeps the child from bleeding and must be infuse your teammate to keep factor is high enough
In hemophilia how can you limit joint involvement and management of pain?
Elevate, immobilize, and ice. Provide range of motion exercises once the bleeding stops, leading into joints frequently causes damage severe enough to make joint replacement and young adult hood necessary
What medication should not be given to children with hemophilia?
Aspirin
The pneumonic device rice stands for what and should be used during what?
Rice should be used during acute bleeding and stands for rest, ice, compression, elevate
What is von Willebrand disease
The most common hereditary bleeding disorder which is a deficiency and plasma protein that carries clotting factor eight. Clot formation and bleeding control is impaired
Which bleeding disorder is only present in males and passed on from the mother?
Hemophilia, von Willebrand disease is present in males and females
What are the manifestations of von Willebrand disease?
Prolonged and excessive mucocutaneous bleeding. Gingival bleeding, epistaxis, bruising, increased bleeding during surgery or dental procedures, menorrhagia, gastrointestinal bleeding.
What are the treatment goals for von Willebrand of these
Restore plotting function and prevent bleeding complications
What is given to patients who have von Willebrand disease?
Von Willebrand protein concentrate, and Desmopressin
What is disseminated intravascular coagulation?
A life-threatening complication in which clotting system is abnormally activated resulting in widespread clot formation in the small vessels.
What is commonly affected and disseminated intravascular coagulation?
Pulmonary, Reno, hepatic, and central nervous systems
What is the most common cause of DIC?
Sepsis
What are the manifestations of DIC?
Manifestations range from minor oozing to uncontrolled hemorrhages
