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Med surg 2 > Hematological Assessment 2 > Flashcards

Hematological Assessment 2 Flashcards

1
Q

What are the 3 functions of the hematology system

A

perfusion, clotting, immunity

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2
Q

what is perfusion

A

blood is the oxygen delivery system

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3
Q

what does bone marrow make

A

red blood cells, white blood cells, platelets

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4
Q

what is another name for red blood cells

A

erythrocytes

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5
Q

what is another name for white blood cells

A

leukocytes

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6
Q

what is another name for platelets

A

thrombocytes

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7
Q

what is bone marrow also involved in

A

immune response

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8
Q

what is the spleens white pulp do

A

storage of WBC, major site of antibody production

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9
Q

what is the spleens red pulp do

A

storage site for RBC and platelets

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10
Q

what is the spleens function

A

regulate RBC production, destroys old/imperfect RBCs, filters out bacteria

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11
Q

what does the liver form

A

factor IIV, IX, and X

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12
Q

what does the liver store

A

extra whole blood cells and ferritin

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13
Q

proper liver function is important for the production of…

A

vitamin K

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14
Q

what does albumin do

A

maintains the osmotic pressure in the circulatory system and prevents plasma from leaking into the tissues

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15
Q

what does albumin carry

A

hormones, enzymes, and medications

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16
Q

what is plasma

A

extra cellular fluid where blood cells are suspended

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17
Q

what does plasma consist of

A

albumin, globulin, and fibrinogen

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18
Q

what does globulins do

A

play a role in fighting infection

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19
Q

what does fibrinogen do

A

critical to the clotting process

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20
Q

what is the largest portion of blood

A

red blood cells

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21
Q

what do RBC look like

A

red, smooth, biconcave

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22
Q

what are some WBC granulocytes

A

neutrophils, basophils and eosinophils

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23
Q

what are some WBC agranulocytes

A

lymphocytes and monocytes

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24
Q

what is the smallest blood cell

A

platelets

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25
Q

what do platelets do

A

stick to injured site and form clot to control bleeding, can repair small vessels

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26
Q

where are platelets stored

A

20% in spleen 80% circulating

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27
Q

what is platelet production controlled by

A

substance called thrombopoietin

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28
Q

what is erythropoiesis

A

process of RBC production

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29
Q

how long do RBC live

A

120 day life cycle

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30
Q

where is erythropoietin made

A

kidneys production remains steady to keep up with RBC life cycle

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31
Q

what doe hypoxia stimulate

A

increase release of erythropoietin

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32
Q

what does hyperoxia stimulate

A

slow down of erythropoietin

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33
Q

what is hemostasis

A

multi-stepped process of controlled blood clotting

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34
Q

how does hemostatsis balance clotting

A

anticoagulants

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35
Q

where does the extrinsic clotting pathway work

A

abnormal condition outside the blood vessels

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36
Q

where does the intrinsic clotting pathway work

A

changes within the blood

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37
Q

how does the extrinsic and intrinsic pathway work together

A

the point where the meet results in a stable clot for hemostasis

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38
Q

what is fibrinolysis

A

anticlotting factors that circulate in small amounts in response to the formation of a fibrin clot

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39
Q

what does fibrinolysis prevent

A

over enlargement of the fibrin clot

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40
Q

what changes occur from aging

A

Decrease in blood volume, Bone marrow produces fewer blood cells, Total RBC, WBC counts lower, Lymphocytes are less reactive

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41
Q

when do hemoglobins levels fall

A

after middle-age

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42
Q

what is included in the patient history

A

Age, gender, Liver function, Occupation and hobbies, and home location, Drug use (prescribed, OTC, illicit), Nutrition status, Finances and social support, Family history and genetic risk, Current health problems

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43
Q

what is included in the physical assessment

A

Skin, Head and neck, Respiratory, Cardiovascular, Kidney and urinary, Musculoskeletal, Abdominal, Central nervous system, Psychosocial

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44
Q

what does a peripheral blood smear test

A

used to exam red and white blood cells and platelets - gives a clear picture of changes

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45
Q

what does a CBC include

A

RBCs, WBCs, Platelets, Hgb/Hct

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46
Q

what does reticulocyte count test

A

total percentage of RBC in the blood sample

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47
Q

what does low platelet count mean

A

thrombocytopenia

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48
Q

what does high platelet count mean

A

thrombocytosis

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49
Q

what does hemoglobin electrophoresis test

A

detects different types of hemoglobin

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50
Q

what is Hgb A

A

normal

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51
Q

what is Hgb S

A

sickle cell

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52
Q

what does coombs test test

A

detects antibodies that act against the hemoglobin

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53
Q

what is antibodies that act against hemoglobin known to cause

A

hemolytic anemia

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54
Q

what does serum ferrtin test

A

the level of iron in the blood, transferrin or TIBC - how much iron can your body transport, ferritin the amount of stored iron in the body

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55
Q

what is the follow up care included for bone marrow aspiration and biopsy

A

check site every 2 hours for 24 hours avoid activity that could result in trauma - asprin free analgesic can use ice packs

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56
Q

what is anemia

A

reduction in either the number of RBCs, amount of hemoglobin, or hematocrit

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57
Q

what are some common causes for anemia

A

dietary problems, genetic disorders, bone marrow disease, excessive bleeding

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58
Q

what is mild hemoglobin

A

less then 11

59
Q

what is moderate hemoglobin

A

less then 9

60
Q

what is severe hemoglobin

A

less then 7

61
Q

what does MCV indicate

A

size of RBC

62
Q

what does MCH indicate

A

color of RBC

63
Q

what is abnormal hemoglobin s sensitive to

A

hypoxia - traveling to higher altitudes and dehydration

64
Q

how long do RBCs last for sickle cell anemia

A

20 days - bone marrow cant keep up

65
Q

what is sickle cell anemia

A

blood cells shaped like a sickle, abnormal hemoglobin chain

66
Q

what happens to the spleen from sickle cell

A

enlarged/overworked
splenomegaly, increased risk for infection

67
Q

is sickle cell dominate or recessive

A

recessive

68
Q

when is sickle cell diagnosed

A

about 6 months when fetal hemoglobin beings to replaced by abnormal hemoglobin

69
Q

what are some ss of sickle cell

A

pain and swelling in the joints

70
Q

what race is sickle cell more prominent

A

african americans - but can affect all races

71
Q

sickle cell crisis - SICKLE

A

significant blood loss, illness/infection, climbing ot flying to high altitudes, keeping continued stress, low fluid intake, extreme temp changes

72
Q

what is vaso-occlusive sickle cell

A

RBCs sticking in vessels, meaning decreased blood flow to organs/tissues

73
Q

what is hyperhemolytic sickle cell

A

rapid destruction of RBCs- jaundice

74
Q

what is aplastic anemia

A

bone marrow cannot keep up with RBC production

75
Q

ss of sickle cell

A

anemia ss: Fatigue, pallor, weakness, SOB, increase HR, cold hands and feet

76
Q

**what is dactylitis and where is it seen

A

pain in back, joint related to inflammation - sickle cell

77
Q

why is hydration important for sickle cell

A

dilutes blood keeps RBC from sticking together and helps with renal function

78
Q

what are some interventions for sickle cell

A

bed rest, hydration, O2, pain control, monitory respiratory status, folic acid, neuro checks, vision screening, remove restricting items

79
Q

what does folic acid help with

A

RBC production

80
Q

how do you prevention measures for sickle cell

A

vaccines, no high altitudes, prevent infection, hydration, decrease stress, no smoking, avoid over excertion

81
Q

what kind of testing is done for sickle cell

A

newborn screening, aminocentesis, dithionite tesing

82
Q

what test confirms sickle cell

A

Hgb electrophoresis

83
Q

what is hydroxyurea used to treat and how does it work

A

sickle cell and some cancers
creates fetal hemoglobin, decrease sickling, helps anemia, decreased need for blood transfusion, lowers WBC

84
Q

what is another treatment for sickle cell

A

stem cell transplants

85
Q

how does someone get thalassemia

A

inherited blood disorder

86
Q

what decent is more common for thalassemia

A

mediterranean decent

87
Q

what is thalassemia

A

less hemoglobin then normal

88
Q

what are the ss fo thalalssemia

A

fatigue, weakness, slow growth, pallor

89
Q

what is the treatment for mild thalassemia

A

may not require treatment

90
Q

what is the treatment for severe thalassemia

A

may require blood transfusions or donor stem cell transplant

91
Q

what is iron deficiency anemia

A

low iron levels

92
Q

what is the most common type of anemia

A

iron deficiency

93
Q

where is the most of the bodys iron found in

A

70% found in hemoglobin

94
Q

what does LOW IRON stand for

A

lethargic, overexerted easily, weird food cravings/white faced, inflammation of the tongue/increase HR, reduced hemoglobin levels, observable RBC changes, nail changes (spoon shaped),

95
Q

what should you not take iron with

A

food, coffee, calcium, or antacids wait 2 hours inbetween

96
Q

what helps absorption of iron

A

vitamin c

97
Q

what could iron do to stool

A

dark green or black

98
Q

how should you take liquid iron

A

with straw it could stain teeth

99
Q

what tests evaluate iron levels

A

CBC, iron level, blood smear

100
Q

what could be some causes for iron deficent anemia

A

poor intake, absorption problem (celiac, cystic fibrosis, short gut syndrome), losing iron due to blood loss

101
Q

what is pernicious anemia

A

the body does not produce enough intrinsic factor resulting Vitamin B12 deficiency –> GI system unable to absorb B12 because of the low intrinsic factor making the body attack parietal cells

102
Q

what are some ss of pernicious anemia

A

pale, no energy, red swollen tongue, numbness, confusion, depression, unsteady gait, loss of appetite, SOB with activity

103
Q

what are the neurological symptoms for pernicious anemia

A

tingling, burning, numbness

104
Q

what do you need to give for pernicious anemia

A

vitamin B12

105
Q

what is thrombocytopenia

A

Destructive reduction of circulating platelets after normal platelet production; impaired clotting occurs

106
Q

what is heparin-induced thrombocytopenia

A

immune mediated adverse reaction to heparin, low platlet count

107
Q

stop heparin if platelet count…

A

less then 100,000

108
Q

how do you treat thrombocytopenia

A

platelet transfusions, anticoagulants, splenectomy

109
Q

what is hemophilla

A

Blood does not clot properly resulting in excessive bleeding after an injury or damage.

110
Q

what are ss of hemophilla

A

Bruising, Joint Pain, Swelling, Unexplained Bleeding, Hematuria or Hemoccult

111
Q

how do you treat hemophilla

A

clotting factors, plasma

112
Q

what is DIC

A

Abnormal clotting in the body, All clotting factors are used up, Causes abnormal bleeding

113
Q

what is the treatment for DIC

A

supportive care, fluids and blood transfusions

114
Q

what is factor V leiden

A

A mutation of one genes that controls Factor V, Linked to an increase in blood clots

115
Q

what are the ss of facor v leiden

A

easy bruising, nose bleeds, excessive bleeding after surgery or trauma

116
Q

what is the treatment for factor v leiden

A

Infusion of FFP, blood, and platelets

117
Q

what is von willebrand disease

A

Bleeding disorder caused by low levels of clotting protein in the blood

118
Q

how does someone get von willebrand disease

A

inherited but rarely may develop later in life

119
Q

what are the ss of von willebrand disease

A

Recurrent/prolonged nosebleeds, Bleeding from the gums, Increased menstrual flow, Excessive bleeding with surgery or trauma

120
Q

what is the treatment of choice for von willebrand disease

A

desmopressin

121
Q

what kind of cell is seen in hodgkins lymphoma

A

reed-sternburg cell - giant cell

122
Q

what is non-hodgkins more common in

A

male and older adults

123
Q

what are the ss of non/hodgkins lymphoma

A

Large, painless lymph node(s), Fevers, drenching night sweats, unplanned weight loss, Some have no symptoms at time of diagnosis

124
Q

what are some treatment options for non/hodgkins lymphoma

A

External radiation of lymph node regions, For more extensive disease, radiation and combination chemotherapy is used, CAR-T therapy

125
Q

what is multiple myeloma

A

WBC cancer of mature b-lymphocytes

126
Q

what are the ss of multiple myeloma

A

fatigue, easy bruising, bone pain

127
Q

what is the treatment for multiple myeloma

A

involves watchful waiting, Proteasome Inhibitors, Immunomodulating drugs, HSCT

128
Q

what is leukemia

A

Blood cancer – uncontrolled production of WBCs (blast cells) in bone marrow

129
Q

how is leukemia classified

A

by cell type – lymphocytic or lymphoblastic

130
Q

what are some risk factors of leukemia

A

Ionizing radiation, Viral infection, Exposure to chemicals and drugs

131
Q

what are some transfusion reactions

A

Acute hemolytic, Febrile, Allergic, Circulatory Overload, Sepsis

132
Q

what does warfarin do

A

long term anticoagulant

133
Q

how does warfarin work

A

prevents clotting factors in the liver

134
Q

what tests should you monitor when taking warfarin

A

PT, INR

135
Q

what is normal Prothrombin time

A

10-12 seconds

136
Q

what is normal international normalized ratio

A

0.75-1.25

137
Q

what is the INR therapeutic range when taking warfarin

A

2-3

138
Q

what ss shoul you monitor when taking warfarin

A

ss of bleeding

139
Q

who should not take warfarin

A

active bleeding, wounds, ulcers, spinal/eye/brain surgery, renal or liver failure

140
Q

what is warfarins antidote

A

vitamin K

141
Q

what is heparin used for

A

short term anticoagulant

142
Q

how does heparin work

A

Prevents clotting by activating antithrombin, which indirectly inactivates thrombin and factor Xa, inhibiting fibrin formation

143
Q

what is heparins antidote

A

protamine

Med surg 2 (12 decks)

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