Hematological Assessment 2 Flashcards
1
Q
What are the 3 functions of the hematology system
A
perfusion, clotting, immunity
2
Q
what is perfusion
A
blood is the oxygen delivery system
3
Q
what does bone marrow make
A
red blood cells, white blood cells, platelets
4
Q
what is another name for red blood cells
A
erythrocytes
5
Q
what is another name for white blood cells
A
leukocytes
6
Q
what is another name for platelets
A
thrombocytes
7
Q
what is bone marrow also involved in
A
immune response
8
Q
what is the spleens white pulp do
A
storage of WBC, major site of antibody production
9
Q
what is the spleens red pulp do
A
storage site for RBC and platelets
10
Q
what is the spleens function
A
regulate RBC production, destroys old/imperfect RBCs, filters out bacteria
11
Q
what does the liver form
A
factor IIV, IX, and X
12
Q
what does the liver store
A
extra whole blood cells and ferritin
13
Q
proper liver function is important for the production of…
A
vitamin K
14
Q
what does albumin do
A
maintains the osmotic pressure in the circulatory system and prevents plasma from leaking into the tissues
15
Q
what does albumin carry
A
hormones, enzymes, and medications
16
Q
what is plasma
A
extra cellular fluid where blood cells are suspended
17
Q
what does plasma consist of
A
albumin, globulin, and fibrinogen
18
Q
what does globulins do
A
play a role in fighting infection
19
Q
what does fibrinogen do
A
critical to the clotting process
20
Q
what is the largest portion of blood
A
red blood cells
21
Q
what do RBC look like
A
red, smooth, biconcave
22
Q
what are some WBC granulocytes
A
neutrophils, basophils and eosinophils
23
Q
what are some WBC agranulocytes
A
lymphocytes and monocytes
24
Q
what is the smallest blood cell
A
platelets
25
what do platelets do
stick to injured site and form clot to control bleeding, can repair small vessels
26
where are platelets stored
20% in spleen 80% circulating
27
what is platelet production controlled by
substance called thrombopoietin
28
what is erythropoiesis
process of RBC production
29
how long do RBC live
120 day life cycle
30
where is erythropoietin made
kidneys production remains steady to keep up with RBC life cycle
31
what doe hypoxia stimulate
increase release of erythropoietin
32
what does hyperoxia stimulate
slow down of erythropoietin
33
what is hemostasis
multi-stepped process of controlled blood clotting
34
how does hemostatsis balance clotting
anticoagulants
35
where does the extrinsic clotting pathway work
abnormal condition outside the blood vessels
36
where does the intrinsic clotting pathway work
changes within the blood
37
how does the extrinsic and intrinsic pathway work together
the point where the meet results in a stable clot for hemostasis
38
what is fibrinolysis
anticlotting factors that circulate in small amounts in response to the formation of a fibrin clot
39
what does fibrinolysis prevent
over enlargement of the fibrin clot
40
what changes occur from aging
Decrease in blood volume, Bone marrow produces fewer blood cells, Total RBC, WBC counts lower, Lymphocytes are less reactive
41
when do hemoglobins levels fall
after middle-age
42
what is included in the patient history
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
43
what is included in the physical assessment
Skin, Head and neck, Respiratory, Cardiovascular, Kidney and urinary, Musculoskeletal, Abdominal, Central nervous system, Psychosocial
44
what does a peripheral blood smear test
used to exam red and white blood cells and platelets - gives a clear picture of changes
45
what does a CBC include
RBCs, WBCs, Platelets, Hgb/Hct
46
what does reticulocyte count test
total percentage of RBC in the blood sample
47
what does low platelet count mean
thrombocytopenia
48
what does high platelet count mean
thrombocytosis
49
what does hemoglobin electrophoresis test
detects different types of hemoglobin
50
what is Hgb A
normal
51
what is Hgb S
sickle cell
52
what does coombs test test
detects antibodies that act against the hemoglobin
53
what is antibodies that act against hemoglobin known to cause
hemolytic anemia
54
what does serum ferrtin test
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
55
what is the follow up care included for bone marrow aspiration and biopsy
check site every 2 hours for 24 hours avoid activity that could result in trauma - asprin free analgesic can use ice packs
56
what is anemia
reduction in either the number of RBCs, amount of hemoglobin, or hematocrit
57
what are some common causes for anemia
dietary problems, genetic disorders, bone marrow disease, excessive bleeding
58
what is mild hemoglobin
less then 11
59
what is moderate hemoglobin
less then 9
60
what is severe hemoglobin
less then 7
61
what does MCV indicate
size of RBC
62
what does MCH indicate
color of RBC
63
what is abnormal hemoglobin s sensitive to
hypoxia - traveling to higher altitudes and dehydration
64
how long do RBCs last for sickle cell anemia
20 days - bone marrow cant keep up
65
what is sickle cell anemia
blood cells shaped like a sickle, abnormal hemoglobin chain
66
what happens to the spleen from sickle cell
enlarged/overworked
splenomegaly, increased risk for infection
67
is sickle cell dominate or recessive
recessive
68
when is sickle cell diagnosed
about 6 months when fetal hemoglobin beings to replaced by abnormal hemoglobin
69
what are some ss of sickle cell
pain and swelling in the joints
70
what race is sickle cell more prominent
african americans - but can affect all races
71
sickle cell crisis - SICKLE
significant blood loss, illness/infection, climbing ot flying to high altitudes, keeping continued stress, low fluid intake, extreme temp changes
72
what is vaso-occlusive sickle cell
RBCs sticking in vessels, meaning decreased blood flow to organs/tissues
73
what is hyperhemolytic sickle cell
rapid destruction of RBCs- jaundice
74
what is aplastic anemia
bone marrow cannot keep up with RBC production
75
ss of sickle cell
anemia ss: Fatigue, pallor, weakness, SOB, increase HR, cold hands and feet
76
********what is dactylitis and where is it seen
pain in back, joint related to inflammation - sickle cell
77
why is hydration important for sickle cell
dilutes blood keeps RBC from sticking together and helps with renal function
78
what are some interventions for sickle cell
bed rest, hydration, O2, pain control, monitory respiratory status, folic acid, neuro checks, vision screening, remove restricting items
79
what does folic acid help with
RBC production
80
how do you prevention measures for sickle cell
vaccines, no high altitudes, prevent infection, hydration, decrease stress, no smoking, avoid over excertion
81
what kind of testing is done for sickle cell
newborn screening, aminocentesis, dithionite tesing
82
what test confirms sickle cell
Hgb electrophoresis
83
what is hydroxyurea used to treat and how does it work
sickle cell and some cancers
creates fetal hemoglobin, decrease sickling, helps anemia, decreased need for blood transfusion, lowers WBC
84
what is another treatment for sickle cell
stem cell transplants
85
how does someone get thalassemia
inherited blood disorder
86
what decent is more common for thalassemia
mediterranean decent
87
what is thalassemia
less hemoglobin then normal
88
what are the ss fo thalalssemia
fatigue, weakness, slow growth, pallor
89
what is the treatment for mild thalassemia
may not require treatment
90
what is the treatment for severe thalassemia
may require blood transfusions or donor stem cell transplant
91
what is iron deficiency anemia
low iron levels
92
what is the most common type of anemia
iron deficiency
93
where is the most of the bodys iron found in
70% found in hemoglobin
94
what does LOW IRON stand for
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
what should you not take iron with
food, coffee, calcium, or antacids wait 2 hours inbetween
96
what helps absorption of iron
vitamin c
97
what could iron do to stool
dark green or black
98
how should you take liquid iron
with straw it could stain teeth
99
what tests evaluate iron levels
CBC, iron level, blood smear
100
what could be some causes for iron deficent anemia
poor intake, absorption problem (celiac, cystic fibrosis, short gut syndrome), losing iron due to blood loss
101
what is pernicious anemia
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
what are some ss of pernicious anemia
pale, no energy, red swollen tongue, numbness, confusion, depression, unsteady gait, loss of appetite, SOB with activity
103
what are the neurological symptoms for pernicious anemia
tingling, burning, numbness
104
what do you need to give for pernicious anemia
vitamin B12
105
what is thrombocytopenia
Destructive reduction of circulating platelets after normal platelet production; impaired clotting occurs
106
what is heparin-induced thrombocytopenia
immune mediated adverse reaction to heparin, low platlet count
107
stop heparin if platelet count...
less then 100,000
108
how do you treat thrombocytopenia
platelet transfusions, anticoagulants, splenectomy
109
what is hemophilla
Blood does not clot properly resulting in excessive bleeding after an injury or damage.
110
what are ss of hemophilla
Bruising, Joint Pain, Swelling, Unexplained Bleeding, Hematuria or Hemoccult
111
how do you treat hemophilla
clotting factors, plasma
112
what is DIC
Abnormal clotting in the body, All clotting factors are used up, Causes abnormal bleeding
113
what is the treatment for DIC
supportive care, fluids and blood transfusions
114
what is factor V leiden
A mutation of one genes that controls Factor V, Linked to an increase in blood clots
115
what are the ss of facor v leiden
easy bruising, nose bleeds, excessive bleeding after surgery or trauma
116
what is the treatment for factor v leiden
Infusion of FFP, blood, and platelets
117
what is von willebrand disease
Bleeding disorder caused by low levels of clotting protein in the blood
118
how does someone get von willebrand disease
inherited but rarely may develop later in life
119
what are the ss of von willebrand disease
Recurrent/prolonged nosebleeds, Bleeding from the gums, Increased menstrual flow, Excessive bleeding with surgery or trauma
120
what is the treatment of choice for von willebrand disease
desmopressin
121
what kind of cell is seen in hodgkins lymphoma
reed-sternburg cell - giant cell
122
what is non-hodgkins more common in
male and older adults
123
what are the ss of non/hodgkins lymphoma
Large, painless lymph node(s), Fevers, drenching night sweats, unplanned weight loss, Some have no symptoms at time of diagnosis
124
what are some treatment options for non/hodgkins lymphoma
External radiation of lymph node regions, For more extensive disease, radiation and combination chemotherapy is used, CAR-T therapy
125
what is multiple myeloma
WBC cancer of mature b-lymphocytes
126
what are the ss of multiple myeloma
fatigue, easy bruising, bone pain
127
what is the treatment for multiple myeloma
involves watchful waiting, Proteasome Inhibitors, Immunomodulating drugs, HSCT
128
what is leukemia
Blood cancer – uncontrolled production of WBCs (blast cells) in bone marrow
129
how is leukemia classified
by cell type – lymphocytic or lymphoblastic
130
what are some risk factors of leukemia
Ionizing radiation, Viral infection, Exposure to chemicals and drugs
131
what are some transfusion reactions
Acute hemolytic, Febrile, Allergic, Circulatory Overload, Sepsis
132
what does warfarin do
long term anticoagulant
133
how does warfarin work
prevents clotting factors in the liver
134
what tests should you monitor when taking warfarin
PT, INR
135
what is normal Prothrombin time
10-12 seconds
136
what is normal international normalized ratio
0.75-1.25
137
what is the INR therapeutic range when taking warfarin
2-3
138
what ss shoul you monitor when taking warfarin
ss of bleeding
139
who should not take warfarin
active bleeding, wounds, ulcers, spinal/eye/brain surgery, renal or liver failure
140
what is warfarins antidote
vitamin K
141
what is heparin used for
short term anticoagulant
142
how does heparin work
Prevents clotting by activating antithrombin, which indirectly inactivates thrombin and factor Xa, inhibiting fibrin formation
143
what is heparins antidote
protamine
