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NUR 195 > Hematological Disorders > Flashcards

Hematological Disorders Flashcards

1
Q

WHAT AM I:

  • sudden on set of symptoms
  • leukocytes are undifferentiated
  • immature calls (blasts)
  • progresses rapidly
  • death can occur in weeks to months without rapid treatment.
A
  • acute leukemia
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2
Q

What is this a common feature of:
- unregulated proliferation of leukocytes in the bone marrow and suppression of other cells, including RBC’s and platelets.

A
  • acute leukemia
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3
Q

What are these clinical manifestations of:

  • fever, infection from neutropenia
  • weakness, fatigue from anemia
  • bleeding tendencies from thrombocytopenia
  • enlarged spleen
  • hyperplasia of the gums
  • bone pain from expansion of the bone marrow.
A
  • Acute Myeloid Leukemia
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4
Q

How do you diagnosis acute myeloid leukemia?

A
  • bone marrow aspiration

- biopsy

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5
Q

Complications of AML?

A
  • bleeding and infection are the most common causes of death
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6
Q

What is the most optimal treatment for AML?

A
  • a stem cell transplant other wise you focus on optimal quality of life.
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7
Q

When a patient with AML is a candidate for a stem cell transplant what are the next steps?

A
  • induction therapy chemo/radiation > to destroy abnormal cells
  • then consolidation chemo/radiation > to destroy residual abnormal cells
  • then the stem cell transplant
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8
Q

Nursing management for AML is aimed at?

A
  • assessing, monitoring and providing care towards infection prevention, bleeding prevention, and promoting comfort, and patient education.
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9
Q

What am I:

  • uncontrolled proliferation of immature lymphoid cells, B- cells, and T-cells.
  • peak incidence 4 years of age, higher in boys, survival rate increases with age.
A
  • Actue lymphocytic leukemia (ALL)
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10
Q

What are these clinical manifestations of?

  • immature lymphocytes proliferate and impede the development of normal myeloid cells, results in reduced number of leukocytes, erythrocytes, and platelets.
  • leukemic cells infiltrate into other organs causing pain to enlarged spleen or liver and bone pain
  • the testes and the CNS are sanctuary sites for leukemic cells: may cause swelling in testes or discomfort, HA, visual changes, vomiting, and neurologic deficits
  • children may report bone and joint pain
A
  • acute lymphocytic leukemia (ALL)
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11
Q

How do you diagnosis ALL?

A
  • bone marrow aspiration and biopsy

- lumbar puncture

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12
Q

What is the treatment for ALL?

A
  • may involve chemo into the intrathecal space at the time of lumbar puncture.
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13
Q

Mean should have a testicular exam because the testes are a sanctuary for?

A
  • acute lymphocytic leukemia (ALL)
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14
Q

For nausea and pain in patients with AML and ALL is often from?

A
  • mucositis: this is pain and inflammation of the mucous membranes lining the digestive tract
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15
Q

What lab values should you monitor for AML and ALL?

A
  • leukocyte count
  • ANC
  • hematocrit
  • platelets
  • creatinine
  • electrolytes
  • liver function tests
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16
Q

What are the phases of chronic myeloid leukemia (CML)?

A
  • chronic
  • accelerated
  • acute
17
Q

Which phase of CML is when most of the leukocytes produced are mature and retain some ability to function normally?

A
  • chronic
18
Q

What phase of CML is when the number of abnormal cells are being produced at a faster rate?

A
  • accelerated
19
Q

What phase of CML is when the predominant cell type is immature?

A
  • acute
20
Q

Which phase are most patients with CML diagnosed in?

A
  • chronic
21
Q

Untreated CML will progress to the advanced phases in ______ years.

A

3 - 5

22
Q

Research has shown that CML is primarily due to?

A
  • chromosomal abnormality
23
Q

Myeloid cells that over proliferate in the liver and spleen cause?

A
  • pain and enlargement
24
Q

What are these symptoms of:

  • fatigue, night sweats abdominal pain, early satiety (feeling of fullness), and weight loss
  • extremely high leukocyte counts (over 100,000) may have signs of leukostatis - high volume of leukocytes slows blood flow through the capillaries due to increased viscosity
  • signs may be confusion, vision changes, SOB, chest pain due to decreased capillary perfusion to the brain, eyes, and lungs
  • may have enlarged tender spleen, liver may be enlarged
A
  • CML
25
Q

Medication for CML:

A
  • tyrosine - kinase inhibitor

* * avoid grapefruit juice, antacids, PPI’s **

26
Q

What do you monitor during CML therapy?

A
  • CBC with expected normalization within the first 4 - 6 weeks.
  • continued monitoring about every 3 months.
    • WBC need to be quickly reduced to minimize complications.
27
Q

What leukemia is this:

  • excessive accumulation of cells in the marrow and circulation, primarily B lymphocytes
  • elevated lymphocyte count, can exceed 100,000/mm
  • lymphadenopathy
  • hepatomegaly and splenomegaly develop
A

Chronic lymphatic Leukemia (CLL)

NUR 195 (13 decks)

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