Hematological disorders flashcards (2)
What are 3 examples of anti-infectives?
antibiotics, anti-virals, anti-fungals
What are the s/s that a patient has had an allergy response to a med? And What should the nurse do?
chills, fever, torso flat rash. Stop infusion, follow protocol
Name 3 routes for Anti-fungals
topical, Im, IV
What is the fxn of RBCs?
carry O2 to cells via Hgb
True or False, numbers of WBCs directly affect oxygenation
False, RBCs do
What is the normal Hgb & Hct?
13.5-15, 35-45
Which cell creates plug for hemostais at site o finjury?
Platelets
What is normal platelet count?
150,00-400,000
Too many platlets=
cloting problem
Too few platelets=
bleeding
What is normal WBC count?
5,000-10,000
Too few WBCs=
infection, tissue damage
Too many WBCs=
infection, anmormal response (cancer)
Anemia can lead to_____
tissue hypoxia
When doing an assessment for Anemia, what should you include in the assessment?
family history, drugs and chemicals (antibiotics, chemotherapy, arsenci), subjective data: fatigue and malasie, activity intolerance, cold intolerance, dizziness
Pallor, pale nail beds mucous membranes and conjunctiva, DOE, orthro HTN, tachycardia, murmurs, anorexia, weight loss, headaches, abdormal CBC, decreased RBC Hgb hect, MCB increase, MCHC norm/hypo chromatic are all objective data for what illness?
Amemia
Carrie is an 87 year old woman dx with anemia, what would you expect her labs to be?
dec Hgb, inc. MCB, dec. MCHC, WBC- diminished response to infection
Jean comes into the hospital clotting, hypertensive, with altered perfusion, what is her dx?
polycythemia
What can polycythemia lead to?
strokes, MI, arterial ulcers, organ damage, bleeding
What is the tx for Jean’s polycythemic state?
hydration, phlebotomy
Marybeth is admitted for anemia, what would you expect her tx workup to be?
O2, blood/blood product transfusion, nutritional supplements (vitamins, folic acid, iron, B complex, Diet high in iron and Ca++, BRMs
What are 2 examples of BRMs?
erythropoietin (Epogen, procrit)
What are 5 nursing dx for anemia?
Decreased CO, altered tissue perfusion, fatigue, anxiety, ineffective breathing pattern, altered comfort r/t DOE & chest pain, activity intolerance
What are the nursing interventions for anemia/polycythemia?
adequate rest, monitor vital signs, lab work
Malcom is a new patient in ICU being treated for anemia, what would you assess througout your shift?
efectiveness of meds, circulation, mucous membranes, breathing, oxygenation
What are other nursing interventions for anemia?
protect extremities from cold, develop activity schedules to provide rest, consult with RD re diet high in protein & iron, monitor blood for pyrogenic rxn, fluid overload, trali, hemolysis
What types of blood products can a person receive?
whole blood, packed cells, plasmanate and albumin IV - WBC poor
How often should vital signs be taken when giving blood?
Temp before, then 15 min after, then 30-60 min
What can cause thrombocytopenia?
blood loss, idiopathic autoimmune, bone marrow suppression
What is abnormal platelet count?
less than 100,000- 50,000 has clinical symptoms
George comes into the ED with petechia, a hematoma on his abdomen, and purpura. He appears fatgued and showing sign of decrease LOC. He states he vommitted frank blood before coming into the ED. What is this an example of?
Thrombocytopenia
Mc. Dreamy is caring for George (thrombocytopenia), what would his common tx be>
platelet administration, BRMs- neupogen, GCSF
What are 5 nursing dx for thrombocytopenia?
risk for injury-bleeding, altered skin integrity, fatigue, altered though processes, decreased CO, and altered tissue perfusion
If a person is at risk for thrombocytopenia, what kind of interventions would you implement?
soft bristled toothbrush, avoid flossing, electric razors, avoid injections, avoid platelet inhibiting drugs, avoid invasive procedures, monitor labs, monitor vital signs, color, SaO2, hemastat stools, emesis
Malignancies, splenectomy, polycythemia vera are all causes of what?
Thrombocytosis
Which lab value indicates Thrombocytosis?
platlets greater 400,000
What are the medical orders for Thrombocytosis?
hydration, anticoagulation (heparin), coumadin, thrombolytics, phlebotomy
What is normal PTT?
25- 32 seconds no heparin, 35-50 seconds on heparin
What is normal INR?
1, 2-3 if on coumadin
What is normal PT. It is useless w/out what?
12.5-13 seconds,INR
If you suspect you patient is thrombocytopenic, what would you assess?
vital signs (BP, HR, rhythm, peripheral pulses, RR & pattern), intermittent claudication, skin, tissue integrity, LOC, orientation and lab values
You are caring for a patient with thrombocytosis, what interventions would you implement?
TED hose, SCDs, elevate legs, don?t cross legs, mobilize, monitor effects of meds - bleeding, therapeutic levels
low WBCs
inability to fight infection, immune response
What type of lab work would a person with low WBC have?
WBC plus differential, absolute neutrophil counts, precent neut
What would be a medical order for abdnormal WBCs?
blood transfusions, bone marrow transplant, BRMs: neupogen, GCSF, anti-infectives
What are 4 nursing dx for WBC disorders?
high risk of infection, altered tissue perfusion, potential altered skin and tissue integrity, risk of injury, anaphylaxis