Hematological Problems (Exam 1 ) Flashcards
1
Q
Bone Marrow
A
- one of the largest ORGANS in the body
- found in all bones
- primary function is hematopoiesis
- red
- yellow
2
Q
Blood is used for
A
transportation
regulation
protection
3
Q
Blood transports
A
oxygen, nutrients, hormones, waste products
4
Q
Blood regulates
A
of fluid , electrolytes, and acid base balance
5
Q
Blood protection
A
ability to clot and ability to combat infections
6
Q
Eyrthrocytes (RBCs)
A
- function to transport O2 and CO2
- produced in red bone marrow
- life span 115-130 days
- eliminated by phagocytoisis in the spleen and liver
- Approx 5 million in the body
7
Q
Leukocytes ( WBC’s )
A
- Approximately 5000 - 10,000
- granulocytes
- agranulocytes
- monocytes
8
Q
Red bone marrow
A
found in the pelvis, sternum, ribs ends of long bones and vertebral
9
Q
Red bone marrow purpse
A
hematopoiesis
10
Q
Yellow bone marrow
A
is red marrow changed to fat (adipose)
does not contribute to hematopiesis
11
Q
Blood basics
A
Blood is a type of connective tissue
- arterial blood - bright read
- venous blood- dark red
- visosity- 3 to 4 times thicker than water
- pH 7.35-7.45
- Volume 5-6 liters
12
Q
Blood Contributing organs
A
- bone marrow
- spleen
- liver
- lymph nodes
13
Q
bone marrow hematopiesis
A
forms blood cells
14
Q
Spleen
A
- Produces RBCs during fetal formation
- Filters out old RBCs, filters iron and returns it to the marrow for re-use
- Filters out bacteria, stores WBCs and immunoglobulins
- Stores RBCs and platelets about 30% of platelets are storred in the spleen
15
Q
Liver
A
- Functions as a filter, filters out bad things
- Produces procagulants
- Stores iron
16
Q
Lymph nodes
A
- filter out pathogens from the blood, WBCs tend to hang out in lymph nodes, smetimes during an viral or bacterial infection lymph nodes swell
17
Q
Substances needed to produce RBCs
A
Iron
Vitamin B12
Folic Acid
Vitamin B6
18
Q
Phagocytosis
A
are broken RBCs and iron will be recycled out of them
19
Q
Graulocytes (WBC) groups
A
Basoiphils
Eosinophils
Neutophils
20
Q
Neutriphils
A
most common
Phagocytosis 70% of total WBCs
Fight bacteria by phagocytosis, primary responders in acute inflammatory states
21
Q
Eosinophin
A
2-4% of total WBCs parasitic infections allergic reactions
22
Q
basophils
A
2% of total WBCs inflammatory response and allergic reactions
23
Q
Agranulocytes
A
lymphocyte
monocytes
24
Q
lymphocytes
A
20-40% of total WBCs immune response
- B cells and T cells
- produced in lymph nodes
- produce antibodies to viral invasion
25
Monocytes
4-8% of total WBCs
- eats everything
- phagocytosis of red RBC & WBC
26
Thrombocytes (platelet)
- cell fragments
- primary function- clotting
- life span only 5-9
- 1/3 of bodies platelets are stored in the spleen
27
Additional testing
In addition to platelets coagulation factors are needed for coagulation
- most coagulation factors are produced by the liver
- a deficiency of either platelets or coagulation facts creates a risk for bleeding
- they would be released in a time of a large trauma
28
Normal Iron Metabolism
- only 5-10% of ingested iron is absorbed
- 2/3 of the bodies iron is in RBCs
- 1/3 is stored as ferritin
- transported by trasnferrin
- recycled after liver/spleen ingest old RBCs
29
Mechanisms
- vasoconstriction
- platelet plug
- fibrin clot
- Lysis of the clot
30
Vessels centrist
to minimize blood loss
31
plateletes
are activated and rush to the injury site, sticking together and forming a platelet plug establishing a clot
32
Fibrinogen is covered to fibrin by
thrombin
33
fibirnolysis
is when the clot dissolves
34
Health History
- prior hematologic problems
- hereditary disorders
- leukemia
- bleeding problems
- anemia
- any trouble with blood
- family history of hemophilia and sickle cell
35
Medication/ Exposures
- OTC meds
- Alcohol
- Exposure to chemicals
- exposure to radiation
36
OTC medications
aspirin reduces platelet aggregation which increases potential for bleeding, aspirin, ibuprofen, herbals
- toxic dose of tylenol is 15 grams
37
alcohol
damages liver which produces many clotting factors and dehydration
38
exposure to chemicals and radiation
can destroy blood cells
39
Symptoms of anemia
- first symptoms- weakness, fatigue and malaise
- more brusing than usual or bleeding in urine, feces and mouth
- swelling or edema ( lymph nodes in neck & groin, lower extermities)
- pain in joints, bones, or abdomen (sore tongue might mean anemia)
- skin changes0 in color texture, appearance and pruitus
- neurologic changes - headache alterations in vision numbness tingling dizziness or light headedness
- cardiovascular and resp. changes, tachycardia palpations, chestpain, shortness of breath
- GI - anorexia nausea vomiting
40
Physical Assessment
- Skin- color ecchymosis, pruitus
- Eyes- jaundice
- Mouth
* pallor- inadequate oxygenation
* red and smooth- perncious or iron deficiency anemia
* bleeding and oozing from gums
- lymph nodes- palpate for pain and enlargement
- heart & lung sounds
- abdomen enlarged liver and spleen
- musculoskeletal- limited ROM and pain upon movement
41
To palpate lymph nodes
- use the flats of your fingers and press gently
- everytime the lymph bodes swell and it goes back to normal size it never goes back to the original size due to scar tissue
- if you can palpate the liver or spleen there is a problem
- check the gum line if there is a pink tinge to the spit this may indicate bleeding along gum line
42
Diagnostic studies of Hematologic System
Laboratory studies
- complete blood count
- white blood cells
- platelet count
- Blood typing and Rh Factor
43
CBC
measures ability to carry oxygen and resist invaders
44
Erythrocytes measurements
hemoglobin is the main component of RBC
| hematocrit is the percentage of blood occupied by RBC
45
leukocyte measurement
differential is distribution of various types of WBC
46
Coagulation studies
Platelet count 150,000- 400,000
PT used to assess effectiveness of Coumadin
PTT used to assess effectivenes of heparin
47
in order for heprarin to work on a thrombus
the ptt must be 1.5-2.5 times the normal value
| the doctor will determine therapeutic range
48
type A blood
antigen A
| donors A & O
49
Type B blood
antigen B
| Donors B and O
50
blood type AB
antigens - neither A or B
| Donors A, B ,AB and O
51
0
antigens - neither
| O (universal donor)
52
type be blood is popular for
plasma transfusions
53
neative RH
if someone is negative they can not recieve a positive
54
positive rh
if someone is positive they can receive a positive or a negative
55
Bone Marrow Biopsy
provides information on blood cell production
aspiration biopsy
aspiration is used when a small amount is needed
local anesthesia
sterile procedure
56
Purpose of bone marrow biopsy
diagnoses: multiple myeloma, all types of leukemia, some lymphomas and some stages if solid tumors
57
nursing care of bone marrow biopsy
possible pre procedure analgesia
pressure dressing to site, bleeding is a possible complication
painful might need pre and post procedure medication
