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Nursing Adult Health II > Hematological Problems (Exam 1 ) > Flashcards

Hematological Problems (Exam 1 ) Flashcards

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1
Q

Bone Marrow

A
  • one of the largest ORGANS in the body
  • found in all bones
  • primary function is hematopoiesis
  • red
  • yellow
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2
Q

Blood is used for

A

transportation
regulation
protection

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3
Q

Blood transports

A

oxygen, nutrients, hormones, waste products

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4
Q

Blood regulates

A

of fluid , electrolytes, and acid base balance

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5
Q

Blood protection

A

ability to clot and ability to combat infections

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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
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7
Q

Leukocytes ( WBC’s )

A
  • Approximately 5000 - 10,000
  • granulocytes
  • agranulocytes
  • monocytes
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8
Q

Red bone marrow

A

found in the pelvis, sternum, ribs ends of long bones and vertebral

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9
Q

Red bone marrow purpse

A

hematopoiesis

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10
Q

Yellow bone marrow

A

is red marrow changed to fat (adipose)

does not contribute to hematopiesis

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11
Q

Blood basics

A

Blood is a type of connective tissue

  1. arterial blood - bright read
  2. venous blood- dark red
  3. visosity- 3 to 4 times thicker than water
  4. pH 7.35-7.45
  5. Volume 5-6 liters
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12
Q

Blood Contributing organs

A
  • bone marrow
  • spleen
  • liver
  • lymph nodes
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13
Q

bone marrow hematopiesis

A

forms blood cells

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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
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15
Q

Liver

A
  • Functions as a filter, filters out bad things
  • Produces procagulants
  • Stores iron
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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
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17
Q

Substances needed to produce RBCs

A

Iron
Vitamin B12
Folic Acid
Vitamin B6

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18
Q

Phagocytosis

A

are broken RBCs and iron will be recycled out of them

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19
Q

Graulocytes (WBC) groups

A

Basoiphils
Eosinophils
Neutophils

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20
Q

Neutriphils

A

most common
Phagocytosis 70% of total WBCs
Fight bacteria by phagocytosis, primary responders in acute inflammatory states

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21
Q

Eosinophin

A

2-4% of total WBCs parasitic infections allergic reactions

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22
Q

basophils

A

2% of total WBCs inflammatory response and allergic reactions

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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
Q

Monocytes

A

4-8% of total WBCs

  • eats everything
  • phagocytosis of red RBC & WBC
26
Q

Thrombocytes (platelet)

A
  • cell fragments
  • primary function- clotting
  • life span only 5-9
  • 1/3 of bodies platelets are stored in the spleen
27
Q

Additional testing

A

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
Q

Normal Iron Metabolism

A
  • 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
Q

Mechanisms

A
  • vasoconstriction
  • platelet plug
  • fibrin clot
  • Lysis of the clot
30
Q

Vessels centrist

A

to minimize blood loss

31
Q

plateletes

A

are activated and rush to the injury site, sticking together and forming a platelet plug establishing a clot

32
Q

Fibrinogen is covered to fibrin by

A

thrombin

33
Q

fibirnolysis

A

is when the clot dissolves

34
Q

Health History

A
  • prior hematologic problems
  • hereditary disorders
  • leukemia
  • bleeding problems
  • anemia
  • any trouble with blood
  • family history of hemophilia and sickle cell
35
Q

Medication/ Exposures

A
  • OTC meds
  • Alcohol
  • Exposure to chemicals
  • exposure to radiation
36
Q

OTC medications

A

aspirin reduces platelet aggregation which increases potential for bleeding, aspirin, ibuprofen, herbals

  • toxic dose of tylenol is 15 grams
37
Q

alcohol

A

damages liver which produces many clotting factors and dehydration

38
Q

exposure to chemicals and radiation

A

can destroy blood cells

39
Q

Symptoms of anemia

A
  • 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
Q

Physical Assessment

A
  • 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
Q

To palpate lymph nodes

A
  • 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
Q

Diagnostic studies of Hematologic System

A

Laboratory studies

  • complete blood count
  • white blood cells
  • platelet count
  • Blood typing and Rh Factor
43
Q

CBC

A

measures ability to carry oxygen and resist invaders

44
Q

Erythrocytes measurements

A

hemoglobin is the main component of RBC

hematocrit is the percentage of blood occupied by RBC

45
Q

leukocyte measurement

A

differential is distribution of various types of WBC

46
Q

Coagulation studies

A

Platelet count 150,000- 400,000
PT used to assess effectiveness of Coumadin
PTT used to assess effectivenes of heparin

47
Q

in order for heprarin to work on a thrombus

A

the ptt must be 1.5-2.5 times the normal value

the doctor will determine therapeutic range

48
Q

type A blood

A

antigen A

donors A & O

49
Q

Type B blood

A

antigen B

Donors B and O

50
Q

blood type AB

A

antigens - neither A or B

Donors A, B ,AB and O

51
Q

0

A

antigens - neither

O (universal donor)

52
Q

type be blood is popular for

A

plasma transfusions

53
Q

neative RH

A

if someone is negative they can not recieve a positive

54
Q

positive rh

A

if someone is positive they can receive a positive or a negative

55
Q

Bone Marrow Biopsy

A

provides information on blood cell production
aspiration biopsy
aspiration is used when a small amount is needed
local anesthesia
sterile procedure

56
Q

Purpose of bone marrow biopsy

A

diagnoses: multiple myeloma, all types of leukemia, some lymphomas and some stages if solid tumors

57
Q

nursing care of bone marrow biopsy

A

possible pre procedure analgesia
pressure dressing to site, bleeding is a possible complication
painful might need pre and post procedure medication

Nursing Adult Health II (6 decks)

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