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Med Surg > Hematology > Flashcards

Hematology Flashcards

1
Q

Common signs and symptoms of hematologic disorders:

A

Weakness, fatigue, and general malaise, pallor of the skin and mucous membranes (conjunctivae, oral mucosa)

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2
Q

In hematological disorders, when the hemoglobin level is low, the heart attempts to compensate by?

A

pumping faster and harder to deliver more blood to hypoxic tissue.

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3
Q

In hematological disorders, increased cardiac workload can result in

A

tachycardia, palpitations, dyspnea, dizziness, orthopnea, and exertional dyspnea

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4
Q

In hematological disorders, heart failure may eventually develop d/t

A

an enlarged heart (cardiomegaly) and liver (hepatomegaly) and by peripheral edema.

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5
Q

In hematological disorders, pernicious anemia affects the:

A

central and peripheral nervous systems

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6
Q

Neuro assessments in hematological disorders should include:

A

the presence and extent of peripheral numbness, paresthesias, ataxia, poor coordination, and confusion.

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7
Q

In hematological disorders, delirium can sometimes occur from:

A

other types of anemia, particularly in older adults

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8
Q

This hematological disorder is congenital but typically idiopathic:

A

Aplastic anemia

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9
Q

Aplastic anemia is a disorder caused by

A

a decrease in or damage to marrow stem cells, damage to the microenvironment within the marrow, and replacement of the marrow with fat.

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10
Q

In aplastic anemia, Stem cell damage is caused by the body’s T cells

A

mediating an inappropriate attack against the bone marrow, resulting in bone marrow aplasia (i.e., markedly reduced hematopoiesis).

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11
Q

insidious- bone marrow failure (may be first real knowledge), purpurus, renal hemorrhage, splenomegaly are all symptoms of

A

Aplastic Anemia

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12
Q

Pernicious Anemia is an absence of

A

intrinsic factor

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13
Q

In pernicious anemia, Intrinsic factor is normally secreted by

A

cells within the gastric mucosa; it binds with dietary vitamin B12 and travels with it to the ileum, where the vitamin is absorbed

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14
Q

In pernicious anemia, without intrinsic factor, orally consumed vitamin B12 cannot be

A

adequately absorbed, and erythrocyte production is eventually diminished.

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15
Q

bleeding from ulcers, gastritis, inflammatory bowel disease, or GI tumors in men and postmenopausal women is most commonly caused by:

A

iron deficiency anemia

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16
Q

smooth, red tongue, brittle and ridged nails, and angular cheilitis: these are all signs of?

A

Severe or prolonged iron deficient anemia

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17
Q

A health history should be obtained for individuals with iron deficient anemia when they have a history of:

A

multiple pregnancies, GI bleeding, and pica

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18
Q

Mortality rate for this disorder can exceed 80%

A

DIC

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19
Q

Causes of DIC:

A

Sepsis, trauma, cancer, abruptio placentae, allergic reactions

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20
Q

2/3 of DIC cases are initiated by:

A

an infection or a malignancy

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21
Q

an infection or a malignancy

A

inflammation and coagulation within the vasculature

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22
Q

In DIC, the excessive clotting triggers the fibrinolytic system to

A

release fibrin degradation products, which are potent anticoagulants

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23
Q

Compromised organ function or failure, Ischemia, and bleeding (less common) are clinical manifestations of:

A

DIC

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24
Q

What will be tested to diagnose DIC?

A

low platelet and fibrinogen levels; prolonged PT, aPTT, and thrombin time; D-dimer

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25
Q

Because of bacterial proliferation, blood administration should not exceed _ hours:

A

4

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26
Q

How often does blood tubing need to be changed in order to decease chances or bacterial contamination?

A

after every 2 units transfused

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27
Q

How many mL of blood and anticoagulants does a single unit of whole blood contain?

A

450mL whole blood, 50mL of an anticoagulant

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28
Q

What % of PRBCs are made up of hematocrit?

A

70% (very concentrated)

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29
Q

What temperature are PRBCs stored at?

A

4C, 39.2F

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30
Q

How long can PRBCs be stored before they can be discarded?

A

42 days with a special preservative

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31
Q

To prevent clumping, platelets are:

A

gently agitated while stored

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32
Q

What temperature are platelets stored at?

A

must be stored at room temperature because they cannot withstand cold temperatures

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33
Q

Why is plasma immediately frozen?

A

to maintain the clotting factors

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34
Q

How long does plasma last?

A

1 year if it remains frozen

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35
Q

The blood product can be further pooled and processed into blood derivatives of albumin, immune globulin, factor VIII, and factor IX.

A

Plasma

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36
Q

When is FFP given?

A

planned surgery or invasive procedure
in the presence of abnormal coagulation tests,
for the reversal of warfarin in the presence of active bleeding or planned procedure when vitamin K is inadequate
For thrombotic thrombocytopenic purpura, and congenital or acquired factor deficiency with no alternative therapy.
trauma patients requiring massive transfusion and warfarin-related intracranial hemorrhage

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37
Q

What is the greatest cause of transfusion reactions?

A

patient is transfused an incompatible unit of blood product

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38
Q

Transfusion reactions are most frequently due to:

A

presence of donor leukocytes within the blood component unit (PRBCs or platelets)

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39
Q

What should the RN do when a transfusion reaction occurs?

A

•Assess
•Stop
•Notify the primary provider and implement prescribed treatments. Continue to monitor
Notify blood bank
•Return blood and tubing to lab (or blood bank as per policy)
•Obtain any samples needed
•Document

40
Q

The majority of anemias are considered:

A

benign

41
Q

iron deficiency, renal disease anemia, and aplastic anemia are considered:

A

proliferative anemias (all involve decreased production)

42
Q

Hemolytic anemias are characterized by

A

break down

43
Q

plasma is yellow because

A

there are no red blood cells

44
Q

albumin is a

A

plasma protein

45
Q

Hematopoiesis is the complex process of:

A

the formation and maturation of blood cells

46
Q

the primary site for hematopoiesis is:

A

bone marrow

47
Q

Glucose is carried by

A

erythrocytes

48
Q

Hematopoietic stem cells break down in which cells?

A

blood cells, myeloid stem cells, and lymph stem cells

49
Q

the average average lifespan of a RBC is?

A

120 days

50
Q

Eosinophils are released during:

A

inflammatory response to fight infection

51
Q

Eosinophils are elevated with:

A

allergies, autoimmune disorders, infections, tumors, fungus, virus

52
Q

alpha, beta, and gamma cells make up:

A

globulin cells

53
Q

used to form red blood cells when there is a low number

A

epogen (medication)

54
Q

Iron deficiency occurs in bariatric surgery because?

A

there is less stomach acid following bariatric surgery and iron needs acid to aid in its absorption

55
Q

Vitamin K is given to patients with:

A

very high INR level

56
Q

In DIC, fingertips die from?

A

clotting

57
Q

D dimer is drawn a lot to determine if patient has:

A

pulmonary embolism

58
Q

aPTT needs to be drawn every _ hours to assess if the rate needs to be changed

A

6

59
Q

Therapeutic phlebotomy is used to treat:

A

polycythemia vera (this causes an elevated RBC volume- causes lower perfusion and blood clots because its too thick)

60
Q

Apheresis is the removal of:

A

blood plasma from the body by the withdrawal of blood, its separation into plasma and cells, and the reintroduction of the cells, used especially to remove antibodies in treating autoimmune disease

61
Q

PRBC infusion should always be done using a __ gauge needle or large for insertion in large vein

A

20 (pink tip)

62
Q

criteria for PRBC infusion

A

use normal saline transfusion because it is isotonic, check VS frequently for reaction, always check hospital policy for run time

63
Q

normal hemoglobin Lab levels:

A

10-14 female, 12-16 male

64
Q

Chronically high hemoglobin is caused by:

A

dehydration, burns (fluid volume deficit), polycythemia (blood removal)

65
Q

normal Prothrombin time- INR:

A

10-13 seconds

66
Q

INR needs to be 3-4 seconds in patients with an

A

artificial heart valve

67
Q

Myelo- means:

A

marrow of the spinal cord

68
Q

Lympho- means:

A

fluid that contains white blood cells

69
Q

Acute leukemias occur in ________ population

A

younger

70
Q

Chronic leukemia occurs in ______ population

A

older

71
Q

Normal value of Hct

A

male 42-52%, female 35-47%

72
Q

Normal value of WBC

A

4500-110,000 (mm3)

73
Q

Normal value of platelets

A

150,000-450,000 (mm3)

74
Q

Normal value of Hgb

A

male 13-18g/dL, female 12-16g/dL

75
Q

Clinical Manifestations of ___________ include:
Bleeding from mucous membranes, venipuncture sites, GI and GU tracts.
Bleeding ranges from minimal occult internal bleeding to profuse hemorrhage from all orifices

A

DIC

76
Q

What is the treatment for DIC?

A

Treatment

Treat underlying cause

Oxygenation

Replace fluids

Correct electrolyte imbalances

Vasopressors

FFP & PLATELETS

Heparin (questionable)

77
Q

The following labs are used to diagnose which condition?

Platelets (drop)
Clotting factors (drop)
D-dimer (increase)
PT & aPTT (increase)
Lab values + scoring system
A

DIC

78
Q

This kind of anemia is genetic;
Inability to properly utilize vitamin B12 (needed for development of RBC’s) d/t lack of intrinsic factor from GI tract - cannot absorb B12

A

Pernicious anemia

79
Q

This kind of anemia is caused by a decrease in/damage to marrow stem cells, leading to a replacement of marrow with FAT; Usually idiopathic, toxic materials, viral infection or pregnancy can trigger

A

Aplastic anemia

80
Q

Symptoms of anemia:

A

fatigue, pallor, dyspnea, bruising

81
Q

Stem cell transplant and immunosuppressive therapy are involved in the treatment of:

A

aplastic anemia

82
Q

Diagnostics for aplastic anemia include:

A 
Diagnostics
CBC revealing pancytopenia
Neutrophil count <1500
Hgb <10g/dL
Platelets <50,000
Bone marrow aspirate showing marrow replaced with fat
83
Q

____________ needed for RBC formation; Low intake, high demand for _________ in the body, malabsorption can lead to deficiency

A

folic acid

84
Q

Folic acid levels in serum and within the red blood cells

A

folic acid deficiency diagnostics

85
Q

This kind of anemia is characterized by erythrocytes losing its round, pliable, biconcave disc shape; adheres to endothelium of small vessels and each other
Increased blood viscosity
Decreased oxygen

A

Sickle cell anemia

86
Q

Genetic - caused by inheritance of the hemoglobin gene. Usually from African descent.

A

sickle cell anemia

87
Q

Treatment for sickle cell anemia

A

Treatment
Hydroxyurea
Folic acid replacement
RBC transfusions

88
Q

The following symptoms are manifestations for?

Anemia
Jaundice
Enlargement of bones of face/skull
Tachycardia
Cardiac murmurs
Cardiomegaly
Dysrhythmias
Heart failure
Thrombus formation
A

Sickle cell anemia

89
Q

________ is characterized by increased volume of RBC’s

Primarily; secondary –

Reduced oxygen/neoplasms, excessive production of erythropoietin, more RBC’s

A

Polycythemia

90
Q 
In \_\_\_\_\_\_\_\_\_\_\_ you can see:
Can be asymptomatic
Fatigue
Headache
Dizziness
SOB
Inability to concentrate
A

Polycythemia

91
Q

In order to be diagnosed with polycythemia:

A

Hct >55% in males and 50% in females

92
Q

Treating the primary condition and

therapeutic phlebotomy are treatments for which blood disorder?

A

Polycythemia

93
Q 
This blood disorder is inherited:
Subclass A & B
A caused by deficient/defective factor VIII
B caused by deficient/defective factor IX
A

Hemophilia

94
Q

Clinical manifestations of hemophilia include:

A

BLEEDING

Hemorrhages in various parts of the body but 75% occurs in joints

95
Q 
Treatment of \_\_\_\_\_\_\_\_\_\_\_ includes:
Recombinant forms of factor VIII and X
FFP
Neutralizing antibodies to factor concentrate
Immunosuppression therapy
A

Hemophilia

Med Surg (5 decks)

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