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NCLEX > Hematology > Flashcards

Hematology Flashcards

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1
Q

erythrocytes

A

carry oxygen, concave disk, bendy and can fit through tight spaces in arteries, capillaries and veins

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2
Q

Rhesus (Rh) Factor

A

inherited protein attached to the surface of red blood cells, either positive or negative

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3
Q

Universal blood donor

A

O-

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4
Q

Rh positive can receive

A

positive or negative blood

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5
Q

Rh negative can only receive

A

negative blood

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6
Q

When giving blood can always give

A

only what they already OR less protein markers than what they have, blood won’t have anything for the body to respond

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7
Q

thrombocytes

A

clump together to achieve hemostasis; platelet plug and agglutination

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8
Q

Intrinsic coagulation

A

triggered by changes in the blood

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9
Q

extrinsic coagulation

A

triggered by something occurring outside the blood vessels (such as trauma)

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10
Q

Erythropoietin

A

produced by kidneys and stimulates production of erythrocytes

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11
Q

thrombopoietin

A

produced by spleen; controls thrombocyte production, 20% of thrombocytes are stored in the spleen, spleen breaks down old erythrocytes

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12
Q

clot is formed by

A

thrombin -> fibrinogen -> fibrin -> clot

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13
Q

clotting factors are produce in the

A

liver

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14
Q

anticoagulants

A

heparin, anti platelets, warfarin, factor Xa inhibitors

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15
Q

Heparin

A

anticoagulant; enhances antithrombim III which inhibits thrombin and prevents clots from forming; Intrinsic pathway

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16
Q

Heparin nursing considerations

A

monitor for bleeding- hematuria, hematemesis, bruising, monitor aPTT

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17
Q

heparin antidote

A

protamine sulfate

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18
Q

For a pt on heparin we want the aPTT to be

A

1.5-2x the normal

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19
Q

Heparin Induced Thrombocytopenia and Thrombosis (HITT)

A

heparin complication, occurs 5-10 days after heparin exposure, unexplained platelet drop and get clots, adverse response

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20
Q

HITT S&S and Tx

A

skin lesions at heparin injection sites, chills, fever dyspnea, chest pain, complications: DVT and PE

discontinue all heparin and start a different anticoagulant

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21
Q

Low molecular weight heparins

A

“parin”; prevents clots, always given SC, not interchangeable with heparin, dose is based on body size, no labs monitored, only anticoagulants that can be used in pregnancy

22
Q

Warfarin

A

disrupts liver synthesis of vitamin K dependent clotting factors; monitor for bleeding, PT and INR (therapeutic is 2-3), contraindicated in pregnancy

23
Q

low molecular weight heparins are porcine derived which means

A

they come from pigs and could have cultural or religious complications

24
Q

warfarin antidote

A

vitamin K

25
Q

ASA

A

Decrease platelet aggregation leading to decrease clotting

26
Q

ASA nursing considerations

A

risk of bleeding , don’t give with anticoagulants, not given to pediatrics

27
Q

Salicylism and S&S

A

ASA toxicity; nausea, tinnitus, headache, delirium, hyperventilation, pulmonary edema, Overdose; resp depression and acidosis

28
Q

ASA antidote

A

sodium bicarbonate

29
Q

Fibrinolytics/Thrombolytics

A

“kinase”, tPA (alteplase); break up existing clots by converting plasminogen to plasminogen

30
Q

door to tPA time for a stroke

A

60min OR 4.5hrs since last known normal

31
Q

Polycythemia vera

A

excessive number of erythrocytes, leukocytes, and thrombocytes, blood becomes thick/hyper viscous, thicker blood = more problems with perfusion

32
Q

Polycythemia vera S&S

A

skin dark purple, cyanotic appearance, distended veins causing itching, htn, thrombosis, hypoxia

33
Q

Polycythemia vera Tx and education

A

Apheresis: withdrawal of blood and removal of excessive components and reinfuse back to pt, anticoagulated (too many thrombocytes = risk for thrombi, hydration

education: clot prevention; hydration, avoid constrictive/tight clothin, compression stockings, elevate feet, no smoking, stop activity at first sign of chest pain

34
Q

anemia

A

reduction in number of erythrocytes, can occur with many different disease processes, several types and causes

35
Q

iron deficiency anemia causes

A

inadequate dietary intake, chronic alcholism, malabsorption syndromes, partial gastrectomy, rapid metabolic activity

36
Q

Vitamin B12 deficiency anemia causes

A

dietary deficiency, failure to absorb vitamin B12 from intestinal tract

37
Q

aplastic anemia

A

body stops producing enough new blood cells caused by myelotoxic agents; radiation, benzene, chloramphenicol, alkylating agents, antimetabolites, sulfonamides, insecticides

38
Q

anemia S&S

A

tachycardia, orthostatic hypotension, dyspnea on exertion, decreased SpO2, fatigue, pallor, cool, mottled, delayed cap refill, unable to tolerate cold

39
Q

anemia tx

A

depends on type of anemia; iron supplements, B12 increase in diet and supplements, aplastic anemia tx depends on cause, blood transfusions

40
Q

sickle cell anemia

A

causes the red blood cells to sickle and break down, is autosomal recessive, not able to carry oxygen, due to shape can get caught in vessels and cause obstruction

41
Q

Sickle cell crisis

A

decreased blood flow to tissues leads to hypoxia, ischemia, and infarction, severe joint pain, sequestration (blood pools, often in spleen, splenomegaly and tenderness, acute exacerbation can be caused by hypoxia, high altitude (due to low O2), and fever

42
Q

Sickle cell anemia S&S

A

pallor, pain, fatigue, arthralgia, chest pain, respiratory distress

43
Q

sickle cell anemia tx

A

IV fluids (dilute blood so they are not concentrated), blood transfusion (optimize perfusion), O2 (increase oxygen to tissues if hypoxic), pain management, hydroxyurea

44
Q

hydroxyurea

A

increases production of fetal hemoglobin to reduce crises

45
Q

Disseminated Intravascular Coagulation (DIC)

A

disorder in which the proteins that control blood clotting become overactive; caused by a precipitating event which leads excessive clotting and excessive bleeding

46
Q

DIC triggers

A

blood transfusion, cancer, pancreatitis, liver disease, severe tissue injury (burns, head injury), pregnancy complication

47
Q

DIC bleeding S&S

A

ecchymosis, hematomas, hemoptysis, melena, pallor, hematuria

48
Q

DIC clotting S&S

A

depends where clot goes

Chest: chest pain, SOB, dyspnea
Legs: pain, redness, warmth, swelling
Brain: headache, speech changes, paralysis, dizziness

49
Q

Lab findings in DIC

A

decrease in platelet count and fibrinogen; increase in PT/INR, PTT, D-dimer

50
Q

DIC treatment

A

determine underlying cause and treat, administer clotting factor, administer platelets, bleeding precautions

51
Q
A

NCLEX (23 decks)

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