Hematology Flashcards
Anemias can be put into one of what three classifications?
iron deficiency
vitamin deficiency
pernicious anemia
Blood loss anemia like from surgery can also play a factor in here but these 3 are the types we are responsible for.
You’ll ask the pt if they’ve noted any swelling and you can tell them where the lymph nodes are found. Which is ______, ______, and ______? Assess for enlarged glands (lymph nodes). This is something to assess during a what type of Hematological Disorder assessment?
Neck
Groin
middle of their chest.
History Assessment
Have they had any increased pain?
Have they had any above normal fatigue and weakness that can’t be accredited to maybe longer work days or due to something, it’s just unexplained fatigue and weakness. This is something to assess during a what type of Hematological Disorder assessment?
History Assessment
Any bleeding, pallor that they’ve noticed, any shortness of breath, fainting, or vertigo. Vertigo is different than being dizzy, it’s probably close enough that you probably don’t have to go into too much detail but it is a little different than being dizzy. This is something to assess during a what type of Hematological Disorder assessment?
History Assessment
You can ask them if they’ve noticed any jaundice, night sweats, fever, or weight loss and those three (night sweats, fever, and weight loss) are called B category symptoms because it has a lot to do w/ your ______. This is something to assess during a what type of Hematological Disorder assessment?
B-cells
History Assessment
Tachycardia (you wouldn’t ask them if they have tachycardia) you’d say have you noticed your heart racing or pounding or anything like that. Ask about activity intolerance, frequent infections, and headaches. This is something to assess during a what type of Hematological Disorder assessment?
History Assessment
Follow up and palpate for lymph node enlargement. You’ll look at labs to see if there is anemia.
Assess for Ecchymosis which is bruising.
Assess for skin pallor, cyanosis, jaundice, and petechiae.
Assess for Gingivitis inflammation of the gums.
This is something to assess during a what type of Hematological Disorder assessment?
Physical Examination
On Opthalmoscopic examination (bleeding fundi) they might see bleeding in the eyes.
Sclera: jaundice, capillary hemorrhage so the whites of the eyes are red.
This is something to assess during a what type of Hematological Disorder assessment?
Physical Examination
Hepatomegaly, and sometimes splenomegaly, sometimes the cellular activity gets so frantic that the spleen and the liver might start doing some of the work and they make it congested, it gets painful, and enlarged.
This is something to assess during a what type of Hematological Disorder assessment?
Physical Examination
Sternal tenderness because there are some lymph nodes there also.
Myocardial hypertrophy.
Epistaxis Meaning nose bleeds.
This is something to assess during a what type of Hematological Disorder assessment?
Physical Examination
Dyspnea on exertion, dyspnea is really a subjective symptom so you can describe what you see but if you’re going to ask, you’d have to ask them if they have shortness of breath.
This is something to assess during a what type of Hematological Disorder assessment?
Physical Examination
This is considered Anemia: decreased production of RBCs, increased RBC destruction, or blood loss.
What red blood cell disorder is this?
Hypoproliferation
Normal hemoglobin for a female is 12-16 g per deciliter, and 14-18 for a male. Hematocrit is rule of thumb usually 3 times the amount of hemoglobin, so normal for a female is 36-48, for male 42-54% and she is just going to give the rest of the lab results and they’re on the lab template we got at the beginning of the semester and posted on canvas?
WBCs 5-10,000
Platelets 150-400,000.
A normal INR is 1, someone on Coumadin you would want to be 2-4. If it gets over 5 the risk of bleeding is too great and outweighs the benefit of anti-coagulation.
What red blood cell disorder is this?
Hypoproliferation
The 3 types of anemia are iron deficient, vitamin deficient, and pernicious. What red blood cell disorder is this?
Hypoproliferation
We will just briefly talk about polycythemia. Polycythemia: results from hypoxia (when hypoxia occurs more RBCs will be made to carry more O2 around).
What red blood cell disorder is this?
Hyperproliferation
Polycythemia results from hypoxia (when hypoxia occurs more RBCs will be made to carry more O2 around. People that live in higher altitudes can have this since their body adapts to the lower amount of O2 that’s in their air.)
What red blood cell disorder is this?
Hyperproliferation
This can be caused by erythropoietin secreting tumors, kidney disease, and genetic defects.
What red blood cell disorder is this?
Hyperproliferation
This woman has very marked pallor, this type of anemia means there’s not enough RBCs in the body so there is not enough RBCs to carry O2 to the tissues. What type of anemia is this?
Iron Deficient Anemia
There are a lot of different types, this is the most common form of anemia. 20% of women have this type of anemia , 50% of pregnant woman have it, and only 3% of men. Iron is very essential as a part of hemoglobin and it’s normally obtained through diet and without it the body can’t carry O2 effectively.
What type of anemia is this?
Iron Deficient Anemia
Causes are inadequate dietary intake of iron, loss of blood including heavy menstrual bleeding.
What type of anemia is this?
Iron Deficient Anemia
Usually what happens in your body is your RBCs have a lifespan of 90-120 days and then they are broken down and the body recycles that iron when you lose blood as w/ heavy menstrual bleeding or other types of hemorrhage like surgery or something, you also lose the iron that’s in those blood cells so you then have less iron than you actually need.
What type of anemia is this?
Iron Deficient Anemia
Bone marrow suppression and chemotherapy can also cause this type of anemia. In men and post-menopausal women this is usually caused by GI bleed, use of aspirin, NSAIDs, or certain cancers particularly esophageal, stomach, and colon. What type of anemia is this?
Iron Deficient Anemia
Pregnant or lactating women because iron requirements go up.
Infants, children, and adolescents in rapid growth phases because the body can’t keep up.
What type of anemia is high risk in these groups?
Iron Deficient Anemia
People with poor dietary intake of iron.
People with blood loss r/t PUD (peptic ulcer diseases), long term ASA (aspirin) use, and colon cancer.
What type of anemia is high risk in these groups?
Iron Deficient Anemia
Pallor- very pale complexion and not someone who is fair it’s an odd color.
What type of anemia has these signs and symptoms?
Iron Deficient Anemia
Fatigue
Weakness
Dyspnea r/t hypoxemia
Brittle nails
Pica which is eating non-food substances Headache
What type of anemia has these signs and symptoms?
Iron Deficient Anemia
Labs will be Low: Low Hgb Low Hct Low serum ferritin Low serum iron. What type of anemia has these lab values?
Iron Deficient Anemia
Study Tip: In order for this to be treated we have to identify the cause so that’s one of the 1st steps is to identify what’s going on.
Recommended daily allowances and this is from the National Institute of Health’s website for ages 19-50 and that’s the age group we will focus on. For women the minimum daily requirement is 18 mg a day and for men it’s 8 mg a day, so women need ___ more mg a day then men.
10
Dark Green, Leafy Vegetables, Dried Beans Peas Dried Fruits Eggs Enriched Breads Iron-Fortified Cereal Lean Meats Nuts Raisins Seafood/Shellfish Spinach Tofu Wheat Germ Whole-Grain Breads This is a list of dietary sources of \_\_\_\_.
Answer: Iron
Sometimes there are issues w/ people who are _______ but iron should not be a problem and there are certainly some vegetable that contain more iron than some meats.
vegetarian or vegan
It’s better if you replace iron with your natural diet, the more natural the better it’s utilized by the body and the better the outcome. If we have to we can use oral supplements. Iron is given to orthopedic patient’s since they lose blood during _____.
surgery
They will put surgical patients on iron supplements and they are best taken on an empty stomach however a lot of people can’t tolerate that because it causes severe gastric upset, really painful. If they can’t tolerate it on an empty stomach then they can take it w/ meal but it drastically __\\ the amount of iron that’s absorbed. Vitamin C _______ the absorption of iron.
reduces
decrease
Increases
Iron is essential in the production of hemoglobin. ______ and _______ should not be taken at the same time as an iron supplement since it will interfere w/ the absorption.
Milk & antacids
Iron can also be given IV & IM the liquid solution it comes in can be very dark and can stain tissues and clothes so that’s a medication when you give it IM you MUST always give it _____. Available in both IV and IM forms.
Z track
Study Tip: F/U (follow up) as necessary as iron deficiency anemia may recur.
Nausea Constipation Dark stool Epigastric pain. These are the side affects of what medication?
Oral Iron supplements
After 2 months of oral iron supplements the ____ should return to normal but it’s recommended that people take iron supplements for _____ months to fully replenish the body stores of iron.
Hct
6-12
Caused by low amounts of: Folate Vitamin B-12 Vitamin C What type of anemia is caused by this?
vitamin deficiency anemia
Someone will develop __\\ if they don’t eat enough of specific vitamins or also they are eating enough but for some reason their body isn’t absorbing or processing them. It can cause weakness and shortness of breath the Symptoms: look the same as Iron Deficient anemia.
vitamin deficiency anemia
The Treatment for _______ is vitamin supplements & dietary changes. Usually vitamin deficiencies develop slowly and take months to years and the symptoms might be very subtle and as it worsens the symptoms will increase.
vitamin deficiency anemia
We will talk about some dietary sources of folate, the recommended daily allowance from the National Institute of Health’s website is _______ for both men and women.
400mcg
A lot of times deficiency of folate is seen in people who are poorly nourished especially those who are alcoholics, infants, and pregnant women. Folate does help form _______ so it’s necessary in their production.
RBCs
Sources are leafy green vegetables like spinach, citrus fruits, and dried beans and peas.
These are the dietary sources of what vitamin?
Folate/iron
In 1996, the food and drug administration published regulations that required the addition of folic acid to enriched bread, cereals, flours, cornmeal, pasta, rice, and other grain products.
These are the dietary sources of what vitamin?
Folate