Hematology Book Flashcards
**know normal lab values for CBC
RBC 3.8-5.03
hb: 10.2-13.4
hit: 31.7-39.8
WBC: 4.86-11.4
platelet: 203-367
** understand anemia well. including how it occurs, what we see in the labs, what do we do about it
anemia is decreased number of RBC, quantity of hbg, and volume of PRBC to below normal caused by loss/destruction or impaired/decreased rate of production
treat underlying cause/possible transfusion
** what are we looking for with MCH and MCV
MCH: mass/volume
MCV: size
**reticulocyte count
decrease production: decrease reticulocyte
blood loss: increase reticulocyte
normal:
- infant 2-6%
- adult .5-2.5%
** normal and abnormal values for WBC, RBC, platelets
powerpoint
- WBC: 4.5-11
- RBC: 3.5-5.5
- platelet: 150-420
** understand the 3 types of anemia (microcytic, normocytic, macrocytic)
microcytic: small, decreased MCV
normocytic: decreased production
macrocytic: lagre, vit b12/folate decreased
** Understand iron deficiency anemia. what are the most common causes, how can we treat it? what are the symtoms? early vs late?
most common anemia
microcytic
increase cow milk consumption in toddlers but could also be due to menorrhagia or GI bleeds. increase iron in foods or supplement with 2-5mg/kg/day, symptoms of iron supplement is N/V/C and dark stools. Early anemia is asymptomatic. late anemia has tachycardia, tachypnea, cardiomegaly, koilpokolosis, and enlarged tongue, with fatigue and irritability
SICKLE CELL
**understand how children get the disease, what does it mean for them? what complications can the disease cause? how do we treat it?
autosomal recessive, both parents need it, 25% per pregnancy. acute chest syndrome, lower respiratory tract illness, consolidation with defined edges, vaso occlusive crisis, spleen squestrioun, pain meds, O2, IV fluids, antibiotics
SICKLE CELL
** what things make a complication more likely to happen
hypoxia, stress, dehydration, temp extremes, infection
SICKLE CELL
** what is vaso occlusive crisis? s/s or this, treatment for it, what causes it, what might a care plan for this patient look like? nursing dx?
stasis of blood with clumping of cells
pain, fever, tissue engorgment, abdominal pain
pain meds, O2, IV fluid
causes it: hypoxia, stress, dehydration, temp extremes, infection
pain meds, IV fluids, o2
nursing dx: tissue perfusion, pain, fluid volume
SICKLE CELL
** acute chest what is it, what are the s/s, tx?
cut lower resp tract illness
infiltrate XR, fever, chest pain, tachypnea, decrease O2
pai. meds, ABX, O2, Iv fluids, blood transfusion
SICKLE CELL
** what are some emergencies that occur in sickle cell patients
splenic sequestration, aplastic crisis, vasooculsion crisis, acute chest syndrome
SICKLE CELL
** what do we worry about in sickle cell patients with fever
emergency 38.5<
infection and can lead to crisis
SICKLE CELL
** common medications
folic acid
penicillin
hydroxurea
SICKLE CELL
** review PCA use, who is it appropriate for, what considerations for families, what do we watch for or what complications might we be concerned about with PCA
+6yr and can self report pain
only child can press button
tolerance, resp depression
SICKLE CELL
** can sickle cell be cured? how? what are the risks
stem cell transplant
anemia, infection, bleeding, rejection
** what is hemophilia? what is the etiology? clinical manifestations? tx?
decrease clotting factor, X linked recessive disorder,
spontaneous bleeding, hemarthosis, ecchymosis, hematuria, intracranial bleeding
desmopressin, recomant factor VIII
erythropoesis
formation of RBC
polycythemia
above average number of RBC
