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NURSING 3 > Hematology Disorders > Flashcards

Hematology Disorders Flashcards

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1
Q

Slide 1 - types of anemia

A

Go look

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2
Q

Slide 1 - types of WBC

A

go look

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3
Q

How much of the blood does plasma make up compared to cellular component?

A

Plasma - 55%

Cellular component - 45%

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4
Q

What does plasma consist of?

A 
Albumin
Globulin
Fibrinogen
Clotting factors
Electrolyes
Waste Products
Nutrients
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5
Q

what does the cellular component of the blood consist of?

A

Erythrocytes (RBCs)
Leukocytes (WBCs)
Thrombocytes (Platlets)

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6
Q

Hematopoiesis

A

the production of blood cells and platelets, which occurs in the bone marrow.

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7
Q

How long do RBC, WBC and platelets live?

A

RBC - 120
WBC - days to years
Platelets - 7 - 10 days

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8
Q

Hemostasis

A

Balance between clotting and clot dissolution ?

the stopping of a flow of blood.

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9
Q

How much volume of blood do we normally have?

A

1.2-1.5 gallons

5 L

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10
Q

Describe the erythrocyte membrane

A

It is thin for permeability of o2 and co2

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11
Q

What do you call a mature erythrocyte with iron called

A

hemoglobin

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12
Q

What are reticulocytes?

A

immature erythrocytes

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13
Q

Erythropoiesis

A

myeloid stem cells in the bone marrow - These cells are responsible for the continual replenishment of all blood cell types in the body

the production of red blood cells.

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14
Q

Erythropoietin

A

hormone produced by kidney - stimulates red blood cell production

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15
Q

Iron - women

A

Iron is lost when females menstruate

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16
Q

Where is the majority of iron carried?

A

hemoglobin

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17
Q

What happens when there are low levels of iron in the blood?

A

hemoglobin synthesis is depressed; erythrocytes produced are small and low in hemoglobin = microcytic anemia

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18
Q

What are examples of granulocytes?

A

Eosinophils
Basophils
Neutrophils

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19
Q

What are examples of agranulocytes?

A

monocytes

lymphocytes

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20
Q

Eosinophils

A

Parasitic and allergic diseases

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21
Q

Basophils - things to remember

A

Contain heparin and histamine

Released in response to allergens

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22
Q

Neutrophils - things to remember

A

Comes from myeloid stem cell

Most abundant in body

Circulates for 6 hours then migrates into body tissues – phagocytosis (alive for 1-2 days)

Arrive within 1 hour of onset of inflammatory reaction and initiate phagocytosis

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23
Q

Things to remember about monocytes

A

Once in tissues – macrophages
Fungi and Viruses
Active in the spleen, liver, peritoneum and alveoli
— Removing debris

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24
Q

Things to remember about lymphocytes

A

produced - lymphoid stem cells or thymus

produce antibodies and identifying other cells and organisms as foreign

25
Q

What is platelet formation regulated by

A

the hormone thrombopoietin

26
Q

Platelet - role

A

controls bleeding; adheres to site of injury –> platelet plug

27
Q

Plasma: clots

A

remaining is serum (?)

28
Q

Plasma protein - exampels

A

albumin and globulins

29
Q

Albumin

A

Maintenance of fluid balance with the vascular system

  • produced in liver
  • capacity to bind substance (calcium, bilirubin, hormones)
30
Q

Spleen - role

A 
Recycling iron
Pooling of platelets
Blood volume regulation
Filter for bacteria 
Can restart hematopoisis - if needed
31
Q

Go look at slide 11

A

go

32
Q

Gerontological considerations - hematology

A

Bone marrow’s response is decreased
Most susceptible to myelosuppressive effects of medications
Anemia risk

33
Q

What might cause anemia in the elderly?

A 
Iron deficiency
Calorie malnutrition
Inflammation
Chronic disease
Cardiac and pulmonary patients cannot tolerate low blood volume
34
Q

Hematocrit is what?

A

percent of blood consisting of erythrocytes

35
Q

Peripheral smear - hematology dx

A

shape, size of leukocytes, erythrocytes, and platelets

36
Q

False elevated hematocrit can be correlated to what

A

fluid volume deficit patients

37
Q

Low hemoglobin/hematocrit - why might someone be asymptomatic

A

your body has compensatory mechanisms

38
Q

What are s/s of low hemoglobin/hematocrit

A

fatigue, poor activity tolerance, headaches, dizziness, irritability, difficulty sleeping or concentrating, progressive fatigue, poor activity tolerance, headaches, dizziness, irritability, difficulty sleeping or concentrating, tinnitus, anorexia, dyspnea, palpitations, chest pain, indigestion, abnormal menstruation in females, impotence in males, and loss of libido

Pallor – mucous membranes, nail beds, conjunctiva, palms

Tachypnea and tachycardia with activity

39
Q

Patients with severe neutropenia are at a significantly increased risk for developing what?

A

opportunistic infections and sepsis

40
Q

Low while blood cell count - Skin

A

Check for tenderness, erythema, edema, breaks in skin integrity, moisture, drainage, lesions (especially under breasts, axillae, groin, skin folds, bony prominences, perineum, and perirectum); check all puncture sites (e.g., IV sites) and central venous access device sites for erythema, tenderness, induration, and drainage.

41
Q

Low WBC count - oral mucosa

A

Check for moisture, lesions, color (check palate, tongue, buccal mucosa, gums, lips, oropharynx); assess level of pain and taste changes, which may precede objective signs of mucosal damage by 3 to 5 days.

42
Q

Low WBC count - respiratory

A

Check the presence of cough, sore throat, tachypnea, pain on inspiration; auscultate breath sounds. Note color, amount, and consistency of sputum.

43
Q

Low WBC count - gastrointestinal

A

Check for abdominal discomfort and distention by palpating the abdomen, assess for nausea, change in bowel pattern; auscultate bowel sounds

44
Q

Low WBC count - genitourinary

A

Check for dysuria, urgency, frequency; check urine for color, clarity, and odor

45
Q

Low WBC count - Neurologic

A

Ask about headache, neck stiffness, visual disturbances; assess level of consciousness, orientation, and behavior

46
Q

Low WBC count - temp

A

Check for elevation (greater than 38°C [greater than 100.4°F]).

47
Q

Absolute neutrophil count (ANC) - 1,500 to 1,000

A

indicates mild neutropenia

48
Q

Absolute neutrophil count (ANC) - 999 - 500

A

indicates moderate neutropenia

49
Q

Absolute neutrophil count (ANC) - less than 500

A

indicates severe neutropenia

50
Q

People with a low Absolute neutrophil count (ANC), what should they do to stay safe?

A

avoid large crowds

avoid sick people

51
Q

Bone marrow aspiration and biopsy: why?

A

Used to diagnose malignancies, benign hematologic disorders, infections and storage disorders, response to treatment

52
Q

Bone marrow aspiration and biopsy: risk

A

infection and pain

53
Q

Bone marrow aspiration and biopsy: position

A

prone or lateral

54
Q

Bone marrow aspiration and biopsy: how can a nurse help during the procedure

A

encourage them to take deep breaths and use relaxation techniques to help with discomfort

55
Q

Bone marrow aspiration and biopsy: post-procedure care

A

Patients should be instructed not to submerge in a bath for 24 hours, until the site heals. A mild analgesic (e.g., acetaminophen) may be useful.

Aspirin-containing analgesics should be avoided because of the increased risk of bleeding

56
Q

normal PTT

A

21-35 – a therapeutic range is 1.5-2 times that range

57
Q

normal INR

A 
normal = below 1.6 
therapeutic = 2-3 (someone on warfarin)
58
Q

What tools are used to determine if someone is at risk for bleeding

A

through exam
CBC / peripheral smeal
PT and INR
PTT

59
Q

Slide 1/45 tells you about types of anemia

A

go look

NURSING 3 (16 decks)

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