Hematology/Hemostasis Flashcards

1
Q

Hematology

A

Study of blood and blood-forming tissues

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2
Q

Components of Hematologic System

A

Sleep, lymph system, liver, bone marrow, blood

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3
Q

Spleen Functions

A

Hematopoietic- produce RBC
Filter- old RBC, iron
Immune system- lymphocytes and monocytes
Storage- RBC and platelets

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4
Q

Red Pulp of Spleen

A

RBC production and storage

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5
Q

White Pulp of Spleen

A

Contains lymphocytes and monocytes

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6
Q

Lymph System

A

Filtration
Carries lymph fluid (too much = lymphedema)
Lymph capillaries and ducts- drain and carry
Lymph nodes- filter particles out

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7
Q

Liver

A

Filter- removes activated clotting factors/fibrin
Stores iron and produced hepcidin
Blood coagulation- prothrombin II (vitamin K needed)

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8
Q

Bone Marrow

A

Red- RBC formation (irregular/flat bones)

Yellow- fatty (middle of long bones)

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9
Q

When is a bone marrow needle aspiration performed?

A

Severe anemia, neutropenia, acute leukopenia, thrombocytopenia
Posterior iliac crest

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10
Q

Blood Function

A

Transportation- O2, nutrients, waste, hormones
Regulation- fluid electrolytes, acid-base balance
Protection- form clots, combat infection

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11
Q

Hematopoiesis

A

Blood cell formation (in bone marrow)
RBC, WBC, PLT
From stem cells

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12
Q

Erythrocytes

A

Composed of hemoglobin- binds O2, CO2

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13
Q

RBC Functions

A

Transportation- O2, CO2, nutrients, hormones
Protection- clotting
Regulation- acid-base balance, fluid electrolyte, body temp

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14
Q

Erythropoiesis

A

RBC production (stim. by hypoxia)
Erhythropoietin (stimulates production)
Reticulocyte- immature RBC

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15
Q

Hemolysis

A

Destruction of RBC by macrophages
Occurs in bone marrow and spleen
Bilirubin- breakdown of RBC

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16
Q

Thrombocytes

A

Platelets
Initiate clotting
1/3 stored in sleep

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17
Q

Hemostasis

A

Blood clotting processes

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18
Q

Phases of Hemostasis

A

Vasospasm
Formation of platelet plug
Clotting cascade activation
Lysis of clot

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19
Q

Vasospasm

A

Immediate vasoconstriction

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20
Q

Formation of Platelet Plug

A

PLT activate when exposed to collagen
Platelet activation
Platelet adherence (mediators block anticoagulation message)
Aggregation of PLT

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21
Q

Clotting Cascade Activation

A

Fibrin clot formation
Inactive until stimulated by 2 pathways- intrinsic/extrinsic
Prothrombin -> thrombin -> activates fibrinogen to fibrin

22
Q

Extrnisic Pathway

A

Tissue trauma, rapid, tissue thromboplastin III, need Calcium
INR

23
Q

Intrinsic Pathway

A

Blood vessel damage, slower, factor V/VIII

24
Q

Firbinolysis

A

Breakdown of clot

Plasminogen -> plasmin -> digest fiber in clot and fibrinogen

25
Q

Anticoagulation

A

Antithrombins- heparin, lovenox

26
Q

Hypocoagulability

A

Deficient clotting of blood

Thrombocytopenia- low PLT

27
Q

Hypercoagulability

A

Increased clotting

Can result in venous thrombosis, arterial thrombosis, embolization

28
Q

Blood-Related Abnormalities

A

Pale skin/lips, increased bruising, cyanosis, oral lesions, enlarged lymph nodes, jaundice, tachy, hepatomegaly, splenomegaly

29
Q

Labs

A

CBC, ESR (inflammation), Iron, Bilirubin (breakdown of RBC), PT (extrinsic), PTT (intrinsic)

30
Q

Effect of Aging

A

Decrease bone marrow production
Decreased stem cells
Decreased ability to compensate when ill
Decreased hemoglobin

31
Q

Purpose of Blood Transfusion

A

Restore/maintain blood volume
Improve O2-carrying capacity
Replace deficient blood components and coagulation

32
Q

Autotransfusion

A

Pt given back out blood

33
Q

Blood Groups

A

Type A- A antigen and anti-B antibody
Type B- B antigen and antiA antibody
Type AB- A and B antigens and no antibody
Type O- no antigens and A and B antibodies

34
Q

Rh Groups

A

Found on RBC membrane
Rh +- have D antigen
Rh– no D antigen

35
Q

Whole Blood

A

All blood components
Increase total blood volume- trauma
500mL over 2-4 hr (1hr if emergent)

36
Q

Red Blood Cells

A
Packed or frozen
Washed, irradiated, and leukocyte poor
Increases O2 carrying capacity
300mL over 2-4hr
IgM- may react
37
Q

White Blood Cells

A

Fight antibiotic-resistant septicemia and low granulocyte supply
300mL over 2-4 hr
Never use leukocyte depleting filter
Increased incidence of febrile, non-hemolytic reactions

38
Q

Platelets

A

Replace clotting factors
Prepped from whole blood
30-6-mL over 1hr

39
Q

Fresh Frozen Plasma

A

Clotting factor replacement (no PLT)
Must be ABO compatible
200-250mL over tolerated time span
INR, PT, PTT

40
Q

Albumin

A

Small protein separated from plasma
Replaces volume
No cross and type necessary

41
Q

Cryoprecipitate

A

From FFP
Clotting factor replacement
Infuse as tolerated
No cross and type necessary

42
Q

Procedure of Blood Admin

A
Consent
Order
Access
Tubing and Solution
Verification
Assessment
Administration
43
Q

8 Right of Blood Transfusion

A
Product
Patient
Dose
Time
Reason
Site
Documentation
Response
44
Q

Allergic Reaction (IgE)

A

Itchy, hives, fever, chest pain

Hypotension (histamine causing dilation)

45
Q

Febrile Non-Hemolytic

A

Increased temp by 1.8*
Chills, headache
Give antipyretic, leukocyte poor blood, steroids

46
Q

Acute Hemolytic (IgM)

A

Life-threatening- HF, renal failure
Incompatible blood, wrong storage
Give normal saline, episode, diuretics, vasopressor

47
Q

Anaphylactic

A

Bronchospasms, SOB, pulp edema, hypotension

Give epi, corticosteroid, histamine

48
Q

Circulatory Overload

A

Too much blood is short amount of time
SOB, crackles
Stop infusion, give O2, diuretics
At risk: elderly, HF, renal failure

49
Q

Sepsis

A

Stored wrong, over 4 hour max
Chills, fever
Give antibiotics, fluids

50
Q

SPIN

A

Stop transfusion
Pulse and VS
Infuse normal saline
Notification

51
Q

Documentation

A

Time, solution, VS, client response/action