Hematology/immune System

Question 1

Anemia
Deficiency of iron
Causes:

Answer 1

Decreased intake (Meat)

Malabsorption : B12

Blood loss

Renal disease (cant produce erythropoietin)

Question 2

Antidote for warfarin and what to avoid bc of it

Answer 2

Vit K

Avoid leafy greens as it will counteract the effects

Question 3

Anemia s/s

Answer 3

Pallor

Fatigue

SOB

Headache

Look at gums and nailbeds for pallor

Question 4

Anemia tx

Answer 4

Increase intake of iron

Replace blood

Increase Vit B12 and folic acid (B9): absorption

PO: ferrous sulfate: iron pill/liquid

IM/IV: iron dextran: infusion monthly

Question 5

Anemia
SE/AR

Answer 5

NVD, dark stools due to meds

Heart burn

Consitpation

Stained teeth

IM: pain, swelling, redness, darkening of skin at site

Question 6

Anemia pt education

Answer 6

Take one hour before meals= empty stomach

Take with vit c: orange, cranberry juice

Avoid taking with caffeine: will inhibit absorption

Question 7

Pernicious anemia

Answer 7

Vit B12 deficiency

Failure to absorb B12 due to lack of intrinsic factor
*so give it as an injection

Question 8

Pernicious anemia s/s and Tx

Answer 8

Glossitis (red beefy tongue)
Loss of appetitie
Weight loss
NVD

Tx: Vit B12 injection or intanasal spray

Question 9

Hematopoietic growth factors

Answer 9

Proteins/colony-stimulating factors because they cause stem cells to form colonies of growth factors

Stimulate the production and excretion of RBCs, WBCs, and platelets

Question 10

Hematopoietic growth factor usage

Answer 10

Acceleration of:
-neutrophil regrowth after chemo
-bone marrow after bone marrow transplant(have to have complete immune suppression in order to get)

Stimulation of erythrocyte production in persons with chronic renal failure

Question 11

Hematopoietic growth factor names

Answer 11

Erythropoitic growth factor

Leukopoietic growth factor

Thrombopoietic growth factor

Question 12

Erythropoietic growth factor

Answer 12

Stimulat frowth and development of new RBCs

Given IV/SQ

Epoetin alfa (procrit, epogen)

Must monitor CBC for Hct and Hgb if their good notify the provider and dont give

Question 13

Erythropoietic growth factor SE/AR

Answer 13

HTN (give a antihypertensive and keep giving med)

HA

body aches

Joint pain

Question 14

Leukopoietic Growth factor

Answer 14

Stimulate the frowth and maturation of neutrophils (WBCs)

Used to build up immune system of immunosuppressed pts (HIV, post-chemo)

Meds:
Filgrastim (Neupogen)
Pegfilgrastim (Neulasta)

Question 15

Leukopoietic growth factors SE/AR

Answer 15

Bone pain

Leukocytosis (causes spleen to enlarge as it filters WBCs)

Splenomegaly (long term use)

Question 16

Thrombopoietic growth factors

Answer 16

Stimulate production of thrombocytes (platelets)

Stimulates the production of heatopoietic stem cells and megakaryocyte progenitor cells (these produce platelets)

Med:
oprelvekin (Neumega)

Question 17

Thrombopoietic growth factor SE/AR

Answer 17

N/V/D
Fluid retention/edema
Neutropenic fever
Dizziness
Cardiac dysrhythmias
Dyspnea
Headache