hematology/infectious disease Flashcards
What is polycythemia vera
excessive number of erythrocytes, leukocytes and thrombocytes causing blood to become hyper viscous and perfusion problems
What do you see in people with polycythemia vera
dark purple cyanotic appearance
distended veins-causing intense itching
hypertension
thrombosis
poor gas exchange
how do you treat polycythemia vera
withdraw whole blood
refuse plasma
anticoagulation
hydration
patient education for polycythemia vera
drink at least 3 liters of liquid each day
avoid tight or constrictive clothing
wear gloves when outdoors in temps below 50
contact provider at sign of infection
wear support hose or stalking when up
elevate feet when seated
stop activity with chest pain
use electric shaver
use soft tooth brush
do not floss between teeth
quit smoking
What is anemia
reduction in number of erythrocytes
What cause iron deficient anemia
iron deficient diet
chronic alcoholism
malabsorption syndromes
partial gastrectomy
rapid metabolic activity (pregnancy, adolescence, infection)
What causes vitamin b12 deficient anemia
dietary deficiency
failure to absorb from intestinal tract
what causes failure to absorb vitamin b12
partial gastrectomy
pernicious anemia
malabsorption syndromes
What is aplastic anemia
body stops producing enough new blood cells
includes exposure to myelotoxic agents
list myelotoxic agents
radiation
benzene
chloramphenicol
alkylating agents
antimetabolites
sulfonamides
insecticides
signs of aplastic anemia
tachycardia
orthostatic hypotension
dyspnea on exertion
decreased spo2
fatigue
increased need for sleep
pallor
cool
mottled
delayed cap refill
unable to tolerate cold
how do you treat aplastic anemia
discontinue causative agents
blood transfusion
how do you administer iron
with food
vitamin c helps with absorptions
What is a sickle cell crisis
decreased blood flow leading to hypoxia, ischemia and infarction
severe joint pain
sequestration
-blood pools, often in spleen, splenomegaly and tenderness
what can cause a sickle cell exacerbation
hypoxia
exercise
high altitude (low oxygen)
fever
signs of a sickle cell crisis
pallor
pain
fatigue
arthralgia
chest pain
respiratory distress
Treatment of sickle cell crisis
IV fluids
blood transfusion
O2
pain management
hydroxyurea
what does hydroxyurea do
increase production of fetal hemoglobin to reduce crisis
What is disseminated intravascular coagulation
disorder in which proteins that control blood clotting become overactive
bleeding and clotting at the same time
triggers of DIC
Blood transfusion
cancer
pancreatits
liver disease
severe tissue injury
pregnancy complication
what to watch for in bleeding of DIC
ecchymosis
hematomas
hemoptysis
melena
pallor
hematuria
signs of clot in heart or lungs
chest pain
dyspnea
SOB
signs of clots in legs
pain
redness
warmth
swelling
signs of clotsBrain
headache
speech changes
paralysis
dizziness
lab finding in DIC
platelet count decreases
fibrinogen decreases
INR increases
PTT increases
D-dimer increases
Treatment of DIC
determine underlying cause and treat
administer clotting factors
administer platelets
bleeding precautions
What is required PPE for contact precautions
wash hands
gloves
gown
dedicated equipment
infections requiring contact precautions
MRSA
VRE
noroviruses
rotavirus
conjunctivitis
diphtheria (cutaneous)
herpes
muman metapneumovirus
pediculosis
scabies
poliomyelitis
staph
What is required with droplet precautions
hand wash
face mask
goggles
what infections require droplet precautions
flue
pertussis
mumps
rhinovirus
adenovirus
meningitis
street
rubella
epiglottitis
parvo
diphtheria pharyngeal
What is required with airborne precautions
clean hands
n-95
keep door closed
what infections require airborne precautions
TB
rubeola virus (measles)
varicella
sars
smallpox
What is sepsis
systemic inflammatory reaction to an infections
Signs of sepsis
elevated lactic acid
metabolic acidosis
leugocytosis
hypotension
tachypnea
tachycardia
febrile
treatment of spesis
blood cultures first
broad spectrum IV ABX
IV fluids
vasopressors
