Heme System Flashcards
The _____ ______ produces blood cells.
bone marrow
These cells carry oxygen.
RBC’s
Platelet plug formation.
Thrombocytes (Platelets)
secrete toxins to fight all pathogens.
Neutrophils (WBC)
Fight parasite worms and elevate allergic response.
Eosinophils ( WBC)
Release histamine to increase inflammatory response.
Basophils (WBC)
Adaptive immune response cells. (T cells, B cells, Memory cells)
Lymphocytes (WBC)
recognize infections and fight them off. (antigen presenting cells)
Monocytes
an inherited protein attached to the surface of red blood cells.
Rh factor
Rh positive can receive _____ or ______ blood.
Positive or negative
Rh negative can ONLY receive ______ blood.
negative
AB can receive blood from _______.
everyone
another name for hemostasis is ______.
clotting
Type O is the ______ _______.
universal donor
There two pathways to blood clotting _______ and _______.
intrinsic and extrinsic
Intrinsic blood clotting is trigged by ____ ___ ____ _____.
changes in the blood. (platelet aggregation)
Extrensic clotting is triggered by?
Something outside the blood vessels. (trauma)
You need _____ to clot.
Ca
What are the 3 heme accessory organs?
- kidneys
- spleen
- liver
The kidneys stimulate the production of _________.
erythrocytes
The spleen controls _______ production.
spleen controls thrombocyte production.
The liver helps with the ________ factor.
clotting
Name 3 anticoagulants
- Heparin
- Warfarin
- Aspirin
Enoxaprin is also called?
LMW Heparin
Clopidogrel (Plavix) is a _______ drug.
antiplatelet
Apixaban (Eliquis) is a ______.
anticoagulant
if a patient has a clot Heparin will ____ ______ ______ _____ ______?
Not get rid of it.
The end result of heparin is to?
slows down clotting
Heparin is used to prevent clots in patients with ______, ________, _______.
strokes, chronic a-fib, and post-op.
Clients on a heparin drip have aPTT levels drawn q___ - ____ hours to titrate the drip.
4-6
Therapeutic aPTT: _____ - ______x normal.
1.5-2x (how long you want the blood to take to clot)
Biggest side effect to monitor with Heparin is _______.
bleeding
Name 4 signs x symptoms of bleeding from heparin.
- Hematuria (pink tinged sputum)
- Hematemesis (bloody vomitus)
- Bruising
- H&Hct (decreased)
The antidote to heparin is ______ ______.
protamine sulfate
HITT is a complication of ______ therapy.
Heparin
HIIT usually occurs ______ - _______ days after Heparin exposure.
5-10 days
If there is an unexplained _____ _____ in any client on heparin suspect HIIT.
platelet drop
Chest pain, Chills, Dyspnea, and fever are clinical manifestations of ______.
HIIT
What is the treatment of HIIT?
Discontinue ALL heparin and start a different coagulant.
Name 3 NC’s of LMW heparin.
- Always give SC
- Can be used during pregnancy (the only one)
- May have cultural/religious implications.
Vitamin _____ is the antidote for Warfarin.
Vitamin K
A patient on warfarin should avoid a diet with?
leafy green veggies b/c they are high with Vitamin K.
_____ is contraindicated during pregnancy.
warfarin
Name 2 nursing considerations for Aspirin.
- Bleeding (don’t admin a week before surgery)
- Caution with Pediatric clients (Reyes syndrome)
______ ______ can occur with viral infections like the flu or chicken pox: causes vomiting delirium, coma, and death.
Reyes Syndrome
What is Salicylism?
ASA toxicity (due to overdose)
_______ _________ is the treatment for acidosis and fluid resuscitation in salicylic.
Sodium Bicarbonate
Urokinase, streptokinase, and alteplase are all?
Fibrinolytics/ Thrombolytics
Fibrinolytics/ Thrombolytics are _____ _____.
clot busters
TPA must be given for a stroke within ______ min.
60 minutes
Fibrinolytics/ Thrombolytics are a bleeding risk. DO NOT _________?
give with other anticoagulants.
____ _____ is the approved compatible IV fluid to infuse with/after blood.
NS
When should vital signs be taken for blood admin?
Before, during, and after.
How long should you monitor the client after administering blood?
30 minutes
Name 4 febrile signs of transfusion reactions?
- Fever
- hypotension
- chills
- tachypnea
Name 4 hemolytic symptoms of a transfusion reaction.
- chest pain
- hypotension
- tachycardia
- apprehension
Name 3 symptoms of a allergic transfusion reaction.
- itching
- urticaria / rash
- bronchospasm
After a transfusion reaction prepare to admin ______ and _______.
diphenhydramine and O2
How many RN’s need to check blood?
Two
What should the blood tubing have?
filter with a larger gauge IV
A rare blood disorder that has an excessive number or abc’s, WBC’s, and thrombocytes.
Polycythemia Vera
Polycythemia Vera causes the blood to be?
hyper viscous (thick and sticky - decreasing perfusion)
Name 3 assessments of Polycythemia Vera.
- Skin - dark purple, cyanotic appearance.
- HPTN
- Thrombosis
What is the tx for polycythemia vera? (name 3)
- Apheresis (remove blood and reinfuse plasma)
- Anticoagulation (heparin, warfarin, LMW hep)
- Hydration (dilute RBC’s)
What are two client education for polycythemia?
- Sop activity at the first sign of chest pain.
- avoid tight or constrictive clothing
What are 3 causes of Vitamin B12 deficiency anemia?
- Partial gastrectomy
- pernicious anemia (body can’t absorb Vitamin B12)
- malabsorption syndromes
When the body stops producing enough new blood cells.
Aplastic anemia
What causes aplastic anemia?
- radiation
- insecticides
- overall bone marrow damage
name 4 assessment findings of aplastic anemia.
- pallor / cool / clammy
- fatigue
- dyspnea
- Orthostatic HYPO
With sickle cell the RBC’s are not able to what?
Carry enough oxygen because of the sickle shape
In sickle cell crisis the decreased blood flow leads to what?
- hypoxia
- Ischemia
- infarction
In sickle cell there is sever joint _______ and ________.
severe joint pain / splenomegaly
hypoxia, exercise, high altitude, and fever can all cause _____ _____ ______.
sickle cell crisis
Name 3 assessments of sickle cell crisis.
- pallor
- pain
- chest-pain
What are the 4 main treatments for sickle cell crisis?
- IV fluids
- Blood transfusion
- O2
- Medications
makes your red blood cells bigger. It helps them stay rounder and more flexible — and makes them less likely to turn into a sickle shape
hydroxurea
a disorder in which proteins that control blood clotting become overactive. There is excessive clotting and excess bleeding.
DIC
Name 2 triggers of DIC
- pregnancy complications
- blood transfusions
headache, speech changes, paralysis, and dizziness are all signs of?
A possible brain clot.
‘RANDI’ bleeding precautions
R- Razor electric
A - Aspirin (NO)
N - Needles (small gauge)
D - Decrease needle sticks
I - Injury (protect)
DIC can be caused by _______, _________, and ______.
ecclampsia / GN sepsis / cancer
What is the tx for DIC?
Packed RBC’s and fresh frozen plasma transfusions. Heparin may be prescribed for any thrombi.
What is albumin?
A major protein found in the blood plasma.
Name 3 important roles of Albumin.
- Oncotic pressure regulation.
- fluid balance maintenance
- immune function
Name 3 conditions that are associated with hypoalbuminemia.
- nephrotic syndrome
- burns
- liver cirrhosis
another word for epistaxis is?
nose bleed
How to stop nosebleed?
pinch continuously not intermittently
When taking enoxaparin (LMW Hep), it doesn’t require the monitoring of _____.
aPTT
Name 4 contraindications with enoxaparin
- Recent spinal surgery
- epidural
- peptic ulcer disease
- thrombocytopenia
Primary prevention is?
intervening before the health issue
Secondary prevention is?
early identification of the disease
tertiary prevention is?
treats the disease and prevents further complications.
Education, immunization, and modifying risk behaviors are examples of which level of prevention?
Primary
Screenings, health fairs, and regular BP checks are examples of which level of prevention?
Secondary
Nutritional education for chronic illness, outpatient therapy and support groups are all examples of which level of prevention?
Tertiary
An internal radiation therapy where a ration source is placed close to cancer?
Brachytherapy
A patient doigt brachythrapy has to have visitors stay at least _____ ft away.
6
On brachytherapy a family should only visit ____ min to ____ hours a day.
30 minutes to 2 hours a day
Name 4 risk factors of prostate cancer.
- age >40
- Familial history
- African-American ethnicity
- Diet high in animal fats
albumin is a _____.
protein
albumin is synthesized in the ______.
liver
