Hemotological Problems Flashcards
Hemophilic A is experiencing thigh swelling after a fall. This is an emergency
What will be the standard treatment
Factor replacement
a treatment for hemophilia that involves replacing missing blood clotting factors
Patient with chemotherapy-relat3d neutropenia is receiving filtration injections. Which most important to tell HCP
- Patient states : My bones are aching
- Platelets 110,000
- WBC 39,000
- Reports: Medication stings when injected
WBC 39,000
Leukocytosis is a side effect of Filgrastim (Bone marrow stimulant) -medication dose decrease or stopped
Bone pain common with Filgrastim but medication can be continued
Stinging = inject slower
Normal platelets 150,000 and 450,000
WBC 4,500 and 11,000
Which requires immediate intervention when preparing to admin packed RBCs
- Waiting 20 minutes after obtaining RBC to infuse them
- Starting IV line with a 22 catheter
- Priming transfusion with 5% Dextrose in LR
- Telling patient that PRBC may cause serious transfusion reaction
- Priming transfusion with 5% Dextrose in LR
ONLY USE NS 0.9- avoids hemolysis of RBC
Larger Guage should be used but if 22 is used dilute with NS
Priority for sickle cell anemia with BP 102/ 64, OX SAT 92%, Pain 8/10.
- Admin morphine 4 - 8 mg IV
- Oxygen 4/L NC
- Infuse 200mL/hr
- Warm packs to painful joints
Oxygen 4/L NC
Oxygen for sickle cell must be applied if <95%
Hypoxia & Deoxygenation of blood cells are common cause of sickling
Hemophilia A is admitted to ER after car crash. Which is the priority
- Transport to radiology for cervical spine radiology
- Transfuse factor VII concentrate
- Type & cross match for 4 units of PRBC
- Infuse NS at 250ml/h
- Transfuse factor VII concentrate
Priority is to make blood clot
DIC patient which assessment has the most immediate implications for care
- No palpable radial or pedal pulse
- Patient reports chest pain
- OX Sat 87%
- Mottling of hands and feet
- OX Sat 87%
Because decreases oxygen will have the greatest impact on all body systems
Most important for iron deficient anemia who is taking iron supplements
- Black stools
- Occasional Constipation
- Daily multivitamin
- Takes antacids with iron to avoid nausea
- Takes antacids with iron to avoid nausea
Antacid will affect the absorption of iron
Black stools are normal with iron
First to see
- 26 thalassemia hemoglobin 8 and order for blood Transfusion
- 44 admitted 3 days ago sickle cell crisis scheduled for CT scan
- 50 stage IV non-Hodgkin crying “I’m not ready to die”
- 69 chemotherapy induced neutropenic oral temp 100.1
- 69 chemotherapy induced neutropenic oral temp 100.1
Neutropenic & slight temp can turn into an emergency real quick
5 minutes into transfusion patient becomes Flushed & tachypnic and says I’m having chills, get me a blanket. Best response
- Obtain a warm blanket
- Check oral temp
- Stop transfusion
- Admin ox
- Stop transfusion
Patient maybe having a febrile reaction.
Stop transfusion & check VS
Multiple myeloma which requires rapid action by the nurse
- Chronic bone pain.
- Blood uric acid is very elevated
- 24 hr urine test shows Bence Jones Proteins
- New onset leg numbness
- New onset leg numbness
Maybe causes by spinal cord compression
Elevate leg & contact HCP
Chronic bone pain, hyperuricemia, Bence Jones proteins are all normal findings with multiple myeloma
Bence Jones
small proteins that are part of antibodies called light chains and are found in urine.
Common in multiple myeloma, a blood cancer that starts in plasma cell
22 with history of splenectomy several years ago. Which is an immediate concern to the nurse
- Engages in unprotected sex
- Oral temp 100
- BP 148/ 76
- Daily marijuana use
- Oral temp 100
Spelene plays role in phagocytis of microorganisms & they are at high risk for infection.
Acute myelogenous leukemia is receiving induction-phase chemotherapy. Which assessment finding requires rapid action
- K 7.8
- Urine output less than intake 400mL
- Inflammation & redness of oral mucosa
- Ecchymoses on anterior trunk
- K 7.8
Tumor lysis syndrome can cause Hyperkalemia
Tumor lysis syndrome is a SE of chemotherapy with acute leukemia
Hodgkin lymphoma radiation therapy to groin area- skin red and tender. Which activity is appropriate for UAP
- Check skin for signs of redness & peeling
- Assist patient in selecting appropriate clothing
- Explain good skin care to patients family
- Clean skin over area daily with mild soap
Clean skin over area daily with mild soap
Selecting clothing would be a job for the RN
