important

Question 1

THROMBO-CYTOPENIA

Answer 1

reduction of platelets below 150 × 10 /L or 150 000 per mcL.

Question 2

The causes of platelet disorders

Answer 2

impaired production, increased destruction, or abnormal distribution.

Platelet disorders can be inherited, but the vast majority of them are acquired.

The causes of acquired disorders include autoimmune diseases, increased platelet consumption, splenomegaly, marrow suppression, bone marrow failure, and the ingestion of certain foods, herbs, and drugs.

Question 3

immune thrombo-cytopenic purpura (ITP) and therapy

Answer 3

The most common acquired thrombo-cytopenia is a syndrome of abnormal destruction of circulating platelets

Multiple therapies are used to manage the client with ITP, such as corticosteroids or splenectomy.

Question 4

heparin use

Answer 4

ife-threatening condition called heparin-induced thrombo- cytopenia (HIT) or heparin-induced thrombo-cytopenia and thrombosis syndrome (HITTS).

Heparin must be discontinued when HITTS is first recognized,

which is usually if the patient’s platelet count has fallen 50% or more from its baseline

or if a thrombus forms while the client is on heparin therapy.

Question 5

thrombosis-cytopenia goals

Answer 5

(1) have no gross or occult bleeding,
(2) maintain vascular integrity, and
(3) manage home care to prevent any complications related to an increased risk for bleeding.

Question 6

nursing diagnoses for thrombocytopenia

Answer 6

Potential for bleeding as evidenced by inherent coagulopathy
* Potential for impaired oral mucous membrane integrity as evidenced by decrease in platelets and treatment regimen
* Inadequate knowledge as a result of insufficient information,insufficient knowledge of resources

Question 7

clinical manifestations

Answer 7

Could be asymptomatic
Bleeding: mucosal or cutaneous, gingival bleeding
when platelet count is low, rbc can leak out of the blood vessels and into skin causing petechiae and a lot of them results in a bruise called purpura
Labs – cbc including platelet count
Bone marrow aspiration and biopsy

Question 8

diagnostic

Answer 8

bone marrow aspiration and biopsy
2) cbc including platelet count
3) specific laboratory studies

Question 9

therapy for immune thrombocytopenia purpura

Answer 9

Corticosteroids
* Intravenous immunoglobulin
(IVIG)
Splenectomy
* Platelet transfusions
(if life-threatening)
* Immunosuppressives
(e.g., rituximab [Rituxan],
cyclosporine)

Question 10

Hemophilia

Answer 10

an X-linked recessive genetic disorder caused by defective or deficient
coagulation factor.

The two major forms of hemophilia, which can occur in mild to severe forms, are hemophilia A (classic hemophilia, factor VIII deficiency) and hemophilia B (Christmas disease, factor IX deficiency).

Question 11

Von Willebrand disease

Answer 11

is a related disorder involving a deficiency of the von Willebrand coagulation protein.

Question 12

hemophilia therapy

Answer 12

Replacement of deficient clotting factors is the primary means of supporting a patient with hemophilia.

In addition to treating acute crises, replacement therapy may be given before surgery and before dental care as a prophylactic measure.

Question 13

Home management

Answer 13

is a primary consideration for the client with hemophilia because the disease follows a progressive, chronic course.

Question 14

patient teaching for haemophilia

Answer 14

The patient with hemophilia must be taught to recognize disease-related problems and to learn which problems can be resolved at home and which require hospitalization.

Question 15

DISSEMINATED INTRAVASCULAR COAGULATION DIC

Answer 15

is a serious bleeding and thrombotic
disorder results from abnormally initiated and accelerated clotting which can lead to uncontrollable hemorrhage

Question 16

CAUSE of DIC

Answer 16

DIC is always caused by an underlying disease or condition. The underlying problem must be treated for the DIC to resolve.

Question 17

treatment of DIC

Answer 17

It is important to diagnose DIC quickly, stabilize the patient if needed (e.g., oxygenation, volume replacement),

institute therapy that will resolve the underlying causative disease or problem, and provide supportive care for the manifestations resulting from the pathology of DIC itself.

Question 18

Neutropenia

Answer 18

is defined as a neutrophil count of less than 1 to 1.5 × 10^9/L, or 1 000 to 1 500/mcL.

Question 19

normal neutrophils level

Answer 19

Normally, neutrophils range from 2.2 to 7.7 × 109/L.

Question 20

Severe neutropenia

Answer 20

Severe neutropenia is defined as an ANC less than 0.5 × 10^9/L.

Question 21

why is neutropenia bad

Answer 21

Because neutropenia is a reduction in neutrophils, a type of granulocyte and low levels makes it hard for your body to fight infection

The neutrophilic granulocytes are closely monitored in clinical practice as an indicator of a patient’s risk for infection.

Question 22

SAFETY ALERT for neutropenia

Answer 22

SAFETY ALERT
* A low-grade fever in a neutropenic patient is of great significance be- cause it may indicate infection and quickly lead to septic shock and death unless treated promptly.
* A fever greater than 38°C and/or new signs or symptoms suggesting an infection and a neutrophil count less than 0.5 × 109/L is a medical emergency.
* Neutropenicpatientswithsignsorsymptomsofinfectionshouldgoto the hospital.
* Blood cultures should be drawn STAT and antibiotics started within 1 hour.

Question 23

The nurse must monitor the neutropenic patient for signs and symptoms of

Answer 23

infection and early septic shock.