Module 14 Exam Material Flashcards
What is the major function of WBC (Leukocyte)?
Fights infection
What is the major function of Neutrophil?
essential in preventing or limiting bacterial infection via phagocytosis
What is the major function of Eosinophil?
Involved in allergic reactions (neutralizes histamine); digest foreign proteins
What is the major function of Basophil?
contains histamine, integral part of hypersensitivity reactions
What is the major function of Lymphocyte?
integral component of immune system
What is the major function of T lymphocyte?
responsible for cell-mediated immunity; recognizes material as “foreign” (surveillance system)
What is the major function of Plasma cell?
secretes immunoglobulin (antibody); most mature form of B lymphocyte
What is the major function of RBC (Erythrocyte)?
carries hemoglobin to provide oxygen to tissues; average lifespan is 120 days
What is the major function of Platelet (Thrombocyte)?
fragment of megakaryocytic; provide basis for coagulation to occur; maintains hemostasis; average lifespan is 10 days
Describe cellular immunity
T lymphocytes are responsible for delayed allergic reactions, rejection of foreign tissue (e.g., transplanted organs), and destruction of tumor cells.
Describe humoral immunity
Plasma cells, in turn, produce antibodies called immunoglobulins (Igs), which are protein molecules that destroy foreign material by several mechanisms
Where is the site of activity for most macrophages?
Mainly in the spleen
Describe Hemostasis
the process of preventing blood loss from intact vessels and of stopping bleeding from a severed vessel, which requires adequate numbers of functional platelets.
Extrinsic Pathway
When tissue is injured, this pathway is activated by the release of thromboplastin from the tissue
** also known as tissue factor pathway
Intrinsic Pathway
activated when the collagen that lines the blood vessels is exposed
- slower and this sequence is less often responsible for clotting in response to tissue injury
**also known as contact activation pathway
Describe Leukopenia
Decreased number of circulating leukocytes
Autosomal Recessive Hematologic disorders
Hemochromatosis
Sickle cell disease
Thalassemia
Autosomal Dominant Hematologic Disorders
Factor V Leiden
Familial hypercholesterolemia
Hereditary angioedema
Hereditary spherocytosis
Von Willliebrand Disease
X-linked Hemtaologic Disorders
Hemophilia
Nursing Assessment for Hematologic Disorders
Collect family history information on both maternal and paternal relatives from three generations of the family
If risk suspected, carefully screen for bleeding disorders prior to surgical procedures
Patient Assessment Specific to Hematologic Disorders
Extreme fatigue
delayed clotting of blood
easy/deep bruising
abnormal bleeding - frequent nosebleeds
abdominal pain
joint pain
- Review blood cell counts for abnormalities
-Assess for presence of illness despite low risk (young adult with blood clot)
Physical assessment of an individual with hematologic disorder
Should be comprenhensive and include careful attention to skin, oral cavity, lymph nodes, and spleen
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Prior episodes of bleeding (epistaxis, menorrhagia, hematochezia, gastrointestinal bleeding, and/or ulcers)
What are the potential indications of hematologic disorders?
Thrombocytopenia
Coagulopathy
Anemia
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Prior blood clots
Pulmonary emboli
Miscarriages
What are the potential indications of hematologic disorders?
Thrombotic Disorder
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Fatigue and weakness
What are the potential indications of hematologic disorders?
Anemia
Infection
Malignancy
Clonal disorders
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Dyspnea, particularly dyspnea on exertion
Orthopnea
shortness of breath
What are the potential indications of hematologic disorders?
Anemia
Infection
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Prior radiation therapy (especially pelvic irradiation)
What are the potential indications of hematologic disorders?
Anemia
Pancytopenia
Melodysplastic syndrome
Leukemia
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Prior Chemotherapy
What are the potential indications of hematologic disorders?
Myelodysplastic syndrome
Leukemia
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Hobbies/occupational/military exposure history (especially benzene, agent orange)
What are the potential indications of hematologic disorders?
Myelodysplastic syndrome
Leukemia
Myeloma
Lymphoma
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Diet history
What are the potential indications of hematologic disorders?
Anemia (due to vitamin B12 , folate, iron deficiency
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Diet history
What are the potential indications of hematologic disorders?
Anemia (due to vitamin B12 , folate, iron deficiency
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Alcohol consumption
What are the potential indications of hematologic disorders?
Anemia (effect on hematopoiesis, nutritional deficiencies)
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
use of herbal supplements
What are the potential indications of hematologic disorders?
Platelet dysfunctional
Health Findings = Potential Indications of Hematologic Disorder
Health History Findings:
Concurrent medications
What are the potential indications of hematologic disorders?
Neutropenia
Anemia
Hemolysis
Thrombocytopenia
Nonmalignant Hematologic Disorders
Anemia
Neutropenia
Lymphopenia
Polycythemia
Bleeding Disorders
Sickle Cell Disease
Acquired Coagulation Disorders - DIC
Hypoproliferative Anemia
resulting from defective RBC Production
- Iron deficiency (microcytic)
- Vitamin B12 deficiency (megaloblastic)
- Folate (megaloblastic)
- Decreased erythropoietin production (e.g. from chronic kidney disease)
- Cancer/inflammation
**low production of RBC
Hemolytic Anemia
Resulting from RBC Destruction
- Altered erythropoiesis (sickle cell, thalassemia, other hemoglobinopathies)
-Hypersplenism (hemolysis)
- Drug induced anemia
- Autoimmune anemia
- Mechanical heart valve -related anemia
Thalassemia
Type of genetic anemia
Often seen in Asian, African, Mediterranean, and Middle Eastern Individuals
- individuals have a high level of small RBCs, lab show small cells at a high volume
-Treatment does NOT include blood products
Neutropenia
Low volumes of neutrophils
puts individual at increased risk for infection, monitor patient closely
Neutropenia
Low volumes of neutrophils
puts individual at increased risk for infection, monitor patient closely
Lymphopenia
low volumes of lymphocyte
Causes
- exposure to radiation
- long-term use corticosteroids
- infections
- neoplasms
- alcohol abuse
Polycythemia
Increased levels of red blood cells does not mean anemia, understand that polycythemia is the increased volume of RBC
Seen in individuals with a Hx of chronic smoking, obstructive sleep apnea, COPD , live in a high altitude and small exposure to carbon monoxide
NOT A FORM OF ANEMIA
Causes of Bleeding Disorders
Trauma
Platelet abnormalities
Coagulation factor abnormality
Nursing management of bleeding disorders
Limit injury
Assess for bleeding
Bleeding precautions
Patients with platelet dysfunction should avoid substances that interfere with platelet function such as:
OTC medications such as aspirin, NSAIDs, as well as herbal supplements, and alcohol.