MS CH 27 Hematologic and Lymphatic System Function, Assessment, and Therapeutic Measures Flashcards
1
Q
What are the components of the hematologic system?
A
Bone marrow, blood, and blood components
2
Q
What are the components of the lymphatic system?
A
Lymph nodes, lymph nodules, lymph vessels
3
Q
What are the functions of blood?
A
Transport, temperature regulation, pH, fluid balance, and immune protection
4
Q
What percentage of blood is plasma?
A
About 55%
5
Q
Where are all formed elements of blood produced?
A
Red bone marrow (hematopoietic tissue)
6
Q
What are the three main plasma proteins?
A
Albumin, globulins, clotting factors
7
Q
What does albumin do?
A
Maintains blood volume and pressure by pulling fluid into capillaries
8
Q
What is the main function of hemoglobin?
A
Carry oxygen
9
Q
What triggers erythropoietin release?
A
Hypoxia
10
Q
What organ produces erythropoietin?
A
Kidneys
11
Q
What are reticulocytes?
A
Immature red blood cells
12
Q
What does a high reticulocyte count indicate?
A
Increased RBC production due to anemia or hypoxia
13
Q
What nutrients are essential for RBC production?
A
Protein, iron, folic acid, vitamin B12
14
Q
What is intrinsic factor needed for?
A
Absorption of vitamin B12
15
Q
Where is intrinsic factor produced?
A
Parietal cells of the stomach
16
Q
What is the lifespan of a red blood cell?
A
About 120 days
17
Q
What breaks down old RBCs?
A
Macrophages in liver, spleen, and bone marrow
18
Q
What causes jaundice?
A
Elevated bilirubin from RBC breakdown
19
Q
What determines ABO blood type?
A
Antigens on red blood cells
20
Q
What determines Rh factor?
A
Presence or absence of D antigen
21
Q
What is the danger of Rh incompatibility?
A
Immune reaction during transfusion or pregnancy
22
Q
What are the granular WBCs?
A
Neutrophils, eosinophils, basophils
23
Q
What are the agranular WBCs?
A
Lymphocytes, monocytes
24
Q
Where do T lymphocytes mature?
A
Thymus
25
What do lymph nodes do?
Filter lymph, house lymphocytes and macrophages
26
What is the function of monocytes?
Become macrophages and phagocytize pathogens
27
What do eosinophils respond to?
Allergic reactions and parasitic infections
28
What do basophils release?
Histamine and heparin
29
What do B lymphocytes produce?
Antibodies
30
What do T lymphocytes do?
Immune surveillance and response (helper, killer, suppressor, memory)
31
What are platelets formed from?
Megakaryocytes
32
What do platelets do?
Involved in hemostasis: vascular spasm, plug formation, clotting
33
What initiates the intrinsic clotting pathway?
Platelet contact with damaged endothelium
34
What initiates the extrinsic pathway?
External tissue damage
35
What does prothrombin activator convert?
Prothrombin to thrombin
36
What does thrombin convert?
Fibrinogen to fibrin
37
What prevents unwanted clotting?
Smooth vessel lining, heparin, antithrombin
38
What is serum?
Plasma without clotting factors
39
What is hematocrit?
Percentage of blood volume occupied by RBCs
40
What is the “buffy coat” in centrifuged blood?
Layer containing WBCs and platelets
41
What is lymphedema?
Swelling caused by lymph accumulation
42
What vessel returns lymph from most of the body?
Thoracic duct
43
What vein receives lymph from the thoracic duct?
Left subclavian vein
44
What are lymph nodules?
Small lymph tissues under mucous membranes
45
What do lymph nodules do?
Trap and destroy pathogens near body openings
46
What organ stores one-third of platelets?
Spleen
47
What does the spleen do?
Filters blood, removes old cells, houses immune cells
48
Is the spleen vital?
No, other organs can compensate
49
What is the thymus' function?
Matures and activates T cells
50
What happens to the thymus with age?
It atrophies
51
What causes ecchymoses?
Bleeding under the skin
52
What is petechiae?
Tiny purplish spots from capillary bleeding
53
What is purpura?
Larger hemorrhages into skin or organs
54
What is a common sign of anemia?
Fatigue and pallor
55
What is a CBC used to evaluate?
RBCs, WBCs, hemoglobin, hematocrit, platelets
56
What test reflects oxygen-carrying capacity?
Hemoglobin
57
What test measures RBC volume?
Hematocrit
58
What is the function of a bone marrow biopsy?
Diagnose disease, assess treatment, detect infection
59
What sites are used for bone marrow biopsy?
Sternum, iliac crest, vertebrae
60
What is PT?
Prothrombin Time—measures clotting factor activity
61
What is INR used for?
Monitoring warfarin therapy
62
What is aPTT?
Activated partial thromboplastin time—monitors heparin
63
What does a Coombs test detect?
Antibodies against RBCs
64
What is agglutination testing used for?
Blood typing, crossmatching
65
What is lymphangiography?
Imaging of lymph flow with dye
66
What is a common side effect of lymphangiography dye?
Blue discoloration of skin or urine
67
What is a lymph node biopsy for?
Determine infection vs. cancer
68
What are packed RBCs used for?
Severe anemia or blood loss
69
What is FFP?
Fresh Frozen Plasma—contains clotting factors
70
What is albumin used to treat?
Hypovolemia due to low albumin
71
What is cryoprecipitate used for?
Replace missing clotting factors
72
What solution is compatible with blood products?
Normal saline
73
What is the maximum time for a unit of blood to hang?
4 hours
74
What is leukocyte-depleted blood used for?
Prevent febrile reactions
75
Why use washed RBCs?
Reduce allergic reactions
76
Why use a blood warmer?
Prevent hypothermia in massive transfusion
77
What should be done during the first 15 minutes of transfusion?
Stay with the patient and monitor for reactions
78
What is a febrile reaction?
Fever, chills, usually mild
79
What is the treatment for a febrile reaction?
Stop transfusion, notify HCP, give antipyretic
80
What is a urticarial reaction?
Hives from allergic plasma reaction
81
How is a urticarial reaction treated?
Stop transfusion, give antihistamines
82
What is a hemolytic reaction?
Incompatible blood causes RBC destruction
83
What are early signs of hemolytic reaction?
Back pain, fever, chills, SOB
84
What is the first step in a hemolytic reaction?
Stop transfusion immediately
85
What is a late sign of hemolytic reaction?
DIC and shock
86
What is an anaphylactic reaction to blood?
Severe allergy causing respiratory/cardiovascular collapse
87
Who is at higher risk for anaphylactic reactions?
Patients with many transfusions or pregnancies
88
What is the treatment for anaphylaxis?
Stop transfusion, initiate emergency care
89
What causes circulatory overload?
Rapid transfusion, especially in elderly patients
90
What are signs of circulatory overload?
Frothy sputum, crackles, dyspnea, JVD
91
What to do in circulatory overload?
Stop transfusion, administer diuretics
92
Why are older adults at risk during transfusion?
Reduced cardiac and renal reserve
93
What is the nurse’s role during transfusion?
Monitor vitals, assess for reactions, verify identity
94
What vital signs should be taken during transfusion?
Before, 15 min after start, then per protocol
95
What is the Joint Commission safety goal related to transfusions?
Use two-person verification process
96
What causes increased bands and segs in WBCs?
Acute bacterial infection
97
What WBC pattern indicates viral infection?
↑ Lymphocytes, ↓ Segs and Bands
98
What organ is most at risk in hemolytic transfusion reaction?
Kidneys
99
What lab test checks platelet function?
Bleeding time
100
What test identifies fragile capillaries?
Capillary fragility test
101
What happens to blood pressure in shock?
Drops (hypotension)
102
What patient education is needed for transfusions?
Report any itching, fever, pain, SOB immediately
103
A nurse assesses petechiae and ecchymosis on a patient. What condition should the nurse suspect?
Possible thrombocytopenia or bleeding disorder (Petechiae and ecchymosis suggest low platelet count or clotting issues.)
104
Which blood test reflects the oxygen-carrying capacity of blood?
Hemoglobin (Hgb indicates the blood’s capacity to carry oxygen.)
105
A patient's RBC count is elevated. What condition might be causing this?
Chronic hypoxia or polycythemia vera
106
Which food should the nurse recommend to a patient with iron-deficiency anemia?
Lean red meat or spinach (Rich in iron)
107
Which vitamin is essential for absorption of iron?
Vitamin C
108
What is the primary function of erythropoietin?
Stimulates red blood cell production in bone marrow
109
What is the expected lifespan of a red blood cell?
Approximately 120 days
110
What complication should the nurse monitor for in a patient receiving multiple transfusions?
Hemolytic or febrile non-hemolytic reaction
111
What action should the nurse take if a transfusion reaction is suspected?
Stop the transfusion and maintain IV access with normal saline
112
A patient has a platelet count of 25,000/mm³. What is the nurse's priority?
Institute bleeding precautions (High risk of spontaneous bleeding)
113
Which blood product provides clotting factors?
Fresh Frozen Plasma (FFP)
114
What assessment finding would most concern a nurse before a transfusion?
Fever of 101°F (38.3°C)
115
What is the role of albumin in the blood?
Maintains oncotic pressure and fluid balance
116
What action should be taken for lymph node enlargement?
Report to HCP; may indicate infection or malignancy
117
What should the nurse include in care for a bone marrow biopsy?
Apply pressure to site and monitor for bleeding
118
Which WBC is most active in bacterial infections?
Neutrophils
119
What is the normal hematocrit range for females?
38%–44%
120
What patient teaching is important after lymphangiography?
Skin or urine discoloration is expected temporarily
121
What lab value indicates dehydration or hypoxia?
Elevated hematocrit (Hct)
122
A patient with liver disease has prolonged PT. What is the cause?
Decreased clotting factor production by the liver
123
A patient has fatigue, glossitis, and tingling. What type of anemia is suspected?
Vitamin B12 deficiency anemia
124
What is the nurse’s priority when caring for a patient on warfarin?
Monitor PT/INR
125
A patient with increased reticulocyte count likely has?
Blood loss or hemolytic anemia
126
The nurse notes spoon-shaped nails. This could indicate?
Iron-deficiency anemia
127
What lab is used to monitor heparin therapy?
aPTT
128
What does the term “bands” in a CBC indicate?
Immature neutrophils—often elevated in infection
129
In lymphatic anatomy, which vessel returns lymph to the left subclavian vein?
Thoracic duct
130
Which blood component carries antibodies?
Gamma globulins
131
What is the purpose of platelets?
Initiate clotting and form plugs in vessels
132
What lab change indicates viral infection?
Increased lymphocytes
133
What should the nurse monitor after splenectomy?
Signs of infection due to decreased immune function
134
Why must the nurse avoid dextrose-containing IV fluids during transfusion?
They cause RBC hemolysis
135
Why is the thymus important in childhood?
It matures T cells
136
A patient develops chills and back pain 10 minutes into a transfusion. What should the nurse do?
Stop the transfusion and notify the provider immediately
137
A patient receiving chemotherapy develops fatigue and pallor. What lab should be checked first?
Hemoglobin (Hgb)
138
What is the primary function of lymph nodes?
Filter lymph and initiate immune responses
139
What is a risk in elderly patients receiving rapid transfusion?
Circulatory overload
140
What complication results from incompatible transfusion?
Acute hemolytic reaction
141
What is the role of fibrin in hemostasis?
Forms a stable blood clot
142
Which nursing intervention is priority during the first 15 minutes of transfusion?
Monitor for signs of reaction
143
Which finding is most indicative of infection in older adults?
Change in mental status
144
What is the best injection site for bone marrow biopsy in adults?
Posterior iliac crest
145
Which test identifies antibodies on patient RBCs?
Direct Coombs test
146
A patient has purpura and petechiae. Which lab is most relevant?
Platelet count
147
What indicates effective erythropoietin therapy?
Increased hemoglobin and hematocrit
148
A patient has jaundice, fatigue, and dark urine. Which lab abnormality is likely?
Elevated bilirubin due to hemolysis
149
Which lab would be increased in an allergic reaction?
Eosinophils
150
Which organ stores platelets and filters RBCs?
Spleen
151
What is the most common cause of febrile transfusion reaction?
Sensitivity to donor WBCs
152
Which nutrient supports DNA synthesis in RBC production?
Folic acid
153
What is a serious complication of blood transfusion in renal patients?
Fluid overload
154
A nurse observes cyanosis in a patient. What does this indicate?
Decreased oxygen saturation
155
What does a high INR indicate?
Increased bleeding risk
156
What is the significance of elevated D-dimer?
Suggests clotting activity (e.g., DVT, PE, DIC)
157
Why is proper site marking important for bone marrow biopsy?
Ensure correct site for invasive procedure
158
What is the role of macrophages in the spleen?
Phagocytize worn-out RBCs
159
When do lymphocytes increase?
During viral infections
160
What is the primary concern when giving blood to a heart failure patient?
Fluid overload
161
Which electrolyte imbalance is most concerning after transfusion?
Hyperkalemia from hemolysis
162
A patient reports severe lower back pain post-transfusion. What should the nurse suspect?
Hemolytic transfusion reaction
163
What is a characteristic symptom of circulatory overload?
Crackles in lungs and frothy sputum
164
What blood type is considered a universal donor?
O negative
165
What is the significance of Rh-negative status in pregnancy?
Risk for hemolytic disease of the newborn
166
What assessment finding indicates iron-deficiency anemia?
Brittle or spoon-shaped nails
167
Which dietary supplement improves iron absorption?
Vitamin C (e.g., orange juice)
168
What is the buffy coat composed of?
WBCs and platelets
169
Which blood product is used for hemophilia?
Cryoprecipitate (clotting factors)
170
What nursing action is essential post-lymph node biopsy?
Monitor for bleeding and infection at the site
171
What organ compensates for spleen removal?
Liver and lymph nodes
172
What is the main risk with leukopenia?
Increased susceptibility to infection
173
What patient education is needed after bone marrow biopsy?
Keep site clean and dry; monitor for bleeding
174
What condition results from too many RBCs?
Polycythemia vera
175
What is a normal platelet count?
150,000–450,000/mm³
176
What causes flushed skin during fever?
Vasodilation near skin surface
177
What structure returns lymph to circulation?
Lymphatic vessels into subclavian veins
178
What intervention helps prevent infection in immunocompromised patients?
Hand hygiene and neutropenic precautions
179
What finding is common in severe anemia?
Tachycardia and fatigue
180
What is the primary cause of macrocytic anemia?
Vitamin B12 or folate deficiency
181
What test assesses clotting after minor trauma?
Bleeding time
182
What causes jaundice in hemolysis?
Excess bilirubin from destroyed RBCs
183
Which WBC is responsible for allergic responses?
Basophils and eosinophils
184
Which cell type produces antibodies?
Plasma cells (from B lymphocytes)
185
What nursing care is priority during transfusion?
Verify blood compatibility with two nurses
186
A patient on heparin develops bleeding. What lab should be reviewed?
aPTT
187
What is a common side effect of lymphangiography dye?
Blue-tinged skin or urine for 1–2 days
188
A patient is pale, short of breath, and weak. What is the likely cause?
Anemia
189
What is the purpose of gamma globulins?
Immune response and antibody function
190
A nurse notes clubbing of fingernails. What does this suggest?
Chronic hypoxia
191
What is antithrombin's role in coagulation?
Inactivates excess thrombin to prevent clots
192
What test is used before transfusion to check compatibility?
Crossmatching
193
What clotting pathway is activated by vessel injury?
Extrinsic pathway
194
What is the role of fibrin?
Forms a stable mesh to complete clotting
195
What hormone influences RBC production?
Erythropoietin
