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Nursing 2005: Clinical Pathophysiology > Nurs 2005: Hematology Disorder > Flashcards

Nurs 2005: Hematology Disorder Flashcards

1
Q

Bone Marrow

A
  • blood forming tissue
  • produces cell components of blood
  • all development of common stem cell
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2
Q

What are the 3 types of blood cells?

A
  1. erythocytes = RBC
  2. leukocytes
  3. platelets
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3
Q

What is the func of eythrocyes?

A
  • oxygenation

- hemoglobin transports O2

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4
Q

What is the production of erythrocytes?

A
  • regulated by cellular O2 requirements and general metabolic activity
  • Erythropoiesis*
  • Reticulocyte - immature erythrocytes
  • nutrition = folic acid, iron, vit b12
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5
Q

Anemia

A
  • dec in RBC
  • dec hemoglobin and hematocrit
    • blood cells are destroyed
  • not disease but manifestation
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6
Q

What are the clinical man of Anemia?

  1. mild anemia
A

Hb = 10-14

  • SOB during exercise
  • palpations
  • external dyspnea
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7
Q
  1. moderate anemia
A

Hb= 6-10

  • SOB at rest
  • inc palpations
  • dyspnea
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8
Q
  1. severe anemia
A

Hb = <6

  • tachycardia
  • affects all body systems
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9
Q

What are the severe clinical man of anemia?

  1. CV
  2. Resp
  3. Neuro
  4. GI
  5. MS
  6. Skin
A
  1. CV
    - inc HR
    - angina
    - MI, CHF
  2. Resp
    - inc RR
    - dyspnea
  3. Neuro
    - h/a
    - dizziness
  4. GI
    - spinomegaly = large spleen
    - hetomegaly = large liver
  5. MS
    - bone pain
  6. Skin
    - pale yellow
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10
Q
  1. “cytic”
    a. macro/micro
  2. “chromic”
    a. hypo
    b. normo
A
  1. “cytic”
    - cell size

a. macro/micro
- large/small

  1. “chromic”
    - hemoglobin content

a. hypo = less than normal
b. normo = normal

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11
Q

Macrocytic- Normochomic Anemias

A. Pernicious Anemia aka megaloblastic

A
  • impaired Vit B 12 absoption
    • vit b 12 = DNA synthesis
  • lack of folic acid
  • cells mature quickly but quickly die
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12
Q

Pernicious Anemia PATHO

A
  • defective secretion of intrinsic factor

- needed for absorption of vit 12

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13
Q

Pernicious Anemia ETIOLOGY

A
  • gastic atrophy

- surgery

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14
Q

Pernicious Anemia Clinical Man

A
  • weakness, fatigue
  • GI problems
  • neuro
  • general problems
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15
Q

Pernicious Anemia DIAGNOSTIC TEST

A

a. serum B 12
- low

b. RBC = big
H&G =

c. Shillings test
- drink Vit 12 solution
- look at amount absorbed in urine

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16
Q

Pernicious Anemia TREATMENT

A
  • vit b 12 injections
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17
Q

B. Folic acid

A
  • lack of vit folate (folic acid)
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18
Q

Folic acid PATHO

A
  • folate needed for DNA synthesis

- RBC formation and maturation

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19
Q

Folic acid ETIOLOGY

A
  • poor diet
  • poor absorption
  • alcohol abuse
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20
Q

Folic acid CLINICAL MAN

A
  • weakness, fatigue
  • GI problems
  • general problems

similar to PA BUT NO NEURO problems

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21
Q

Folic acid TX

A
  • folic acid
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22
Q

Microcystic- Hypochormic Anemia

A. Iron Deficiency Anemia

A
  • depletion of iron in body

- ddec supply of iron for hemoglobin

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23
Q

Iron Deficiency Anemia PATHO

A

a. iron stoes for RBC production depleted

b. insufficient iron transported to bone marrow
- alter RBC production starts

c. hemo deficit RBC’s enter circulation
- replace normal response

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24
Q

Iron Deficiency Anemia ETIOLOGY

A
  • inadequate intake
  • malabsorption
  • blood loss
    • GI bleeding
    • heavy bleeding

d. preggo
- iron go goes to fetus

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25
Q

Iron Deficiency Anemia CLINICAL MAN

A
  1. tongue and lips
    - sore and inflamed mucosa
    - beeft red
  2. H/A
  3. numbness, tingling
  4. confusion
    - lack of O2 in brain
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26
Q

Iron Deficiency Anemia TESTS

A

a. RBC = small
H&H = less

b. serum Fe

27
Q

Iron Deficiency Anemia TX

A
  • stool sample then treat cause

- iron supplements

28
Q

B. Polycythemia

A
  • inc RBC
  • thick blood
  • excess vol
    • inc BP and work of heart
29
Q

Polycythemia PATHO

  1. primary
A
  • chronic problem
    • poor circulation/perfusion
  • caused by excessive proliferation of erythrocyte precursors in marrow.
  • myloproliferate disorder
  • seen > 50 years old
30
Q

Polycythemia PATHO

  1. secondary
A
  • caused by hypoxia
  • compensatory mechanism
  • inc RBC d/t underlying system disorder
31
Q

Polycythemia CLINICAL MAN

A
  1. plethora
    - red hands, feet, d/t vasoconstriction
  2. enlarged retinal and cerrebral veins
    - d/t blood pooling
  3. liver and speel enlargement
  4. headache
  5. confusion
  6. visual disturbances
  7. painful itching
    - poor blood flow in mass cells
32
Q

polycythemia TESTS

A
  1. blood test
    - RBC and WBC high
  2. bone marrow biopsy
33
Q

Polycythemia TX

A
  • reduce blood vol
    • RBC phlebotomy
  • fluids

. meds

34
Q

WBC: Leukocytes

Leukocytes FUNC

  • inc name
  • dec name
A
  • phagocytosis of bacteria and foreign particles
    inc: LEUKOCYTOSIS
    dec: LEUKOPENIA
35
Q

Types of WBC

  1. Granulocytes:
    a. neutrophils
    • neutrophilia = ?
      - neutropenia = ?
A
  • strong phagocyctic activity
  • primary phagocytic cell = inflam - - -
  • neutrophilia = infection, inflam, necrosis
  • neutropenia = prolong infection
36
Q

Types of WBC

  1. Granulocytes:
    b. esinophils
  • eosinophilia = ?
  • eosiniopena = ?
A
  • allergic response in parasitic infections
  • eosinophilia = allergies, infections
  • eosiniopena = surgergy stress
37
Q

Types of WBC

  1. Granulocytes
    c. basophils
  • basophilia
  • basopenia
A
  • limited role in phagocytosis
  • contain heparin, serotonin, histamine
  • basophilia = allergic rx, infection
  • basopenia = preg, shock, hyperthyroidism
38
Q
  1. Lymphocytes function
  • lymphocytosis
  • lympocytopenia
A
  • cellular and humoral responses
  • lymphocytosis = viral infection, hepatitis, leukemia
  • lympocytopenia = AIDS, renal failure, steriods
39
Q

Lymphocytes :

a. B cells
b. T cells

A

a. B cells:
- stim by antigens = antibodies

b. T cells:
- cellular immune response

40
Q
  1. Monocytes func
    - monocytosis
    - monocytopenia
A
  • large, slow moving potent pahgocyes = macrophages
  • monocytosis = late infection, chronic infection
  • monocytopenia = rare
41
Q

Platelets

  1. Thrombocytes FUNC
    - normal range
A
  • blood coagulation
  • control bleeding

normal range
140 k - 340 k

42
Q
  1. Thrombocytopenia
A

< 100 k platelets

<10 k severe bleeding

43
Q

Thrombocytopenia ETIOLOGY

A
  • viral infection
  • nutritional deficits
  • meds
  • ITP = autoimmune destruction of platelets
  • TIP = platelets aggregate = occlusion
44
Q

Thrombocytopenia CLIN MAN

a. petechiae
b. purpura
c. ecchymosis
d. ?

A

a. petechiae = red dots on skin
b. purpura = bigger red dots together
c. ecchymosis = bruise
d. prolong bleeding

45
Q

Thrombocytopenia TESTS

A
  1. platelet count
    - dec amount
  2. bleeding time
    - punc skin and see how long it’ll take to clot
46
Q

Thrombocytopenia TX

A
  • dec platelets = platelets

ITP = steroids

TIP = plasma

47
Q

Thrombocythemia

A
  • elevated count >400k
48
Q

Thrombocythemia ETIOLOGY

A
  • accelerated production

- splenectomy

49
Q

Thrombocythemia CLIN MAN

A
  • thrombosis formation
  • headache
  • transient ischemic attacks
  • GI hemorrhage
50
Q

Thrombocythemia TX

A
  • meds to suppress bone marrow

- pheresis = remove platelets

51
Q

Clotting Mechanism:

  1. Vascular response
A
  • vasoconstriction after blood vessel injurty
52
Q

Clotting Mechanism

  1. Platelets
A
  • activated after injury
  • form clumps, plug
  • facilitates rx of clotting factors
53
Q

Clotting Mechanism

  1. Clotting factors
A
  • activated after injury and thromboplastin

- thrombin –> fibrinogen –> fibrin

54
Q

Coagulation Disorders:

A. Impaired Hemostasis

A
  • vit K

- liver disease

55
Q

Coagulation Disorders:

B. Thrombohemmorrhagic Disorder: Disseminated Intravascular Coagluation

A

thornosis and hemorrhage

56
Q

Coagulation Disorders:

B .DIC ETIOLOGY

A
  • underlying disease
  • shock
  • infection
  • obsetric accident
  • burns]
  • trauma
  • liver disease
57
Q

B. DIC PATHO

A
  • enhanced coagulation mech
  • activation of fibronlytic system
  • depletion of clotting factors
58
Q

B. DIC Clin MAN

a. Bleeding
b. Thrombosis

A

a. Bleeding:
- pallor
- petechia, bruising
- inv RR and HR
- hemoptysis
- dec BP
- GI bleeding
- HA = change in mental status

b. Thrombosis
- dyspnea
- PE
- tissue necrosis
- ARDS
- kidney damage

59
Q

Coagulation Disorders:

B. DIC Test

A
  • platelet count
  • fibrin split products
  • bleeding time
60
Q

Coagulation Disorders:

B. DIC TX

A
  • treat cause
  • blood products
  • anticoagulants
61
Q

Spleen FUNC

A
  • hematopoietic
  • fllter
  • immune
  • storage
62
Q

Spleen Alt in Func:

  1. Overactive spleen
  2. underactive spleen
A
  1. hypersplenism
    - reduc all circulating blood cells
  2. Removal of spleen
    - dec immune sys
    - inc leukocytes
    - more defective blood cells
63
Q

Lymph System FUNC

A
  • prevent edema
    • carries fluid from interstitial spaces and returns excess fluids
  • transport protein and fat

Lymph nodes contain lymphocytes, monocytes and macrophages which cleanse lymph of foreign particles and microorganisms.

64
Q

Alternations in Func

Lymphadenopathy

a. localized
b. general

A

a. localized
- infection in that area

b. generalized
- lymphs enlarged everywhere = cancer

Nursing 2005: Clinical Pathophysiology (9 decks)

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