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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
Iron Deficiency Anemia CLINICAL MAN
1. tongue and lips - sore and inflamed mucosa - beeft red 2. H/A 3. numbness, tingling 4. confusion - lack of O2 in brain
26
Iron Deficiency Anemia TESTS
a. RBC = small H&H = less b. serum Fe
27
Iron Deficiency Anemia TX
- stool sample then treat cause | - iron supplements
28
B. Polycythemia
- inc RBC - thick blood - excess vol - inc BP and work of heart
29
Polycythemia PATHO 1. primary
- chronic problem - poor circulation/perfusion - caused by excessive proliferation of erythrocyte precursors in marrow. - myloproliferate disorder - seen > 50 years old
30
Polycythemia PATHO 2. secondary
- caused by hypoxia - compensatory mechanism - inc RBC d/t underlying system disorder
31
Polycythemia CLINICAL MAN
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 6. confusion 7. visual disturbances 8. painful itching - poor blood flow in mass cells
32
polycythemia TESTS
1. blood test - RBC and WBC high 2. bone marrow biopsy
33
Polycythemia TX
- reduce blood vol - RBC phlebotomy - fluids . meds
34
WBC: Leukocytes Leukocytes FUNC - inc name - dec name
- phagocytosis of bacteria and foreign particles inc: LEUKOCYTOSIS dec: LEUKOPENIA
35
Types of WBC 1. Granulocytes: a. neutrophils - neutrophilia = ? - neutropenia = ?
- strong phagocyctic activity - primary phagocytic cell = inflam - - - - neutrophilia = infection, inflam, necrosis - neutropenia = prolong infection
36
Types of WBC 1. Granulocytes: b. esinophils - eosinophilia = ? - eosiniopena = ?
- allergic response in parasitic infections - eosinophilia = allergies, infections - eosiniopena = surgergy stress
37
Types of WBC 1. Granulocytes c. basophils - basophilia - basopenia
- limited role in phagocytosis - contain heparin, serotonin, histamine - basophilia = allergic rx, infection - basopenia = preg, shock, hyperthyroidism
38
2. Lymphocytes function - lymphocytosis - lympocytopenia
- cellular and humoral responses - lymphocytosis = viral infection, hepatitis, leukemia - lympocytopenia = AIDS, renal failure, steriods
39
Lymphocytes : a. B cells b. T cells
a. B cells: - stim by antigens = antibodies b. T cells: - cellular immune response
40
3. Monocytes func - monocytosis - monocytopenia
- large, slow moving potent pahgocyes = macrophages - monocytosis = late infection, chronic infection - monocytopenia = rare
41
Platelets 1. Thrombocytes FUNC - normal range
- blood coagulation - control bleeding normal range 140 k - 340 k
42
1. Thrombocytopenia
< 100 k platelets <10 k severe bleeding
43
Thrombocytopenia ETIOLOGY
- viral infection - nutritional deficits - meds - ITP = autoimmune destruction of platelets - TIP = platelets aggregate = occlusion
44
Thrombocytopenia CLIN MAN a. petechiae b. purpura c. ecchymosis d. ?
a. petechiae = red dots on skin b. purpura = bigger red dots together c. ecchymosis = bruise d. prolong bleeding
45
Thrombocytopenia TESTS
1. platelet count - dec amount 2. bleeding time - punc skin and see how long it'll take to clot
46
Thrombocytopenia TX
- dec platelets = platelets ITP = steroids TIP = plasma
47
Thrombocythemia
- elevated count >400k
48
Thrombocythemia ETIOLOGY
- accelerated production | - splenectomy
49
Thrombocythemia CLIN MAN
- thrombosis formation - headache - transient ischemic attacks - GI hemorrhage
50
Thrombocythemia TX
- meds to suppress bone marrow | - pheresis = remove platelets
51
Clotting Mechanism: 1. Vascular response
- vasoconstriction after blood vessel injurty
52
Clotting Mechanism 2. Platelets
- activated after injury - form clumps, plug - facilitates rx of clotting factors
53
Clotting Mechanism 3. Clotting factors
- activated after injury and thromboplastin | - thrombin --> fibrinogen --> fibrin
54
Coagulation Disorders: A. Impaired Hemostasis
- vit K | - liver disease
55
Coagulation Disorders: B. Thrombohemmorrhagic Disorder: Disseminated Intravascular Coagluation
thornosis and hemorrhage
56
Coagulation Disorders: B .DIC ETIOLOGY
- underlying disease - shock - infection - obsetric accident - burns] - trauma - liver disease
57
B. DIC PATHO
- enhanced coagulation mech - activation of fibronlytic system - depletion of clotting factors
58
B. DIC Clin MAN a. Bleeding b. Thrombosis
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
Coagulation Disorders: B. DIC Test
- platelet count - fibrin split products - bleeding time
60
Coagulation Disorders: B. DIC TX
- treat cause - blood products - anticoagulants
61
Spleen FUNC
- hematopoietic - fllter - immune - storage
62
Spleen Alt in Func: 1. Overactive spleen 2. underactive spleen
1. hypersplenism - reduc all circulating blood cells 2. Removal of spleen - dec immune sys - inc leukocytes - more defective blood cells
63
Lymph System FUNC
- 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
Alternations in Func Lymphadenopathy a. localized b. general
a. localized - infection in that area b. generalized - lymphs enlarged everywhere = cancer

Nursing 2005: Clinical Pathophysiology (9 decks)

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