Respiratory System (Exam One) Flashcards
What components make up blood?
- Plasma
- Red Blood Cells
- White Blood Cells
- Platelets
What is the normal blood pH?
7.35 - 7.45
What is produced in the red bone marrow?
- Blood cells
- Platelets
What is blood serum?
Plasma without the clotting proteins
White blood cells contain what?
- Granulocytes
- Agranulocytes
What is the normal range for white blood cells (WBC)?
5,000 - 10,000/mm^3
What is the normal range for red blood cells (RBC)?
4.2 - 6.1 x 10^12/L
What is the normal range for hemoglobin (Hgb)?
12.0 - 18.0 g/dL
What is the normal range for Hematocrit (Hct)?
37% - 52%
What is the normal range for platelets?
150,000 - 400,000/mm^3
What is a hematological disorder?
Bleeding disorder
List the three rashes associated with a hematological disorder?
- Petechiae
- Ecchymosis
- Purpura
Is petechiae always associated with a hematological disorder?
No
What are the primary functions of the lymphatic system?
- Maintains blood volumes
- Protects against pathogens
What are lymph nodes?
Masses of lymphatic tissue
Give an example of lymph nodules?
Tonsils
What is the main site for platelet destruction?
Spleen
How does aging affect the lymphatic and hematologic system?
- Less efficient immune response
- Iron deficiency
- Slowed erythrocyte production
- Reduced plasma volume
Older adults are at an increased risk for what?
- Infection
- Anemia
- Dehydration
Coffee ground emesis and black stool is indicative of what?
Bleeding
List coagulation tests?
PT
PTT
INR
What is the normal range for partial thromboplastin time (PTT)?
60 - 70 seconds
What is the normal range for prothrombin time (PT)?
11 - 12.5 seconds
What is the normal range for International Normalized Ratio (INR)?
0.8 - 1.1
The nurse knows the patient should be monitored for what following a bone marrow biopsy?
- Bleeding
- Infection
What is a lymphangiography?
Injection of dye into the lymphatic system
It is important for the nurse to educate the patient on what regarding a lymphangiography?
It will turn the skin, urine, and feces blue for approximately two days
Why are packed red blood cells usually administered?
For anemia or blood loss
When are frozen red blood cells usually administered?
- Autotransfusion
- Prevent febrile reaction
A patient will receive what if they have thrombocytopenia?
Platelets
Fresh frozen plasma provides what?
- Clotting factors
- Volume replacement
Why are cryoprecipitates administered to patients?
Patient is missing specific clotting factors
What blood type is the universal blood donor?
O-
O blood types can only receive what type of blood?
O
What blood type is the universal recipient?
AB+
List the transfusion safety tips?
- Always follow the hospitals verification process
- Fluid compatibility
- Timing
- Filtering
- Washing
- Warming
How many people are needed for verification during a blood transfusion?
At least two
A transfusion patient can only receive what type of fluid?
Normal saline
Each unit of packed red blood cells must be transfused in what amount of time?
2 hours
Blood cannot be transfused longer than ___ _____.
4 hours
Why is filtering important during a blood transfusion?
Removes potential harmful particles
What is the function of washing during a blood transfusion?
- Removes plasma
- Decreases the risk for febrile reaction
When is warming used in a blood transfusion?
- Used when blood must be given quickly
- Prevents hypothermia
What is the most common transfusion complication?
Febrile reaction
The risk of a febrile reaction during a blood transfusion increases with what?
- Prolonged hanging time
- Multiple transfusions
If a febrile reaction occurs, the nurse should do what?
- Stop the infusion
- Contact PCP
- Administer tylenol
What is seen in a urticarial reaction?
Hives
What medications should be ordered before the start of a blood transfusion?
- Tylenol
- Benadryl
Which transfusion complication is the most deadly?
Hemolytic reaction
Why does a hemolytic reaction occur?
Due to blood incompatibility
The nurse knows she should not do what if the patient is experiencing an anaphylactic reaction?
Do not leave the patient
What is anemia?
- Deficiency of red blood cells, hemoglobin, or both
- Reduced capacity to carry oxygen to tissues
What is the most common type of anemia?
Iron-deficiency anemia
What are the two main signs and symptoms of anemia?
- Pallor
- Tachypnea
What is the most common nursing diagnoses for anemia?
Activity intolerance
Why does iron deficiency anemia occur more often in children who are given cow’s milk?
Cow’s milk depletes iron
What is the recommended daily intake of cows milk for children?
24 ounces or less
What are the signs and symptoms of iron deficiency anemia?
- Brittle, concave nails
- Porcelain-like skin
- Pica cravings
How will red blood cells appear in iron deficiency anemia?
- Small
- Pale
List iron rich foods.
- Green leafy vegetables
- Breakfast cereal
- Chicken
- Liver
What is aplastic anemia?
Bone marrow does not produce an adequate amount of red blood cells
What is sickle cell anemia?
- Inherited autosomal recessive disorder
- Decrease in oxygen causes cells to alter into a sickle shape
Sickle cell anemia is assessed on what diagnostic test?
Newborn screening
What is highly significant during a sickle cell crisis?
- Pain
- Fluids
Patients with sickle cell anemia should avoid what?
- Tight clothing
- Alcohol/Smoking
- Strenuous exercise
- Cold temperatures
- Crossing the legs
What is the most common therapeutic intervention for polycythemia?
Phlebotomy
What education should be provided to a patient with polycythemia?
- Drink 3L of water daily
- Avoid restrictive clothing
- Elevate feet
What is DIC? When is DIC commonly seen?
- Bleeding out
- Seen during trauma
- Seen during labor and delivery
What is an early sign of DIC?
- Petechiae
- Easy bruising
- Blood in urine
- Black tarry stools
What is ITP? What age group does it affect?
- Platelet destruction by immune system
- Commonly seen in young children and older adults
What are the signs and symptoms of ITP?
- Petechiae
- Ecchymoses
- Bleeding
What is a therapeutic intervention or treatment for ITP?
Splenectomy
What are the causes of ITP?
- Acute viral illness
- Drug reaction
- Immune system dysfunction
What is hemophilia? How is this disease acquired?
- Group of bleeding disorders due to deficiency in clotting factors
- Hereditary
Which clotting factor has the most common deficiency?
Clotting factor A
If a carrier mother for hemophilia and a father without hemophilia have a child, what is the chance of their female and male offspring having the disease?
Female: 50%
Male: 100%
If a father with hemophilia and a mother who is not a carrier have a child, what is the chance of their female and male offspring having the disease?
Female: 50%
Male: 0%
List the signs and symptoms of hemophilia.
- Hemarthrosis
- Bleeding muscles
- Bleeding subcutaneous tissue
- Bleeding brain
What are the therapeutic interventions for hemophilia?
- Desmopressin
- Blood transfusions
- Pain medication
What should the nurse avoid in patients with hemophilia?
Injections
Children with ____ deficiency absorb ____ more readily.
- Iron
- Lead
What is a normal blood lead level?
< 3.3
What is the nursing priority for a child with lead poisoning?
Caregiver education
What is leukemia?
- Increase in immature white blood cells
- Unable to fight infection
Genetically, this individual is more likely to get leukemia?
Downsyndrome
What is the most common childhood cancer?
Acute Lymphocytic Leukemia (ALL)
Acute myelogenous leukemia (AML) and chronic myelogenous leukemia (CML) affect what age group?
Individuals over 60
Chronic myelogenous leukemia (CML) is characterized by which chromosome?
Philadelphia
Which level of chronic myelogenous leukemia (CML) is fatal?
Level three or chronic
Leukemia may be associated with what?
Mild bleeding disorders
What is the main safety technique utilized with leukemia patients?
Reverse isolation
Hypercalcemia is associated with which disorder?
Multiple myeloma
What specific lab will be elevated with multiple myeloma?
CRP
What is Hodgkin’s disease? Which cells are present?
- Cancer of the lymph system
- Reed-Sternberg cells
What are the signs and symptoms of Hodgkin’s disease?
- Painless swollen lymph node
- Fatigue
- Night sweats
Stridor may be present in what disease? Why?
- Hodgkin’s disease
- Because swollen lymph nodes are occluding the airway
How is Hodgkin’s disease diagnosed?
Biopsy
Is Hodgkin’s or Non-Hodgkin’s disease more common? Which disease is more deadly?
Non-Hodgkins
What is the most common complication of a splenectomy?
Infection
Patients with blood disorders are all at risk for what?
Bleeding
Patients who have this disorder are most at risk for fractures?
Multiple myeloma
What is the priority nursing concern with leukemia?
- Temperature
- Blood in the stool
What disease does not have Reed-Sternberg cells?
Non-Hodgkin’s
What is a common nursing diagnosis for Non-Hodgkin’s lymphoma?
Ineffective coping
Describe the stages of Hodgkin’s disease?
Stage One: One on one side
Stage Two: Multiple on one side
Stage Three: Bilaterally
Stage Four: All over
What are the functions of blood?
- Transport substances
- Regulation of temperature
- Regulation of pH
- Regulation of fluid balance
- Transport of protein cells
What are the two groups of lymphocytes?
- B cells
- T cells
Iron is better absorbed when taken with what vitamin? List dietary sources of this vitamin.
- Vitamin C
- Orange juice
- Oranges
A patient with pernicious anemia will lack what vitamins?
- B12
- Folic acid
What labs are assess for anemia?
- Hemoglobin
- Hematocrit
If red blood cells are affected, what will this cause?
Poor oxygenation
If white blood cells are affected, what will this cause?
Inability to fight infection
If platelets are affected, what will this cause?
Bleeding disorders
What can cause a sickle cell crisis?
Any event that leads to decreased oxygenation
What is a common symptom of sickle cell crisis in the male population?
Priapism (prolonged, painful erection)
When is anemia routinely assessed in the child?
12 months