Screening for Hematologic Disease Flashcards
What are RBC count norms for men?
4.5-6.2
HGB- 37-49%
HCT- 14-17
What are RBC count norms for women?
4-5.5
HGB 36-46%
HCT- 12-15
What are WBC norms?
4,500-11,000
What are platelet norms?
150-400 K
What is worse thick or thin plasma?
thick due to too much clotting could cause DVT
What are common symptoms associated with RBC?
fatigue, dyspnea, dizziness- lack of O2
post op anemia- 8 weeks till normal aerobic capacity
What are common symptoms associated with WBC?
fevers, chill, persistent infections
What are common symptoms with platelet dysfunction?
easy bruising or bleeding
cramping, pain
Who should be screened for hematology issues?
hx of chemo/radiation, chronic NSAID use, spontaneous bleeding, recent surgery,
has rapid onset of dyspnea, chest pain, weakness, fatigue with palpations
fingernail changes (cyanosis or spooning)
What is anemia?
too few RBC, loss of iron from GI bleed?, chemo related?
What are sx of anemia?
chest pain, DOE, decreased DBP, increased HR, HA, drowsiness, depression
What are skin changes in anemia?
pale skin, pale or yellow eyes and mouth
What is polycythemia?
too many RBC more of a med emergency as blood is sticky and could clot
What are sx of polycythemia?
fatigue, SOB, pruitis, HA
What are common characteristics of sickle cell anemia?
AVN, CVA, pain
less HGB and less ability to change shape
Why do pts with sickle cell have enlarged spleen or livers?
they are being overworked trying to remove old/bad RBC
will be tender on palpation
What is leukocytosis?
too many WBC usually as a response to infection but could also be from cancer, hemorrhage, appendicitis, splenectomy
What is leukopenia?
too few, possibly from bone marrow failure
When is WBC count lowest after chemo?
7-14 days post chemo
What are sx of leukopenia?
sore throat, high fever, chills, mouth ulcerations, dysuria, persistent infection
What is leukemia?
production of lots of immature WBC
What are 4 types of leukemia?
ALL- young and old people good prognosis
AML- poor prognosis
CLL- 25-60
CML
What are risk factors for leukemia?
radiation exposure, prior chemo, downs syndrome
What are sx of leukemia?
infection, fever, bruising, epitaxis (nosebleed), hematuria, fatigue, enlarged lymph nodes, weight loss, enlarged spleen
What is thrombocytosis?
too many can be after hemorrhage, cancer related, splenomegaly
What are sx of too many?
pain, clotting, bruising
What is thrombocytopenia?
too few, from BM failure, leukemia, cancer, ASA or NSAIDS
What are sx of too few?
bleeding, bruising, epitaxis, menorrhagia, gum bleeding, melena, joint swelling, throwing up blood
What are petechiae?
small lesions less than 2 mm
What are purpura?
2mm to 1 cm size lesions
What is ecchymoses?
larger lesions
What are signs and symptoms of hemophilia?
hot sore jt with loss of motion, muscles hemorrhages feels like muscle pulls, GI bleed
What should be sent out immediately?
thrombocytopenia? rebound belly tenderness
When should you hold PT for blood glucose?
under 50 or over 240
When should you for K?
under 3 over 6
When should you hold for Na?
under 125 or over 150
What is absolute neutrophil count?
WBC x neutrophils
What are WBC count precautions?
1000-1500 neutropenic precautions may ambulate in hall with MD permission
500-1000 patient needs mask to leave room
under 500 room isolation
What is Hct cut off?
30% - 32% Resistive exercise to tolerance
< 25% No exercise permitted
> 25% Light exercise permitted
< 20% patient may have SOB, tachycardia
What is Hgb cutoff?
< 7 g/dL No exercise permitted or ROM only
8-10 g/dl Light exercise permitted
> 10 g/dL Resistive exercise to tolerance
What is platelet cut off?
≥ 50,000 – progressive resistive exercises
≤50,000 – no deep tissue massage etc, no percussion, no MMT
30,000 – 50,000 – moderate exercise
20,000 – 30,000 – light exercise no bicycle or treadmill
Less than 20,000 – AROM and necessary ADL’s only watch for bleeding.
What is INR cutoff?
over 4 ok
over 5 no exercise
