T4 Blueprint - Hematology and Blood Disorders (Josh) Flashcards
Which organ produces prothrombin and clotting factors?
Liver
Which organ regulates the growth of blood cell and stores platelets?
Spleen
How many RBCs are normal?
4.2-6.1 million/mm3
RBCs:
What products are needed to form Hgb and RBCs?
Iron
Vit B12
Folic Acid
Copper
Pyroxidine
Cobalt
Nickel
RBCs:
What is the lifespan of an RBC?
120 days
A bright red tongue is a sign of —
anemia
Tenderness of pain in sternum is a sign of —
leukemia
Lab Values:
RBCs
4.2-6.1 million/mm3
Lab Values:
WBCs
5,000-10,000
Lab Values:
Hgb
Female: 12-16
Male: 14-18
Lab Values:
Iron
Female: 60-160
Male: 80-180
Lab Values:
Platelets
150,000 - 450,000
Lab Values:
PT
11-12.5 secs
Lab Values:
If PT is high, it means –
If PT is low, it means –
clotting deciciency
vit K excess
Lab Values:
aPTT measures —
Heparin
Lab Values:
aPTT
1.5-2 x’s normal range of 30-40 secs
Lab Values:
INR measures —
warfarin
Lab Values:
INR
1 (normal)
2-3 (warfarin)
Lab Values:
D-dimer measures —
hypercoagulability of blood
Lab Values:
D-dimer
0.43-2.33 mcg/mL
or
0-250 ng/mL
Lab Values:
What does a high D-dimer indicate?
clot formation has occured
Lab Values:
Fibrinogen
170-340
Lab Values:
Fibrin Degradation Products
less than 10 mcg/mL
Lab Values:
Waht does Fibrin Degradation Products measure?
efficiency of meds for DCI
***tells us when clot dissolving activity is occurring
Bone Marrow Aspiration:
What position do we want client in?
side lying or prone position
Bone Marrow Aspiration:
Nursing care postop?
Monitor for signs of infection
Apply ice to biopsy site if prescribed
Mild analgesics for pain
Avoid ASA and other meds that affect clotting
Bone Marrow Aspiratoin:
How often should client inspect site postop?
daily
Anemia:
Signs and Symptoms
Pallor
Fatigue
Numbness of extremities
DOE
Sensitivity to cold
Tachycardia
Dizziness
Orthostatic Hypotension
Bright red tongue
Anemia:
Risk Factors
Blood Loss (ex: GI ulcer)
Inadequate RBC production
Increased RBC destruction
Deficiency in components of RBCs
Bone Marrow Suppression
CBC:
— measure the size of RBCs
— measures the amount of Hgb per RBC
MCV (Mean Corpuscular Vol.)
MCH (Mean Corpuscular Hgb)
CBC:
What will MCV be with Sickle Cell?
What will MCH be with Sickle Cell?
MCV = Normocytic
MCH = Normochromic
CBC:
What will MCV be with Iron Deficiency Anemia?
What will MCH be with Iron Deficiency Anemia?
MCV = Microcytic
MCH = Hyochromic
Anemia:
If MCV are Macrocytic, what do we suspect?
Folic Acid Deficiency
Vit B12 Deficiency
CBC:
What does MCHC measure?
Mean Corpuscular Hgb Concentration
- indication of Hgb amount in relation to size of cell
What is TIBC?
Total Iron Binding Capacity
- measure serum transferrin, a protein that binds with iron and transports it for storage
Which test detects Sickle Cell?
Hgb Electrophoresis
Which test measures ability to absorb B12?
Schilling Test
Anemia:
What type of foods should we encourage?
Red Meat
Organ Meat
Egg yolks
Kidney beans
Green leafy veggies
Nuts
Dairy products
Citrus fruits
Anemia:
When should Hgb be checked if taking iron?
4-6 wks to determine efficacy
Anemia:
What route should Iron Dextran be given?
IM (Z-track)
Anemia:
Nursing considerations for Erythropoietin?
Monitor for increased BP
Monitor Hgb and HCT twice a week
Moniotor for cardiovascular event if Hgb rises more than 1g/dL in 2 wks
Anemia:
If they take B12 shots, how often do they get them?
monthly
Anemia:
If they take B12 shots, how should they be given?
IM or deep SQ to prevent irritation
Anemia:
What will large doses of Folic Acid do?
Mask Vit B12 deficiency
Turn urine dark yellow
Leukemia:
What are the signs and symptoms?
Bone pain
Joint swelling
Enlarged Liver/Spleen
Weight loss
Fever
Poor wound healing
Fatigue, Pallor, Tachycardia, DOE
Bleeding / Bruising
Leukemia:
Is radiation used?
not typically
Leukemia:
Following BM Transplant, what is client at risk of?
infection and bleeding until the transfused stem cells being producing WBCs again
Leukemia:
What are the types of BM Transplantation?
Autologous (own cells)
Syngenec (identical twins)
Allogenec (close match)
Leukemia:
Why are we concerned with bleeding and injury postop?
they will have a low platelet count for a while
Lymphoma:
— is usually younger clients
— is usually after age 50.
Hodgkin’s
Non-Hodgkin’s
Lymphoma:
Is Chemo used?
may or may not be
Lymphoma:
What is primary form of treatment for HL?
Radiation
Lymphoma:
What are s/s?
Enlarged, PAINLESS lymph nodes
Fever
Night Sweats
Weight Loss
Fatigue
Infection
Sickle Cell:
What are s/s?
Pain
Cardiac Issues
Priapism
Skin changes
Organ damage (liver, kidney, CNS)
Joint damage
Sickle Cell:
What is treatment plan order of importance?
HOP
Hydration
Oxygenation
Pain Control
Sickle Cell:
What meds can be used but what are we concerned about
Hydroxyurea
***increases risk of leukemia
Blood Transfusion:
How often are new cross match samples obtained?
q 72 hrs
Blood Transfusion:
What can we premedicate with?
Diphenhydramine
Acetaminophen
Blood Transfusion:
What electrolyte issue do we monitor for?
hyperkalemia
Blood Transfusion:
How often do we check VS?
q 15 mins, 30 mins, then hourly
Blood Transfusion:
If they have no reaction, what rate do we want to administer?
1 unit every 1-2 hrs
Blood Transfusion:
T/F: Rh+ can receive from Rh- but cannot give to Rh-
True
Blood Transfusion:
What are s/s of an acute hemolytic reaction?
Chills
Fever
Low Back Pain
Tachycardia
Tachypnea
Hemoglobinuria
Blood Transfusion:
When would we see a Febrile reaction?
30 mins to 6 hrs after transfusion
Blood Transfusion:
What are s/s of Febrile Reaction to transfusion?
Chills
Fever
Flushing
HA
Anxiety
Blood Transfusion:
In the first 24 hrs, we may see a mild reaction to transfusion. What are the s/s?
Itching
Urticaria (Hives)
Flushing
Blood Transfusion:
What are Anaphylactic S/S of transfusion reaction?
Wheezing
Dyspnea
Chest Tightness
Cyanosis
Hypotension
Blood Transfusion:
If we overload the CV system, what s/s would we see?
HTN
Tachycardia
Tachypnea
JVD
Pulmonary Edema
Blood Transfusion:
Nursing action if they have a reaction?
Stop
NS in separate line
Save blood for testing