T4 Blueprint - Hematology and Blood Disorders (Josh) Flashcards
1
Q
Which organ produces prothrombin and clotting factors?
A
Liver
2
Q
Which organ regulates the growth of blood cell and stores platelets?
A
Spleen
3
Q
How many RBCs are normal?
A
4.2-6.1 million/mm3
4
Q
RBCs:
What products are needed to form Hgb and RBCs?
A
Iron
Vit B12
Folic Acid
Copper
Pyroxidine
Cobalt
Nickel
5
Q
RBCs:
What is the lifespan of an RBC?
A
120 days
6
Q
A bright red tongue is a sign of —
A
anemia
7
Q
Tenderness of pain in sternum is a sign of —
A
leukemia
8
Q
Lab Values:
RBCs
A
4.2-6.1 million/mm3
9
Q
Lab Values:
WBCs
A
5,000-10,000
10
Q
Lab Values:
Hgb
A
Female: 12-16
Male: 14-18
11
Q
Lab Values:
Iron
A
Female: 60-160
Male: 80-180
12
Q
Lab Values:
Platelets
A
150,000 - 450,000
13
Q
Lab Values:
PT
A
11-12.5 secs
14
Q
Lab Values:
If PT is high, it means –
If PT is low, it means –
A
clotting deciciency
vit K excess
15
Q
Lab Values:
aPTT measures —
A
Heparin
16
Q
Lab Values:
aPTT
A
1.5-2 x’s normal range of 30-40 secs
17
Q
Lab Values:
INR measures —
A
warfarin
18
Q
Lab Values:
INR
A
1 (normal)
2-3 (warfarin)
19
Q
Lab Values:
D-dimer measures —
A
hypercoagulability of blood
20
Q
Lab Values:
D-dimer
A
0.43-2.33 mcg/mL
or
0-250 ng/mL
21
Q
Lab Values:
What does a high D-dimer indicate?
A
clot formation has occured
22
Q
Lab Values:
Fibrinogen
A
170-340
23
Q
Lab Values:
Fibrin Degradation Products
A
less than 10 mcg/mL
24
Q
Lab Values:
Waht does Fibrin Degradation Products measure?
A
efficiency of meds for DCI
***tells us when clot dissolving activity is occurring
25
Bone Marrow Aspiration:
What position do we want client in?
side lying or prone position
26
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
27
Bone Marrow Aspiratoin:
How often should client inspect site postop?
daily
28
Anemia:
Signs and Symptoms
Pallor
Fatigue
Numbness of extremities
DOE
Sensitivity to cold
Tachycardia
Dizziness
Orthostatic Hypotension
Bright red tongue
29
Anemia:
Risk Factors
Blood Loss (ex: GI ulcer)
Inadequate RBC production
Increased RBC destruction
Deficiency in components of RBCs
Bone Marrow Suppression
30
CBC:
--- measure the size of RBCs
--- measures the amount of Hgb per RBC
MCV (Mean Corpuscular Vol.)
MCH (Mean Corpuscular Hgb)
31
CBC:
What will MCV be with Sickle Cell?
What will MCH be with Sickle Cell?
MCV = Normocytic
MCH = Normochromic
32
CBC:
What will MCV be with Iron Deficiency Anemia?
What will MCH be with Iron Deficiency Anemia?
MCV = Microcytic
MCH = Hyochromic
33
Anemia:
If MCV are Macrocytic, what do we suspect?
Folic Acid Deficiency
Vit B12 Deficiency
34
CBC:
What does MCHC measure?
Mean Corpuscular Hgb Concentration
- indication of Hgb amount in relation to size of cell
35
What is TIBC?
Total Iron Binding Capacity
- measure serum transferrin, a protein that binds with iron and transports it for storage
36
Which test detects Sickle Cell?
Hgb Electrophoresis
37
Which test measures ability to absorb B12?
Schilling Test
38
Anemia:
What type of foods should we encourage?
Red Meat
Organ Meat
Egg yolks
Kidney beans
Green leafy veggies
Nuts
Dairy products
Citrus fruits
39
Anemia:
When should Hgb be checked if taking iron?
4-6 wks to determine efficacy
40
Anemia:
What route should Iron Dextran be given?
IM (Z-track)
41
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
42
Anemia:
If they take B12 shots, how often do they get them?
monthly
43
Anemia:
If they take B12 shots, how should they be given?
IM or deep SQ to prevent irritation
44
Anemia:
What will large doses of Folic Acid do?
Mask Vit B12 deficiency
Turn urine dark yellow
45
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
46
Leukemia:
Is radiation used?
not typically
47
Leukemia:
Following BM Transplant, what is client at risk of?
infection and bleeding until the transfused stem cells being producing WBCs again
48
Leukemia:
What are the types of BM Transplantation?
Autologous (own cells)
Syngenec (identical twins)
Allogenec (close match)
49
Leukemia:
Why are we concerned with bleeding and injury postop?
they will have a low platelet count for a while
50
Lymphoma:
--- is usually younger clients
--- is usually after age 50.
Hodgkin's
Non-Hodgkin's
51
Lymphoma:
Is Chemo used?
may or may not be
52
Lymphoma:
What is primary form of treatment for HL?
Radiation
53
Lymphoma:
What are s/s?
Enlarged, PAINLESS lymph nodes
Fever
Night Sweats
Weight Loss
Fatigue
Infection
54
Sickle Cell:
What are s/s?
Pain
Cardiac Issues
Priapism
Skin changes
Organ damage (liver, kidney, CNS)
Joint damage
55
Sickle Cell:
What is treatment plan order of importance?
HOP
Hydration
Oxygenation
Pain Control
56
Sickle Cell:
What meds can be used but what are we concerned about
Hydroxyurea
***increases risk of leukemia
57
Blood Transfusion:
How often are new cross match samples obtained?
q 72 hrs
58
Blood Transfusion:
What can we premedicate with?
Diphenhydramine
Acetaminophen
59
Blood Transfusion:
What electrolyte issue do we monitor for?
hyperkalemia
60
Blood Transfusion:
How often do we check VS?
q 15 mins, 30 mins, then hourly
61
Blood Transfusion:
If they have no reaction, what rate do we want to administer?
1 unit every 1-2 hrs
62
Blood Transfusion:
T/F: Rh+ can receive from Rh- but cannot give to Rh-
True
63
Blood Transfusion:
What are s/s of an acute hemolytic reaction?
Chills
Fever
Low Back Pain
Tachycardia
Tachypnea
Hemoglobinuria
64
Blood Transfusion:
When would we see a Febrile reaction?
30 mins to 6 hrs after transfusion
65
Blood Transfusion:
What are s/s of Febrile Reaction to transfusion?
Chills
Fever
Flushing
HA
Anxiety
66
Blood Transfusion:
In the first 24 hrs, we may see a mild reaction to transfusion. What are the s/s?
Itching
Urticaria (Hives)
Flushing
67
Blood Transfusion:
What are Anaphylactic S/S of transfusion reaction?
Wheezing
Dyspnea
Chest Tightness
Cyanosis
Hypotension
68
Blood Transfusion:
If we overload the CV system, what s/s would we see?
HTN
Tachycardia
Tachypnea
JVD
Pulmonary Edema
69
Blood Transfusion:
Nursing action if they have a reaction?
Stop
NS in separate line
Save blood for testing
