Test 1 Study Guide

Question 1

Role of the spleen

Answer 1

Largest lymphatic structure. Lies beneath the diaphragm and behind the stomach. Reservoir of blood and contains phagocytes that engulf damaged rbc’s and foreign substances. Stores ⅓ of available platelets.

Question 2

What blood type is the universal donor?

Answer 2

O neg

Question 3

What vitamin increases the absorption of folic acid and iron?

Answer 3

Vitamin C

Question 4

What is the main nutritional component in Hemoglobin?

Answer 4

Iron=Heme

Protein=Globulin

Question 5

What are the normal levels of Hemoglobin?

Answer 5

12.0 to 17.4 g/dL

Question 6

What is the blood work that shows allergies?

Answer 6

Elevated eosinophil count.

[Radioallergosorbent (RAST) Test measures IgE.]

Question 7

What is a positive Schillings test for?

Answer 7

Used to determine the etiology of Vitamin B12 deficiency causing pernicious anemia.

Question 8

What type of procedure will tell status of blood cell formation?

Answer 8

Bone marrow aspiration. Bone marrow is removed from the posterior iliac crest or the sternum. Bone marrow is examined for the types and percentage of immature and maturing blood cells. Monitor for bleeding afterward.

Question 9

Which person can receive all types of blood?

Answer 9

AB Pos

Question 10

Signs and symptoms of leukopenia.

Answer 10

General reduction of all wbc’s. Fatigue, fever, chills, headache, opportunistic infections in the mouth, throat, nose, rectum, or vagina .

Question 11

Signs and symptoms of thrombocytopenia

Answer 11

Lower than normal levels of platelets. Decreased production in bone marrow or increased destruction in the spleen. Accompanies leukemia and other malignant blood diseases and is caused by severe infections and certain drugs.
Evidenced by:
Purpura (small hemorrhages in the skin, mucous membranes, or subcutaneous tissues).
Bleeding from other parts of the body (nose, oral mucous membrane, GI tract).
Internal hemorrhage-can be severe or fatal
Dx:
Symptoms, low platelet count, and abnormal bleeding and clotting times. Sometimes bone marrow aspiration. Hx may reveal agents associated w/ drug-induced thrombocytopenia (ie. Heparin).
Tx:
Eliminate cause.
Corticosteroids provide symptomatic relief until the platelet count returns to normal
Platelet trans or whole blood trans
Splenectomy
If cause can be removed or fixed: prognosis is good.
Throbocytopenia + Leukemia = poor prognosis
Nursing Interventions:
Managing and minimizing bleeding and hemorrhage.

Question 12

What does copper do in the body?

Answer 12

Assist in making rbc’s. Is involved in the transfer of iron from storage to plasma.

Question 13

Why should a patient with leukemia use an electric razor?

Answer 13

Trauma and microabrasions from a nonelectric razor may contribute to anemia.
Decreased risk of cuts therefore decreased risk for infection.

Question 14

What are coagulopathies?

Answer 14

Bleeding disorders that involve platelets or clotting factors; conditions in which a component that is necessary to control bleeding is missing or inadequate. Two common examples re thrombocytopenia and hemophilia.

Question 15

What are the causes of anemia?

Answer 15

Deficiency of rbc’s or hemoglobin
Hypovolemic: sudden loss of lg vol; chronic loss of sm vol of blood
Iron-def: insufficient iron to produce hemoglobin
Sickle-Cell: Hgb S; sickle- or crescent-shaped rbc’s from inadequate O2 supply to blood
Hemolytic: chronic, premature erythrocyte destruction
Thalassemias: hereditary hemolytic anemia
Pernicious: lack of intrinsic factors necessary for absorption of Vit B12
Folic Acid Def: immature rbc’s; insufficient dietary intake of folic acid

Question 16

Signs and symptoms of chronic hypovolemia.

Answer 16

Pallor, fatigue, chills, postural hypotension, rapid heart rate, rapid resp rate.

Question 17

What is the first intervention for hypovolemic shock?

Answer 17

Replacement of blood through transfusion

Question 18

What are some Tx for iron-deficiency anemia?

Answer 18

Foods with high iron content.
Iron supplement or parenteral admin of iron
Blood Transfusion

Question 19

Instructions for taking oral liquid iron.

Answer 19

Dilute with another liquid and drink with straw to avoid staining teeth.
Take on empty stomach-unless gastric upset: then take with or immediately after meals
Avoid taking with an antacid: interferes with iron absorption

Question 20

What is the causes of sickle cell crisis?

Answer 20

Episodes that occur from vascular occlusion, which develops rapidly under hypoxic conditions. Vascular occlusion concerns; severe pain and stroke (even in small children)
Getting cold leads to vasoconstriction; Dehydration inc risk.

Question 21

Signs and symptoms of acute chest syndrome in sickle cell disease?

Answer 21

Resp symptoms: coughing, wheezing, tachypnea, and chest pain.

Question 22

Signs and symptoms of Cooley’s anemia?

Answer 22

Extreme form of B-thalassemia. Severe anemia symptoms and bronzing of the skin caused by hemolysis of erythrocytes.

Question 23

What are nursing interventions for a patient with polycythemia vera?

Answer 23

(Greater-than-normal levels of all blood cells)

Removal of 500 mL of blood several times a week.
Anticoagulants
Radiophosphorus and radiation Tx to dec rbc production in bone marrow
Antineoplatic drugs to curb excessive bone marrow activity

Question 24

What are the hallmark signs of leukemia?

Answer 24

Rapid proliferation of wbc’s. Mostly immature. Unregulated.

Infections, fatigue from anemia, and easy bruising

Question 25

A client with hemophilia has bleeding besides ice and direct pressure what other treatment will the doctor order?

Answer 25

Trans of fresh blood, frozen plasma, factor VIII concentrate, anti-inhibitor coagulant complex, factor IX concentrate, factor XI, application of thrombin or fibrin to bleeding area.

Aminocaproic acid (Amicar) and fresh frozen plasma can help hold a clot in place once it has formed.