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CNUR 305 > Unit 1: Hematological, Fluid + Electrolyte Imbalance > Flashcards

Unit 1: Hematological, Fluid + Electrolyte Imbalance Flashcards

1
Q

What are the components of blood?

A

-Plasma: Albumin (oncotic pressure)
Fibrinogen (Blood clotting)
-Cells: Erythrocytes (oxygen transport)
Thrombocytes/Platelets (Blood clotting)
Leukocytes (inflammation and immunity)

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2
Q

What are the indications and action of albumin?

A

Indications: Volume expansion, liver failure, hypoproteinemia
Action: increase vascular volume by increasing colloidal oncotic pressure

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3
Q

What are the indications and action of Fresh frozen plasma?

A

Indications: Bleeding caused by clotting factor deficiencies, emergency reversal of warfarin, and plasma protein deficiency
Action: to improve coagulation hemostasis

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4
Q

What are the indications and action of Packed red blood cells

A

Indications: Acute Blood loss and anemia
Action: To improve or restore oxygen carrying capacity hemoglobin

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5
Q

What are the indications and action of Platelets ?

A

Indications: Bleeding caused by thrombocytopenia
Action: Treat of prevent bleeding due t decreased or dysfunctional platelets

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6
Q

What are ketones?

A

A bi-product of carb and protein metabolism

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7
Q

What are casts?

A

When protein binds and takes the shape of cells. Normal when clear, irregular with WBC and RBC

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8
Q

What happens to the hematocrit value with anemia?

A

Hematocrit decreases

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9
Q

What are the 5 W’s of post-op fever

A

Wind: (Day 1-2, Lack of moving bases) Lungs, pneumonia, pulmonary embolus, not atelactisis (collapsed lung).
Water: (Day 3-5) Urinary Tract infection
Walking: (Day 4-6) DVT- pulmonary embolus
Wound: (Day 5-7) Surgical Site infection
Wonder drugs, what did we do?: (Day 7+) Drugs, infection related to invasive lines

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10
Q

What are ‘bands’?

A

Immature neutrophils

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11
Q

What is un-conjugated bilirubin?

A

Indirect bilirubin. Increased with Jaundice
Pre-hepatic: before the liver, not water soluble.
Hepatic: within the liver

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12
Q

What is conjugated bilirubin?

A

Direct bilirubin. Increased with jaundice

Post-hepatic: after the liver

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13
Q

What are liver function tests?

A

Liver enzymes are normally contained within the liver cell.s When liver cells are injured these enzymes spill into blood.
Examples, ALT, AST, ALP, GGT

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14
Q

What tests are indicative of liver cell damage?

A

ALT: Highly specific to liver, ALT rises dramatically in acute liver damage
AST: Not as specific as ALT as enzymes also present in liver, cardiac and skeletal muscle

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15
Q

What test are indicative of biliary flow obstruction?

A

ALP and GGT: increase in either or both is highly suggestive of obstructive disease.

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16
Q

4 causes of edema, which are not fluid excess

A
  1. Increased hydrostatic pressure: Push pressure out. eg. Venous obstruction, heart failure, renal failure
  2. Decreased Plasma oncotic pressure: (colloid pressure). Albumin production: liver disease, protein malnutrition. Albumin loss: kidney disease, burns, wounds. ALBUMIN SUCKS fluid into the vascular space
  3. Increased capillary membrane permeability: Leaky vessels, dilated vessels, trauma, allergic response
  4. Lymphatic obstruction: masectomy
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17
Q

What are Pancreas/Endocrine function tests?

A

Fasting Glucose (4-6), Random Glucose (3.6-10), Hgb A1C (

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18
Q

Heart function tests

A

Troponin, CK-MB, CRP, BNP (brain natuiretic peptide, + evidence of heart failure)., coags (baseline), CBC

19
Q

How can LDL be impacted?

A

‘statins’ medications

20
Q

How can HDL be impacted?

A

Exercise

21
Q

What is the normal range for APTT?

Heparin monitoring

A

26-36 seconds

22
Q

What is the normal range for INR?

Warfarin monitoring

A

0.8-1.2

23
Q

What are colloids?

A

Large molecules, usually protein, DO NOT pass through semi-permeable membrane
Remain intravascular
They draw fluid in

24
Q

What are crystalloids?

A

Small molecules, that pass through semi-permeable membrane.
Electrolyte (Na, K+), and none electrolyte (dextrose)
Isotonic, hypotonic, hypertonic

25
Q

What are the three general causes of anemia?

A 
Losing it (blood loss): acute trauma, chronic ibuprofen use
Trouble making it (Decreased RBC production): decreased erythropoieten (kidney disease), decreased nutrients (iron, B12, folic acid)
Destroying it (Increased RBC destruction): Intrinsic hemolysis, RBC abnormal or extrinsic, hemolysis, RBC normal. Autoimmune disease
26
Q

RBC descriptive features, What is MCV?

A

size

27
Q

RBC descriptive features, What is MCH?

A

weight

28
Q

RBC descriptive features, What is MCHC?

A

Hgb concentration

29
Q

RBC descriptive features, What is RDW?

A

Uniformity of the cell

30
Q

What are the three causes of Neutropenia?

A
  1. Latrogenic (most common) decreased bone marrow function in the treatment of cancer or autoimmune disease, eg. chemotherapy or immunosupression
  2. Disease : overwhelming bacterial infection
  3. Disorder: cancer
31
Q

What is febrile neutropenia ?

A

MEDICAL EMERNGENCY

Neutrophils 38

32
Q

What are the 3 T’s of Heparin Induced Thrombocytopenia?

A

Throbocytopenia: platelet count falls by 50% or more
Timing :occurs between 4-14 days of heparin therapy
Thrombosis: presence of a venous or arterial thrombotic event

33
Q

What is Von Willebrand’s disease?

A

Mild hemophillia
Most common congenital coagulation disorder
clotting factors are missing or deficient
continuum of severity

34
Q

Normal Random Glucose

A

3.6-10.0

35
Q

Normal Potassium

A

3.5-5.1

36
Q

Normal Sodium

A

135-146

37
Q

Normal Creatinine

A

45-110

38
Q

Normal Urea (BUN)

A

3.7-7.0

39
Q

Normal hematocrit

A

0.33-0.48

40
Q

Normal Hemoglobin

A

110-160

41
Q

Normal Platelets

A

150-400

42
Q

Normal WBC

A

4-11

43
Q

Normal APTT

A

26-36

44
Q

Normal INR

A

0.8-1.2

CNUR 305 (7 decks)

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