Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 120 > Unit 5 > Flashcards

Unit 5 Flashcards

1
Q

Where does hematopoiesis occur? What is recycled? And what type of cells are made here?

A 
Bone marrow of ribs, pelvis, sternum, or vertebra.
Iron and heme.
Stem:
Myeloid-RBC, wbc, platelets
Lymphoid-t and b lymphocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Explain MCV, RDW, and MCHC values.

A

MCV-volume/size of RBC
RDW-width of RBC
MCHC-hemoglobin concentration in RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the iron studies used for hematology?

Explain.

A

Serum iron-(60-170)measures circulating iron bound to transferrin.
TIBC-measures transport protein (transferrin) that supplies marrow w/iron.
Percent saturation(25-35)-ratio of serum iron and total iron binding capacity
Ferritin-storage of iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can B12, folate, sed rate, and Coag studies be useful in hematology?

A

B12-Production of rbcs (intrinsic factor is req. to absorb B12, also from digestion)
Folate-makes RBCs
Sed rate-blood test that reveals inflam activity (RA, sarcoidosis)
Coag studies- if lacking clot factors. Pt, PTT, inr measures clot time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the Nurse duty for:
preop for bone marrow bx/aspiration.
Intra-op
Post op

A 
-Careful explanation
Anti anxiety
Signed consent
-aseptic skin cleanse
Local anesthetic
Dr insert needle, syringe attached (sharp pain)
Deep breaths/relaxation, pressure to sight for minutes, sterile dressing
-pain 1-2 days possible
Warm tub bath
Analgesic (non Asa)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what 3 factors are required in RBC formation in response to ________ made by the ___________? What are the norm ranges?
Where do these finish maturing and life span?

A

B12 (200-900)
Iron (60-170)
Folic acid (2-20 or 4.5-45.3)or RBC folate (140-628 or 317-1422)

Erythropoietin, kidneys

Blood system
120 days then die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What 2 factors will signal the bone marrow to abnormally make more rbcs?
What happens to bone in response?

A

Increased RBC death, or inc. immature rbcs released

Marrow space enlargers thinning other areas=weather bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the terms to describe RBC size and RBC concentration of hemoglobin?
What cause changes?

A 
Size:
normocytic (normal)
Microcytic (small)
Macrocytic (large)
Concen of Hemo:
Normochromic (normal)
Hypochromic (too little Hemo)
Hyperchromic (too many Hemo/dense)
Tissue oxygenation, renal changes, and bone marrow interruptions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is anemia? And it’s causes?

A

Not a disease!
Describes quantity of circulating rbcs and an abnormally in Hemo content (or both).

D/O in RBC production (enzyme def), lack of folic acid, b12 prob, renal def (erythropoietin), production d/o, bleeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some s/s of RBC d/o?

A 
Tachycardia
Tachypnea
Fatigue
Pale
B12 def-tongue beefy red
Pica
Heart problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is iron def anemia? Typical causes, s/s, and diag test? Tx?

A

Dietary iron def.

Childhood, pregnancy, times of growth, nutritional interruptions, ca, heavy menstral cycle, ulcers, chronic alcoholism)

Fatigue, anemia

CBC:if bad then bone marrow endoscopy

Inc iron in diet or correct bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is aplastic anemia? Causes, s/s, testing, and tx.

A

Dysfunction in bone marrow.

Congenital, idiopathic, infection, meds, chem/radiation.

Anemia (low Hemo), purpura. Inc WBC=infection;dec platelets=bleeding
Bone marrow testing
Hold pressure to bleed, prevent bleeding occurrences, blood transfusion/platelet, d/c meds, bm transplant, antibiotics/neupogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is pernicious anemia? S/s, test, and tx?

A

Dec. B12, intrinsic factor problem (malabsorption) pts on Metformin, Prilosec (h2protoninhib)

Neurological-motor dysfunction, beefy red tongue, GI d/o

Schillings test-definitive
Injections/po, food intake, d/c meds, alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are complications of sickle cell anemia? S/s? And tx?

A

Vision changes, heart attack, stroke.

Pain

Fluids, pain meds, folic acid, o2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is polycythemia? Cause? Risk? S/s, tx?

A 
Inc rbcs, platelets, and granulocytes.
Idiopathic, hypoxia.
Inc risk for clotting.
Enlarged spleen.
Phlebotomy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 3 conditions of Hemostasis/platelets?

A

Thrombocytopenia-dec platelets
At risk for bleed. Check:platelets, labs, use bleed precautions.

Thrombocytosis-inc platelets,
At risk for clot. Tx: splenectomy, Asa.

Vit K def-injections, meds destroy flora.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where are WBC d/o formed? Diff granulocytes and agranulocytes.

A 
Bone marrow (immune sys)
Gran-
Neutrophil-phagocytosis 
Basophils-mast cells
Eosinophils-allergic reactions
Nongran (agranulocytes)-
Lymphocytes-immune function
Monocytes-produced faster and longer lifespan than neutrophils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diff neutropenia and leukemia.

A

Neut-dec neutrophils, at risk for infection

Leuk-over production of immature wbcs, causes probs with RBCs and platelets since WBC take over bone marrow.s/s:infection, bleed, anemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 2 types of irons?

A

Ferrous sulfate: constipation a

Ferrous gluconate:less GI upset(can take anytime)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define and diff hodgkins and nonhodgkins lymphoma.(s/s, dx)

A

Dz of lymph sys-ca of lymphoid tissue. Many classes to ID extent. Painless enlarged unilateral cervical lymph nodes, persistent, anemia.
Lymph node bx.
Hod-good cure rate
Non hod-spreads faster, poor cure rate, found after advanced.

21
Q

What is multiple myeloma?

A

Bone cancer-spreads (bones are vascular)

S/s: infection, anemia, bleeding.

22
Q

What are the 3 layers of the artery?

A

Tunica:
Intima(inner)-smooth for easy blood flow
Media(mid)-thicker, smooth muscle, elastic
adventitia(outer)-connective tissue

23
Q

What will occur if the artery develops a slow decrease in flow?

A

Example:thrombus plaque

Outside tissue will have collateral tissue develop.

(Preferred over acute complete occlusion)

24
Q

Define capillaries.

What occurs here?

A

Smaller vessels that connect A to V imbedded in the tissue otherwise called microcirculation.
Nutrients out to tissue by hydrostatic pressure, and waste back to vessel by osmotic pressure (protein).

25
Q

What is flow rate? What can be auscultated with inc.?

A

Change in P/R

Bruit-turbulent blood flow

26
Q

What are the regulating mechanisms to peripheral vascular system?

A

CNS->sns(most important blood flow regulator)->norepinephrine (#1 neurotransmitter, promotes constriction)

Circulating hormones/chemicals:
Epi/angio I II-potent vasoconstriction
Histamine/prostaglandin-potent vasodilator
Thrombocytes/serotonin-damaged tissue sends more platelets (bad) and releases these causing vaso constriction (bad) dec flow, and inc risk for aggregation.

27
Q

Diff arteriosclerosis vs atherosclerosis.

A

Arterio-hardening of artery

Athero-plaque formation in artery intima-this creates roughness which then can cause aortic aneurysm=turbulence.

28
Q

What are the major modifiable risk factors for atherosclerosis and PAD?

A

Nicotine-causes vasoconstriction dec flow inc clots
HTN-inc atherosclerotic rate inc PAD/CAD
DM-abnormal blood sugars inc basement membrane thickness
C-reactive protein-c/v inflammation, inc risk for vessel damage
Hyperhomocysteinemia -protein promoting coagulation-thrombus
Fibrinogen-activated to fibrin, makes clots form leads to PAD
D-Dimer-fibrin clots break down and release this. Vein clotting.

29
Q

Where and who is most at risk for PAD?

A

Men
Age over 50
Lower extremities

30
Q

What is important in assessment of intermittent claudication?

A

Fatigue ext.
Cold/numb ext.
Relieved w/ rest. (Pain at rest-bad! Severe PAD)
Pain with walking and anterior foot=severe.
Shouldn’t see edema.
Do not elevate arterial d/o. It decreases flow.

31
Q

PAD assessments of skin.

A 
Cool/pale ext.
White when elevated
Red-blue when down
No hair, shiny
Brittle thick opaque nails
Atrophy
Ulcerations 
Dec cap refill
32
Q

What is ABI?

A

Systolic ankle/systolic brachial

Increased arterial narrowing=dec sys pressure

  1. 0=equal ankle to arm
  2. 9-0.50=insuff
33
Q

What are the characteristics of an arterial ulcer?

A 
Typically tip of toe/webs, foot, heel
Very painful
Deep
Circular
Pale to black ulcer base
Dry gangrene
Minimal edema
34
Q

What are the managements of PAD?

A 
Ext below heart
Exercise to promote flow
Warmth to promote flow
Stop tobacco
Avoid emotional upset
Avoid constrictive clothes
Don't cross legs
Vasodilators/adrenergic blocking agents/analgesic
Sturdy, well fitting shoes, neutral soaps/lotions
Pat feet dry, trim nails across.
Diet intake Vit A, C, protein and zinc.
Weight loss.
35
Q

What are important post op nursing care interventions for surgical managements of PAD?
Vascular grafting, endarterectomy, embolectomy, amputation.

A

Maintain circulation-c/v checks q 15 min. Keep legs uncrossed and dependent. Compression stockings, and monitor for compartment syndrome

36
Q

What is buergers dz? (Thromboangitis obliterans)

A

Inflammation! And clot in small arteries/veins of ext. Thrombus forms and occluded vessel.
Common in men 20-35 and heavy tobacco use.

37
Q

What are s/s of buergers dz? TX?

A 
Pain (#1 indicator)
Rubor
Diminished pulses
Paresthesias
Red/cyanosis as dz progresses (dependent position)
Ischemia
Skin ulceration a
Gangrene
*begins in hands feet then spread to larger-bilateral

Stop tobacco use! Improve circulation, treat ulcer/gangrene, amputation.

38
Q

What is an aneurysm? Diff the types.

A

Dilated area in artery sac like,(weak point) permanent damage, and enlargens. (atherosclerosis make changes that weaken)
Aorta susceptible. Typically ASYMPTOMATIC!
False-outside (intima/media) layers-actual hematoma
True-all three layers
Fusiform-uniform dilation of entire vessel.
Saccular-bulbous protrusion on one side.
Dissecting-split layers of wall by hematoma.

39
Q

What are risk factors for aneurysms?

And inc rupture risk?

A 
Age
HTN
Smoking
Hypercholesterolemia
Hyperlipidemia
Males
Fam hx
Inherited, infection, vasculitis, trauma 
Size:5.5 most likely ind operation-pain, dec BP, dec Hct, loud bruit
40
Q

What is the pre/post operative nursing care for aneurysm?

A

Keep pt on bed rest with calm environment, reducing stress.
No straining or holding breath.no elevation or crossing of legs.
Anti hypertensives and beta blockers.

BP/hemodynamics status, pain, hob elevate 45 deg., n/v checks

41
Q

Thrombus can be caused by __________ and __________.

What are the important assessments for acute arterial embolism?

A

Atrial fib, Cath procedure.

6 P’s:
Pain, pallor, pulse lenses, paresthesia, pokilothermia (coldness), paralysis

42
Q

What is Raynauds? Triggered by? Management?

A

Triggered by abnormal cold sensitivity/emotional.
Intermittent arteriolar vasoconstriction to fingers/toes. Common in women 1 6-40. Usually bilateral.

Avoid stimuli that provoke, CCB, sympathectomy, avoid stress, stay warm, avoid nicotine

43
Q

Dec blood flow equals ______ venous pressure.

Edema equals _____blood flow and nutrient delivery.

A

Increased

Decreased

44
Q

Explain the 3 diagnostics for venous d/o’s.

A

Duplex:standard for lower ext thromboembolism. Flow motion-where stasis/occlusion is.
Air pleth-measure leg volume for leaking of fluid to tissue.
Contrast phleb-done prior to thrombolytic therapy.

45
Q

Venous thromboembolisms typically occurs where?

Thrombus creates what?

A

Deeper veins, they are thinner/weaker.
Edema(phlebitis)
Typically seen in lower ext.

46
Q

How are venous ulcers presented?

A 
Usually medial malleoulus
Pain-ache, cramp, heavy
Discoloration in gainer area
Mod-sev edema
Superficial
Very exudative
Granulation tissue
47
Q

What are the 3 lymphatic d/o? Explain.

A

Lymphangitis: inflammation/indices of lymphatic channels.

Lymphadenitis: inflammation/infection of lymph nodes.

Lymphedema:tissue swelling r/t obstruction of lymphatic flow.

48
Q

What is cellulitis? And care?

A

Bacteria enters skin. Localized swelling, redness, pain.

Antibiotics, elevation, warm moist pack q2-4 hr

NUR 120 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions