Week 14 Flashcards
Hematology
Blood cell production is
Hematopoiesis
undeveloped, precursor cells in the bone marrow
Pluripotent Stem Cells
Substance found in the middle of the center of bones; hematopoiesis takes place here
Bone Marrow
Immature precursor cells for each WBC line
Blast Cells
A rise in WBC count above 11000/mcl
Leukocytosis
A decrease in WBC below 400/mcl
Leukopenia
These cells are first responsers to an infection, stress, or inflammation. Part of the innate immunity
Neutrophils
A lack of sufficient number of neutrophils
Neutropenia
A lab test that identifies the amount of each type white blood cells and immature blood cells
CBC w/ Diff
A large bore needle that extracts cells from the hip bone to examine the precursor cells in various stages of maturation
Bone Marrow Aspiration
A sequence of coagulation factors that form fibrin strands that strength a platelet plug to form a clot
Coagulation Cascade
Insufficient delivery of oxygen to the tissues by inadequate number of mature, healthy RBCs
Anemia
Immature RBCs. Should remain in the bone marrow until maturity
Reticulocytes
Destruction of RBCs
Hemolysis
Misshapen RBCs become trapped and block blood flow, leading to ischemia in different organs
Vas-occlusive Crisis
The physiologic process that stops bleeding at the site of an injury
Hemostasis
Low platelets, which can cause bleeding
Thrombocytopenia
Difference between sickle cell disease and sickle cell trait
- having the trait doesn’t mean you have the disease
- men more likely to have disease
What is vaso-occlusive crisis and what could trigger it to occur
- sickle cell clot> leads to ischemia/ death(cell/organ)
- emergent situation
- infection, stress, dehydration
The major steps of hemostasis
- vasoconstriction
- Development of platelet plug
- coagulation
Fibrinogen coverts to what?
Fibrin
Acute Leukemias deal with what type of cells?
Blast (immature) cells
Chronic leukemias deal with what type of cells?
Mature cells
Which of the following white blood cell (WBC) levels would indicate that a patient has leukocytosis?
1. 1200 cells per microliter
2. 1800 cells per microliter
3. 5000 cells per microliter
4. 12,000 cells per microliter
- 12000/mcl
A patient presents with a white blood cell (WBC) count of 20,000 cells per microliter. Which of the following interpretations would be correct for the nurse to make?
1. The WBC count is so high that the patient will never have to worry about an infection.
2. The patient’s results are diagnostic for allergies or autoimmune disorders.
3. The patient likely has anemia, and the elevated WBC level is attempting to compensate.
4. Although elevated, the WBCs may be poorly functioning, increasing a patient’s risk for infection.
- elevated WBCs may be poorly functioning
A patient’s neutrophil number is 900 cells per microliter. Which of the following would be correct associations for the nurse to make?
- The patient has an increased risk of infection.
- The patient is suffering from anemia.
- The patient has neutrophilia.
- The patient has normal neutrophil levels.
- The neutrophil number is low, this increases pts risk for infection
A nursing student is asking about which general signs and symptoms may be present in cases of advanced leukemia. Which of the following are appropriate responses by the nurse educator? Select all that apply.
No overt signs or symptoms are present.
Bone pain
General leukopenia on completed blood count (CBC)
Splenomegaly
Anemia
Bone pain, Splenomegaly, and anemia
A patient with sickle cell anemia, having been hospitalized with a vaso-occlusive crisis, is being discharged. Which instructions will be helpful for the patient?
1. The number one recommendation is to increase your activity level.
2. Do not overreact. Sickle cell anemia is not a severe disease and should not require hospitalization.
3. Make certain you have adequate hydration and rest, and avoid stressors when possible.
4. Use caution because your blood has limited ability to clot and a small cut may result in significant bleeding.
- pt should maintain adequate hydration and rest, and avoid stressors
A sickle cell anemia crisis leads to hemolysis of red blood cells (RBCs). Which of the following may the nurse expect to see?
1. Decreased serum bilirubin.
2. Increased reticulocyte percentage
3. Increased hematocrit
4. Decreased likelihood of jaundice
- reticulocytes are immature RBCs and levels to replace lost cells
Parents have just been told that their child has hemophilia. Which of the following information would be correct for the nurse to share?
1. Your child has a type of hemophilia that can be outgrown.
2. In your child, platelets do not work correctly. A bone marrow transplant may help..
3. Your child will likely suffer what is known as “vaso-occlusive” crisis.
4. Your child has an increased risk of bleeding, so care must be taken with even small wounds.
- hemophilia disrupts the clotting cascade, increasing the risk for excessive bleeding
A nursing student has a question about prothrombin (PT) and activated partial thromboplastin time (aPTT) values. Which of the following responses show that the student has correct understanding?
- PT and aPTT measure the same thing but are tests run by different companies.
- PT and aPTT, when increased, increase the risk for bleeding..
- PT and aPTT values should be less than 1 second.
- A person with hemophilia would have a reduced PT and aPTT value.
2, Prolonged clotting times increase the risk for excessive bleeding
