Week 4: Renal Flashcards
anemia
a deficiency in the number of erythrocytes (red blood cells [RBCs]), the
quantity or quality of hemoglobin (Hb), and the volume of packed RBCs (hematocrit
[Hct]), or a combination of these.
iron deficiency anemia
may develop from inadequate dietary intake, malabsorption,
blood loss, or hemolysis. Also, pregnancy contributes to iron deficiency because of the diversion of iron to the fetus for erythropoiesis, blood loss at delivery, and
lactation.
thalassemia
group of diseases that involve inadequate production of normal
hemoglobin and therefore decreased erythrocyte production.
megaloblastic anemias
group of disorders caused by impaired DNA synthesis
and characterized by the presence of large RBCs.
2 common forms of megaloblastic anemia
are cobalamin deficiency and folic acid deficiency.
aplastic anemia
disease in which the patient has peripheral blood pancytopenia
(decrease of all blood cell types) and hypocellular bone marrow.
chronic blood loss
bleeding ulcer, hemorrhoids, menstrual and postmenopausal blood loss
hemolytic anemia
condition caused by
the destruction or hemolysis of RBCs at a rate that exceeds production.
sickle cell disease
group of inherited, autosomal recessive disorders characterized by the presence of an abnormal form of hemoglobin in the erythrocyte.
care for pt with sickle cell disease
(a) preventing sequelae from the disease, (b) alleviating the symptoms of the disease, (c) minimizing end–target organ damage, and (d) promptly treating serious sequelae, such as acute chest syndrome. There is no specific treatment for the disease.
Extrinsic causes of hemolysis can be separated into three categories:
(1) physical
factors, (2) immune reactions, and (3) infectious agents and toxins.
infectious agents foster hemolysis in 3 ways
(1) by invading the RBC and
destroying its contents (e.g., parasites such as in malaria); (2) by releasing hemolytic
substances (e.g., Clostridium perfringens); and (3) by generating an antigen–antibody
reaction (e.g., Mycoplasma pneumonia).
Hemochromatosis
iron overload disorder. Although primarily caused by a
genetic defect, it occurs secondary to diseases such as sideroblastic anemia, and may
also be caused by liver disease and the multiple blood transfusions that are used to
treat thalassemia and SCD.
polycythemia
production and presence of increased numbers of RBCs. The
increase in RBCs can be so great that blood circulation is impaired as a result of the
increased blood viscosity (hyperviscosity) and volume (hypervolemia).
thrombocytopenia
reduction of platelets below 150 × 109/L or 150 000 per mcL.
hemophillia
X-linked recessive genetic disorder caused by defective or deficient coagulation factor. The two major forms of hemophilia, which can occur in mild to severe forms, are hemophilia A (classic hemophilia, factor VIII deficiency) and hemophilia B (Christmas disease, factor IX deficiency).
disseminated intravascular coagulation
serious bleeding and thrombotic
disorder.
It results from abnormally initiated and accelerated clotting. Subsequent decreases in
clotting factors and platelets ensue, which may lead to uncontrollable hemorrhage.
neutropenia
defined as a neutrophil count of less than 1 to 1.5 × 109/L, or 1 000 to 1 500/mcL. Normally, neutrophils range from 2.2 to 7.7 × 109/L. Severe neutropenia is defined as an ANC less than 0.5 × 109/L.
myelodysplastic syndome
group of related hematological disorders
characterized by a change in the quantity and quality of bone marrow elements.
Although it can occur in all age groups, the highest prevalence is in people over 80
years of age.
leukemia
broad term used to describe a group of malignant diseases affecting the blood and blood-forming tissues of the bone marrow, lymph system, and spleen.
Acute myelogenous leukemia (AML)
characterized by uncontrolled
proliferation of myeloblasts, the precursors of granulocytes. Onset may be abrupt
and dramatic.
Acute lymphocytic leukemia (ALL)
most common type of leukemia in
children. In ALL, immature lymphocytes proliferate in the bone marrow; most are
of B-cell origin.
Chronic myelogenous leukemia (CML)
excessive development of
mature neoplastic granuloctyes in the bone marrow, which move into the
peripheral blood in massive numbers and ultimately infiltrate the liver and spleen.
Chronic lymphocytic leukemia (CLL)
characterized by the production and
accumulation of functionally inactive but long-lived, mature-appearing
lymphocytes. The lymphocytes infiltrate the bone marrow, spleen, and liver, and
lymph node enlargement is present throughout the body.
mainstay of the treatment for leukemia.
Cytotoxic chemotherapy
The overall nursing goals are that the client with leukemia will
(1) understand and
follow the treatment plan, (2) experience minimal adverse effects and complications
associated with both the disease and its treatment, and (3) feel comfortable and
supported during the periods of treatment, relapse, or remission.
Lymphomas
malignant neoplasms originating in the bone marrow and lymphatic
structures resulting in the proliferation of lymphocytes.
Hodgkin’s lymphoma,
malignant condition
characterized by proliferation of abnormal giant, multinucleated cells, called Reed-
Sternberg cells, which are located in lymph nodes.
Non-Hodgkin’s lymphomas (NHLs)
a heterogeneous group of malignant
neoplasms of primarily B- or T-cell origin affecting all ages. A variety of clinical
presentations and courses are recognized from indolent (slowly developing) to rapidly
progressive disease.
Multiple myeloma,
condition in which neoplastic
plasma cells infiltrate the bone marrow and destroy bone.
splenomegaly,
increased filtering and sequestering capacity,
lowering the number of circulating blood cells.
Autotransfusion,
consists of removing whole blood from a
person and transfusing that blood back into the same person. The problems of
incompatibility, allergic reactions, and transmission of disease can be avoided.
