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Hemaglobin
Hematologic Problems
| Question | Answer |
|---|---|
| Anemia | Decreased Hgb. S/S: tired, pale, tachycardia, murmurs/chest pain |
| Iron Deficiency Anemia | Type of anemia common in very young people, people w/ poor diets, and pregnancy |
| S/S of Iron Deficiency Anemia | Glossitis (inflammation of tongue) |
| Thalassemia | Autosomal Recessive disease common in Mediterranean people, dx by 2 yrs old (physical/mental retardation common) |
| S/S of Thalassemia | Spleen & liver enlargement, jaundice |
| Iron Toxicity Tx: | Desferal, common in patients with Thalassemia. Will need Zinc & Ascorbic acid replacements |
| What is Thalassemia | heme part of Hgb molecule is okay, but unable to produce globulin |
| Megaloblastic Anemia | Anemia caused by Vit B12 deficiency causing large immature RBC's |
| S/S of Megaloblastic Anemia | Neurologic problems, parathesia of hands, and impaired thought processes |
| Folic Acid Deficiency | hemodialysis, poor nutrition, GI issues, poor nutrition, methotrexate, and alcoholism. S/S: smooth, beefy red tongue |
| Aplastic Anemia | Anemia caused by pancytopenia. It's a chromosomal abnormality from radiation, infection & chemo meds |
| S/S of Acute blood loss | Decreased BP, tachycardia, decreased urine output, bleeding. Cold/Clammy skin - indicates shock d/t decreased perfusion (not enough blood volume to organs causing them to go hypoxic) |
| Sickle Cell Disease | Increased oxygen demand b/c cells change shape so they do not hold O2. |
| Sickle Cell | These cells occlude arteries and cause pain; the spleen is constantly removing these mishapen cells leading to anemia -- Complications: chronically anemic, artery occlusion & eventual organ failure |
| Teach Sickle Cell patients | Avoid high altitudes and dehydration, get vaccines |
| Polycthemia | Increased RBC, WBC, platelets. S/S: HTN, viscous blood, chest pain, thrombosis, stroke, excessive Hgb |
| Hydrea | Sickle Cell Anemia, polycthemia |
| Thrombocytopenia | Platelet count <150,000 |
| Immune Thrombocytopenia Purpura (ITP) | autoimmune |
| Thrombotic Thrombocytopenia Purpura (TTP) | drug toxicity or infection |
| Heparin Induced Thrombocytopenia (HIT) | due to heparin |
| S/S Thrombocytopenia | bleeding, bruising, petechia, decreased platelets |
| Treatment for ITP | Corticosteroids (watch for hyperglycemia), spleenectomy, IgG antibody, Rituxan (pre-medicate w/ Benadryl do NOT use w/ Orencia) |
| Treatment for TTP | Corticosteroids or plasmaphoresis (plasma exchange) |
| Treatment for HIT | Angiomax, Refludan, Agatroban (Direct Thrombin Inhibitors given IV drip) monitor PTT |
| Hemophilia | Sex linked recessive disorder. Deficient/Defective clotting disorder |
| S/S Hemophilia | Slow persistant bleeding (nose, GI & joints) or delayed bleeding |
| Treatment for Hemophilia | DDAVP - for vW & VIII Amicar - inhibits breakdown of clots Surgery in 2 weeks to get blood off joints. Rest/Ice Pain relief. Avoid Aspirin |
| Disseminated Intravascular Coagulation (DIC) | Bleeding and clotting cycle disorder, only seen in very sick patients -- supportive care |
| S/S DIC | Decreased Hgb, platelets, fibrinogen (necessary for clotting). D dimer increases |
| Neutropenia | Neutrophil count <1000 (increased risk for infection). May not have normal inflammation response (fever) |
| Treatment for Neutropenia | Neupogen - stimulates WBC production |
| Leukemia | cancer of bone marrow that can affect lymph system & spleen. Dx by bone marrow biopsy |
| Acute Myelogenous | Occurs in adults 60-70. 1st phase. Majority of acute cases. Abrupt & dramatic onset. Decreased Hgb, Hct, platelets |
| Acute Lymphocytic | Occurs in children ages 2-9. Fevers that will not go away despite antibiotic therapy |
| Chronic Myelogenous | 2nd phase in adults where abnormal chromosomes (Philadelphia chromosomes). Cancer cells infiltrate liver & spleen |
| Chronic Lymphocytic | Most common leukemia in adults. Enlarged lymph nodes without any other symptoms. WBC >100,000 |
| Hodgkin's Lymphoma | Malignant cancer in lymph nodes. Giant cells (Reed Sternberg) in lymph, possibly linked to mono |
| S/S Hodgkin's Lymphoma | enlarged lymph nodes, moveable, non-tender, weight loss, fatigue |
| Non-Hodgkin's Lymphoma | Malignancy of B or T cells related to immune suppression. S/S: painless lymph node enlargement |
| Multiple Myeloma | Plasma cells infiltrate bone marrow & destroy the bone (advanced when diagnosed. DX: bone pain & pathological fractures lead to diagnosis) -- RARELY CURED |
| Diagnostics of Multiple Myeloma | M proteins in the blood, Bence Jones Proteins in urine, bone marrow biopsy |
| Multiple Myeloma Risks | bone breakdown leads to increased calcium leading to kidney stones (increase fluids to flush stones out) |
Created by:
kristyd02
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