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Spring- Blood

Blood Disorders

Sickle Cell Anemia Have BOTH defective gene **if you only get one you are a carrier
Abnormal Hbg molecule= Hgb S= causes cells to sickle
complication of sickle cell anemia cells cannot move through the blod vessls- they get stuck bc of shape
caused by dehydration, stress, poor nutrition, vessels become clogged or blocked= tissue hypoxia
death usually occurs from tissue damage to major organs
S/S pain in bones/organs, fever, anemia, clots in lungs or spleen/spleenomegaly, edema, leukocytosis, chest/abdominal pain, D. ulcers
Positive screening of Hgb get immunized, stay rested= reduce the amount of o2 demand for body, rest, eat well, regular check ups
PRIORITY for sickle cell anemia patients PAIN CONTROL-- while in hospital- give Pain med and IV fluids-- may be "fequent fliers"- give apin meds promptly - pain will be over whelming
unique manefestation on Sickle cell anemia Acute chest syndrom
constantly check for HF R or L
coughing, wheezing, techypnea, chest pain Jaundice - due to increase rate of RBC destruction Gallstones - from increase bilirubin
risk for infection compromises growth Priapism-- increased time for an erection
when blood flow is reduced the patient will experience localized ischemia, severe pain, tissue infarction, fever, pain, swelling
treatment is surrpotive rather than curative regular blood transfusion Narcotics Oxygen Hydration
Hemolytic Anemia chronic premature destruction of RBCs (erythrocytes) iron and Hgb are released
caused by autoimmune reaction radiation blood transfusion (maily if you get the wrong blood) arsenic & lead poisoning medication
S/S - may go unnoticed or a sudden, severe reaction may occur mild fatigue, pallor, jaundice, palpitations, hypotension, dyspnea, back & joint pain-- wrong blood
Treatment and Interventions Find and fix UNDERLYING cause Blood transfusion Erythrocytoapheresis- procedure that removes abnormal RBC and replaces them with healthy RBCS Splenectomy- surgical removal of spleen Corticosteroids- decrease autoimmune response
folic acid- increases production of RBCs
Pancytopenia Numbers of ALL marrow-produced blood cells are reduced
Aplastic Anmeia inadequate stem cell production in bone marrow possible autoimmune DEATH RATE IS HIGH
Assessment finding infections (low WBC) coagulation abnormalities (low WBC) small skin hemorrhages (low platlets) enlarged spleem
Nursing Managmetn watch for s/s of infection, assess temp, vitals, monitor for bleeding HISTORY
Pernicious Anemia VIT B 12 deficieny- injections daily for 2 weeks then one per month for rest of life No cure but treatments are available for pt to have normal life span
Caused by partial or complete removal of the fundus of the stomach (gastrectomies)
source of the intrinsic factor which is necessary for absorption of B12 fundus
Necessary element in the production of RBC and NS function VIT B 12
immature RBCs large and die quickly
labwork will show low RBC Hgb low High Bili- jaundice
Cardinal sign tounge in sore and beefy red- toung is very vascular
the more Neurological problems the worst the Anemia is (tingling of hands & feet, loss of body position, memory loss, confusion, depression, if NOT treated- partial or total paraylsis
Diet high in protein, vitamins, minerals
B12 has no side effects & cannot overdose
Folic Acid Def low folic acid levels -- Treatment-- VIT C- helps with maturity of RBC and absoption
Foods with Folate: breads, cereals, green leafy vegies, orange juice, dried peas and beans
Polycythemia Vera (Erythrocytosis) abnormal production of RBCS, WBCS, PLTS RBC count may range from 7-10 mill-- (norm is 3.6-5.4)
oxygen content of blood is diminished due to short life span of RBCS Blood flow rate is slowed due to increased thickness-- increased risk for clots
HTN- bc H blood vol- thick blood CVA- clotting factors H CHF- too much blood hemorrhage- at risk bc amount H amount of Blood
S/S Angina(most common), HA, fatigue, Night sweats, Puritis, Dyspnea, enlarged spleen/liver, skin bruising, bleeding mucous membranes
Treatment- Objective- Supress bone marrown, decrease blood cell mass, reduce # of RBCS, WBCS, PLTS chemo to suppress bone marrow phlebotomy- reduce excess volume (sv x wk) high risk for developing Leukemia
high fluid intake- help prevent clots restriction of blood flow- no tight cloths' encourage isometric exercise if angina - educate patient to REST
Position to put pt in with enlarged spleen sitting position
Lymphatic System a network of vessls that transport lymph (watery fluid from plasma that exits the walls of capillariers and enters interstitial space)
ALWAYS check tonsils for size & enlargement
lymphocytes & macrophages trap destroy remove (why our lymph nodes are swollen)
Primary lymphemdema congenitally acquired/ Affects women more that men (mastectomy)
Secondary Lymphedema develops from complications of other disorders, removal of mult lymph nodes
Parasitic worm-- Most common cause of Lymphedema -- always ask about forgien travel (secondary)
when the volume of lymph exceeds the capicity of the vessels- lymph enters interstitial space w/in soft tissues trapped fluid eventually causes non-pitting edema
nursing management for Lymphedema assess affected area, elevate extremity, encourage movement, support, teach about garments and mechanical devices
Treatment symptomatic
Lymphangitis, Lymphadenitis Strepococcal microorganisms
red streaks-fever-tender-enlarged lymph nodes Visual inspection and Palpation
PAIN managment note the respose to antibiotic therapy- decrease redness, swellilng, elevate extremity, apply warm soaks to area
Infectious Mononucleosis Epstein-Barr Virus Direct contact secretions
Fatigue, Fever, sore throat, cervical lymph enlargement, oozing tonsils, pharyngeal swelling
Epstein-Barr virus can cause lyphoma bc of the way it attacks the body
AViod blood donation for 6 months
Hodgkins Disease Reed Sternberg cells onset 15-40 and then older than 55 orderly growth more curable
Non-Hodgkins NON-reed sternberg cells Genetic - Aggressive peaks after 50 30 subtypes B&T cell origins Mets common Less curable
Leukocytosis increase in WBC sign of infection more indicate leukemia usually accompany fever
common s/s of leukemia anemia, weakness, fatigue
definite cause is unknown- toxic chemicals, radiation, viruses, certain drugs, genetics
ALL occurs primarily in children
AML Affects all age ranges
CLL AND CML CLL- commonly affects those older than 40- MOST COMMON in adults CML- found in those older that 20- incidence increases with age- 95% genetic link
in ALL leukemias- there is risk of infection
ecchymosis bruising
petichia tiny red dots
purupa redish/ purple small skin hemorrhages
most of the pt discomfort results from treatment than the disease chemo/radiation
normal platlet count 150,000-350,000
WBC 5,000-10,000
if you have cancer and you are anemic you will recieve a blood transfusion
treatment of choice if remission occrs Bone Marrow Transplant
Multiple Myeloma Cause is unkown CANCER OF THE plasma cells - results in abnormal production of immunoglobulins Abnormal plasma cells cannot protect the pt
PLASMA CELLS destroy bone & lymph nodes, liver, spleen and kidneys
symptoms occur when kidneys are damaged or infection sets in Pathological FX RENAL CALCULI
HOW MUCH FLUID 3-4 L unless contraindicated
Agranulocytosis Caused by adverse reaction to... Butazolidine, Choloromycetin, Penicillin & its derivatives, Dilantin, Onocovin, Diuretics, Thorazine, Sulfa CELEBREX
Neoplastic disease- cancer causing
chemotherapy, radiation, bacterial and viral infections
RESULTS IN bone marrow suppresion- thus reducing WBC pro # of granulocytes are severly reduced
s/s HA, fever, chills(BAD-chills cause body heat=fever)Fatigue Mucous membrane ulceration of the...
nose, mouth, pharynx, vagina, rectum
MAIN GOAL remove cause of bone marrow supression prevent or treat infection
blood transfusion- provide mature wbc to wk system
protective isolation due to low WBC- reverse or neutropenic
diet soft, bland, high in calories, protein, vitamins
Aplastic Anmeia bone marrow shuts down completely severe life threatening very poor DX
ppl on chemo have blood drwn everyday for labs
1st sign of organ rejection FEVER
thrombocytopenia decrease inPLT count related to
aplastic anemia, tumors, leukemia, chemo
platelet survival rate is also lowered due to infection or viral illness
Created by: sweaver