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Hematology
nursing 165 mtc hematology
| Question | Answer |
|---|---|
| Platelets normals | 150,000 – 400,000 mm |
| how long do platelets live? | Live for 7 to 10 days |
| red blood cell normals | 4,200,000 to 6,100,000/mm3 |
| What do red blood cells produce? | hemoglobin |
| What is a critical component in hemoglobin? | iron |
| Hemoglobin normal for female? | 12- 16 g/dl |
| Hemoglobin normal for male? | 14 – 18 g/dl |
| White blood cell normal? | 5000 – 10,000/uL |
| How long do white blood cells live? | days to years |
| What does Hematopoiesis do? | formation and production of blood cells |
| where does hematopoiesis happen? | bone marrow |
| Where does Erythropoietin hormone primarily produce? | kidney |
| What is gerontological problem that usually effects blood cell production? | anemia |
| What blood value is sometimes falsely high with a condition of fluid volume? | hematocrit |
| What is anemia? | A condition in which the hemoglobin concentration is lower than normal, |
| what is Hypoproliferative anemias | The marrow cannot produce adequate numbers of erythrocytes |
| What does the Hemolytic anemias involve? | premature destruction of erythrocytes |
| What is anemia cause by? | from dietary problems, genetic disorders, bone marrow disease or excessive bleeding |
| What is the most common reason for anemia? | GI bleeding |
| What are the clinical signs of gradual onset of anemia? | no symptoms, slight tachycardia and fatigue |
| what is the nursing management for anemia? | fatigue |
| What is the most common cause of iron deficiency anemia? | bleeding |
| What are the areas of the body that cause anemia? | ulcers, gastritis, gi tumors, inflammatory bowel disease, menorrhagia, chronic alcoholics and other malabsorption conditions. |
| what are the clinical manifestation of iron deficiency anemia? | Weakness, fatigue, dizziness, Pica (chew on ice that is another sign), Brittle, rigid, concave nails, Numbness and tingling, headache and ulcerated corners of the mouth |
| How long must you continue on medication for iron deficiency? | 6 -12 months |
| iron replacement is poorly tolerated or absorbed, so how else can you administer this medication? | IM injections or I.V. administration |
| What is the best way to administer IM iron medication? | Z track |
| What food sources are high in iron? | organ meats ( beef or calf’s liver, chicken liver), other red meats, beans (black, pinto, garbanzo), leafy green vegetables, raisins, molasses |
| What would you take with iron administration? | orange juice |
| Vitamin C foods | citrus fruits and juices, strawberries, tomatoes, broccoli |
| how should liquid forms of iron be administered? | through a straw |
| What anemia is caused by a Vitamin B12 or folic acid deficiency? | Megaloblastic Anemia |
| Alcoholics have a increased need for, what mineral? | folic acid |
| common causes of folic acid deficiency | poor nutritution, malabsorption (Crohn’s disease) and drugs( alcohol), anticonvulsants and oral contraceptives |
| Folate sources | green leafy vegetables, liver, dried beans, nuts and citrus fruits |
| Albumin is a protein in the plasma portion of the blood. Under normal conditions albumin cannot pass through the wall of a capillary. What significance is this for the vascular compartment? | Helps retain fluid in the vascular compartment. |
| The instructor in the anatomy and physiology class is discussing the components of the blood. What would the instructor cite as the most abundant protein in plasma? | albumin |
| B12 deficiency results from poor intake of foods containing vitamin B 12 usually affects, who? | strict Vegans |
| poor absorption of vitamin B 12 can be caused by? | Small bowel resection, diverticula, tapeworm or overgrowth of intestinal bacteria |
| Signs and Symptoms for vitamin B12 Anemia? | numbness and tingling in legs and feet. |
| Prevent and manage of vit. B12 by? | oral supplements, vitamins or fortified soy milk |
| What causes Pernicious anemia? | absence of intrinsic factor and body can't absorb B12 |
| Who has a higher incidence of gastric cancer? | Pernicious anemia |
| What is the medical management for a person with Pernicious anemia? | Monthly injections of B12 for a lifetime? |
| What can Aplastic anemia be caused by? | long-term exposure to toxic agents, ionizing radiation or infection, certain meds |
| What can trigger Aplastic Anemia? | certain infections, pregnancy, chemicals, radiation demage and toxic material |
| symptoms of aplastic anemia? | Fatigue, shortness of breath, and decreased tolerance to activity |
| Pancytopenia means | a deficiency in aplastic, leukopenia and thrombocytompenia |
| leukopenia means | a reduction in white blood cells |
| thrombocytopenia means | a reduction in platelets |
| Diagnostic test result for Hemolytic anemia? | Reticulocyte count elevated, bilirubin increased, haptoglobin depleted |
| Sickle cell Anemia/Disease is | genetic disorder that causes the hemoglobin to become sickled |
| Most common symptom of Sickle cell anemia in crisis | pain |
| Other symptoms of sickle cell anemia besides pain? | chronic anemia, pallor, skin cool to touch, jaundice, fatigue, dyspnea, tachycardia, cardiac murmurs, cardiomegaly, splenomegaly |
| what are the primary target sites of SCA | spleen, lungs and cns |
| what are the complications of SCA? | infection, stroke, renal failure, impotence, heart failure and pulmonary hypetension |
| Diagnostic test results for SCA: | Hematocrit is low, reticulocyte is high, MCHC, total bilirubin high |
| triggers for sickle cell disease | anesthesia, hypoxemia, low environmental temperature, infection, dehydration, excessive exercise |
| what drug is used for medical management of SCA? | corticosteriods |
| what IV therapy is used for Sickle cell crisis | D5W or D5.25NS |
| What medication is used for Sickle cell to stimulate fetal hemoglobin? | hydroxyurea (hydrea) |
| What is the preferred medication for pain management when someone has SC crisis? | morphine |
| SC crisis management | O2, pain meds, hydrate with ND, HOB @ 30 degree or less, |
| PRIAPISM is | persistent penile erection |
| What do you teach the patient to do, when the onset of PRIAPISM happens? | empty bladder, exercise and take warm bathes |
| Neutropenia is | decreased production of neutrophils or increased destruction of these cells |
| What do neutrophils do? | essential in preventing and limiting infection |
| Cause of Neutropenia | aplastic anemia, metastatic cancer, chemotherapy, radiation therapy, hyperspenism |
| Neutropenic Precautions are | strict hand washing, private room, no fresh fruits, vegetables, flowers, no visitors or staff with infection |
| Polycythemia is | too many cells in the blood |
| What is a hallmark of polycythemia vera | splenomegaly |
| PV Symptoms | Persistently elevated hematocrit greater than 55% , A ruddy complexion, splenomegaly, headache, dizziness, tinnitis, paresthesias, fatigue, blurred vision, distension of superficial veins, weight loss, enlarged hemorrhoids |
| Diagnostics test results for PV | RBC volume, hemoglobin, hematocrit, platelet, B12 and uric acid count elevated |
| What are the complication of PV | increased risk for thromhosis and bleeding |
| Medical management for PV | Phlebotomy |
| What is phlebotomy used for with PV? | to reduce high blood cell levels |
| What are the risk factors for PV complications | smoking, obesity, poorly controlled hypertension |
| Things to avoid for those with PV | aspirin, minimize alcohol intake, and iron supplements |
| PV patient with pruritis should do what? | cool or tepid bath along with cocoa butter based lotions. Avoid vigorous toweling off after bathing |
| Which nursing intervention is most appropriate for a client with multiple myeloma | Preventing bone injury |
| Both the liver and the spleen have a role in erythrocyte metabolism. How would this role best be described? | The spleen removes erythrocytes after 120 days, and the liver removes severely damaged erythrocytes |
| What is a obvious sign of anemia | pallor |
| Which type of leukocyte contains histamine and is an important part of hypersensitivity reactions? | basophils |
| Primary function of the spleen? | recycling or iron, pooling of platelets, and blood volume regulation |
| Pertinent findings of thrombocytopenia are? | Bleeding gums, epistaxis, hematemesis, hypotension and tachypnea |
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