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Hematological Health
Hematological Health Deviations
| Question | Answer |
|---|---|
| Erythrocytes are responsible for transporting oxygen to body tissues: T or F | True |
| Erythrocytes are... | Red Blood Cells |
| Where do all blood cells originate from? | Single multipotent stem cell |
| What disease is treated with Factor VIII and/or fresh frozen plasma? | Hemophilia |
| Sickle Cell Disease refers to what group of hemoglobinopathies? | Inherited (Has chromosomal link) |
| Idiopathic Thrombocytopenia Purpura is thought to be an immune response following a viral infection that produces what antibodies? | Antiplatelet |
| What is an example of an Antineoplastic Agent? | Mustargen |
| A Lumbar puncture in regards to (ALL) is looking for Reed-Sternberg cells in the CNS? T or F | False |
| Which lymphoma affects lymph nodes deeper in the body? | Non-Hodgkins Lymphoma |
| What are responsible for transporting nutrients and oxygen to the body tissues and waste products from the tissues? | Erythrocytes or red blood cells (RBC) |
| What are thrombocytes or platelets responsible for? | Clotting |
| What are leukocytes or white blood cells responsible for? | Fighting infections. |
| What are the types of WBCs? | Granulocytes (neutrophils, eosinophils and basophils) and agranulocytes (lymphocytes and monocytes). |
| What does hemoglobin do? | Carries O2 |
| What is Hematocrit? | % of while RBC |
| What is a retic count? | How fast RBCs are being made. |
| What does low H&H cause? | Fatigue |
| What is plasma? | Fluid that blood travels in. |
| Why would you give a patient plasma? | To help with clotting. |
| If someone has low hemoglobin what should you do first? | Administer Oxygen. |
| Common Nursing Diagnosis | Imbalanced nutrition: less than body requirements; Risk for Infection; Fatigue; Anxiety; Decisional Conflict. |
| What is Factor VIII used to treat? | Hemophilia |
| What makes up "whole blood"? | RBCs & WBCs |
| What medical treatment would be required for someone with thrombocytopenia? | Platelet transfusion. |
| What disease is whole blood used for? | Sickle Cell Disease |
| What disease may require fresh frozen plasma? | Hemophilia |
| What does a Hematopoietic Stem Cell Transplantation consist of? | Putting stem cells directly into bone marrow or into the circulatory system. |
| What body organ puts out Sickle Cells? | The Splene. |
| In what nationalities is Sickle Cell Disease most common? | African American, Inidian, Asian Americans and Hispanics. |
| How does Sickle Cell Disease start? | Starts with an illness and dehydration which then causes the sickle cell crisis. |
| What are the top nursing interventions for Sickle Cell Disease? | Administer a hypotonic solution (this will force cells to absorb fluid); Treat patient's pain; administer oxygen and send for lab work. |
| What are common complications of Sickle Cell Disease? | Vaso-occlusive pain crisis (caused by the blood being stuck in the vascular system); Stroke; Acute chest syndrome (Infection or hypovelemic shock, heart can't pump sickle cells); and Splenic sequestration. |
| What does "sickling" cause? | Hypoxia and tissue ischemia to most areas of the body. |
| What is Idiopathic Thromboocytopenic Purpura? | Immune response following a viral infection that produces antiplatelet antibodies. |
| What is Petechiae? | Head-to-toe pinpoint hemorrhages (look like pinpoint bruises) |
| What is Purpura? | Large areas of bruising (hemorrhages). |
| What are some common complications of Idiopathic Thrombocytopenia Purpura? | Severe hemorrhage, bleeding into vital organs and intracranial hemorrhage. |
| What types of medications should patients with Idiopathic Thrombocytopenia avoid and why? | Aspirin, NSAIDS and antihistamines because they participate in the development of anemia. |
| How low is the platelet count before a transfusion is done? | Usually <50,000. |
| What would be some common findings in a patient with Idiopathic Thrombocytopenia? | Epistaxis (bloody nose), bleeding gums, increased bruising, and rapid progression of petechiae, purpura or bruising within 24-48 hours. |
| Where might petechiae first develope? | Lips and buccal mucosa. |
| What is Hemophilia A? | X-linked recessive disorder that results in the deficiency of factor VIII. |
| What should kids with hemophilia receive before any procedure and why? | Factor VIII because they are high bleed risks. |
| What happens to someone with Hemophilia when bleeding occurs? | Their vessels constrict and a platelet plug forms, but because they are deficient of Factor VIII the fibrin will not solidify so the bleeding continues. |
| What is a common complication of patient's with hemophilia? | Hemorrhage. |
| What will a hemophiac's lab results show? | Decreased HgB, Hct and decreased factor levels. |
| What are some common findings in people with hemophilia? | Black tarry stools (lower GI bleed), epistaxis, hypovolemia, bruising, petechia, active bleeding site, limited ROM. |
| What do pediatric cancers usually arise from? | Primitive embryonal (mesodermal) and neuroectodermal tissues. |
| What are the types of pediatric cancers? | Leukemias, lymphomas, sarcomas or central nervous system tumors. |
| What do Adult cancers usually arise from? | Epithelial cells that usually result in carcinomas. |
| Are adult or childhood cancers blood born? | Childhood. |
| what are the two types of Leukemia classifications? | Acute and Chronic. |
| Acute Leukemia | Rapidly progressive disease that effects immature cells; the result is cells without normal function. |
| Chronic Leukemia | Progresses more slowly permitting the maturing of cells, which enables the cells to retain some of their normal function. |
| What are some signs that a child may have leukemia? | The child may not be hitting growth marks, may have trouble seeing, and may have problems with their thyroid. |
| What are the types of therapeutic management used for leukemia? | Radiation, chemotherapy, hematopoietic stem cell transplant. |
| How is it determined as to what type of leukemia a child has? | Type depends on what blood cell is being effected. |
| What is the most common form of cancer in children? | Acute Lymphoblastic Leukemia (ALL) |
| What is Acute Lymphoblastic Leukemia? | Abnormal proliferation of the WBCs involving the bone marrow and peripheral blood. |
| What different types of cells can be involved in determining the classification of ALL? | T cell, B cell, Early pre-B cell, Pre-B cell. |
| What type of cancer is Acute Lymphoblastic Leukemia? | Blood born cancer. |
| What are complications of Acute Lymphoblastic Leukemia? | Fatigue, Weight loss, Growth arrest, Anemia, Neutropenia, Thrombocytopenia, bone and joint pain and CNS involvement. |
| What are the CNS ailments associated with ALL? | Headache, vomiting, seizures, coma, vision alterations, cranial nerve palsies. |
| What gender and age group is at highest risk for ALL? | Boys between the ages of 2 and 5. |
| What are some common findings in patients with ALL? | Fever, bone pain, N/V, recurrent infections, unusual bleeding/bruising, pallor, fatigue and headache. |
| What should be the focus for nursing management of Acute Lymphoblastic Leukemia? | Focus should be on managing disease complications such as infection, pain, bleeding, anemia and adverse effects of chemotherapy. |
| What is Acute Myeloid Leukemia? | Blood born cancer that originates in the bone marrow. It is the abnormal proliferation of immature WBCs in the bone marrow. |
| When abnormal WBCs replace normal WBCs, what is the result? | Anemia, infection and even death. |
| What is the second most common type of leukemia in children? | Acute Myelogenous Leukemia (AML). |
| How is AML classified? | By the myeloid lineage involved and the degree of cell differentiation (M0-M7). |
| How is AML diagnosed? | By bone marrow aspiration (looking for 20% or more "blasts"). |
| What are common complications of AML? | Treatment resistance, infection, hemorrhage, metastisis (easily). |
| What treatment is most effective for Acute Myelogenous Leukemia? | Hematopoietic stem cell transplantation. |
| What type of cancer is a common SECONDARY cancer? | Acute Myelogenous Leukemia |
| What are common findings in patients with Myelogenous Leukemia? | Pallor, salmon or blue-gray colored popular lesions, palpation of subcutaneous rubbery modules (hard), headache, visual disturbances, S/S of increased intracranial pressure, fever. |
| What do benign enlarged lymph nodes indicate in children? | The building up of their immune system. |
| What are lymphomas? | Tumors of the lymph tissue (lymph nodes, thymus, spleen). |
| What are the two catagories of lymphomas? | Hodgkins and Non-Hodgkins. |
| What cells are specific to non-hodgkins lymphoma? | B and T Cells. |
| What lymph nodes does Hodgkin's Lymphoma affect? | Affects lymph nodes closer to the body's surface. |
| What lymph nodes does non-hodgkins affect? | Affects lymph nodes deeper in the body. |
| What cells are affected in Hodgkins Lymphoma? | B |
| What are the two classifications of Hodgkin's Lymphoma? | A (asymptomatic) and B (symptomatic) |
| List symptoms of Hodgkin's Lymphoma. | Weight Loss, Night sweats and fever. |
| Therapeutic Management of Non-Hodgkin's. | Aggressive chemotherapy at time of dx; maintenance chemotherapy lasting 2 years; CNS prophylaxis chemotherapy. |
| How is Non-Hodgkins Diagnosed? | CT Scan, Chest radiography, Bone marrow biopsy, lymph node biopsy. |
| Which childhood cancer is usually "silent" in children until weeks or even days before diagnosis? | Non-hodgkin Lymphoma. |
| What are some adverse affects of chemotherapy? | Infection, Hemorrhage, anemia, N/V, anorexia and alopecia. |
| What normally brings patient's in who may have Non-hodgkins? | Severe Respiratory Distress. |
Created by:
nglidden
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