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Quiz 3

The normal lab value for K+ is 3.5-5.5
The normal lab value for Cl is 90-110
The normal lab value BUN is 10-20
The normal lab value for creatine is 0.6-1.2
The normal lab value for Na is 135-145
Normal WBC count is 5-10 thousand
Normal platelet count is 150-400,000
Normal RBC count is 4.6-6 million
Normal Hgb for a male is 13-18
Normal Hgb for a female is 12-16
Normal Hct for a male is 45-52
Normal Hct for a female is 37-48
What are three specific blood cells found in the heme system? RBC (erythrocytes) WBC (leukocytes) Platelets (thrombocytes)
Site of hematopoesis Bone marrow
Reticulocytes are immature ________ RBCs
What type of hemostasis begins with vascular response, when damaged blood vessel vasoconstricts Primary hemostasis
What type of hemostasis begins with platelet response, inactive factors convert to active Secondary hemostasis
Clotting factor: faster, veins Extrinsic
Clotting factor: slower, arteries Intrinsic
What lab count is a reflection of bone marrow activity (increase with severe hemorrhage)? Reticulocyte
Loss of RBCs, decreased production of RBCs, and increased destruction of RBCs are causes of what? Anemia
Hypoproliferative type of anemia. Most common in children and adolescents. R/T blood loss, Fe malabsorption, increased requirements, and insufficient intake Iron-Deficiency Anemia
Fatigue, HA, pale skin and mucous membranes, and smooth, sore tongue are most common symptoms of what type of anemia Iron-Deficiency Anemia
CBC count is low across the board, including low ferritin when this type of anemia has occurred Iron-Deficiency Anemia
Rare type of anemia, characterized by hypoplasia to stem cells in blood marrow. All cell production decreased. Fat where stem cells should be. May be congenital, acquired, or related to toxins. Aplastic Anemia
Symptoms of this anemia develop slowly. Complications of bone marrow before Dx made. Typical s/s classic anemia ss, dyspnea, infection, leukopenia, thrombocytopenia, lymphadonopathy, spleenomegaly. Decreased reticulocytes Aplastic Anemia
Type of anemia caused by deficiency of folic acid or B12. RBCs abnormally large. WBCs, platelets also abnormal size. Bone marrow analysis reveals hyperplasia. Has very few mature cells. Megaloblastic Anemia
Hgb of 4-5, WBC 2-3, Platelets <50, and elevated MCV (usually >110) are indicative of Pancytopenia
Vitamin B12 and Folic Acid deficiencies are types of what type of anemia? Megaloblastic
What is the most common symptom of anemia? Fatigue
What deficiencies result in megaloblastic anemia? Folic Acid and B12
What symptoms differentiate between the two megaloblastic anemias? Neuro (Impaired balance, ataxia, etc.) with B12
Lack of intrinsic factor, normally secreted in the stomach, is called __________ anemia. Pernicious
Genetic disease. Recessive gene trait. Severe hemolytic anemia. Most common in African Americans and Middle Easterners. Sickle Cell Anemia
Clinical manifestations of this disease are tachy HR, murmurs, and cardiomegaly. Jaundice, weakness, Expansion of bone marrow, especially in skull. Enlarged bones. Sickle Cell Anemia
Three major complications of sickle cell anemia are Sickle cell crisis Acute chest syndrome Pulmonary HTN
Hereditary anemia; recessive gene. Characterized by hypochromia, microcytosis, and hemolysis. Most predominant in people of Mediterranean, Africa, and SE Asian descent. Thalassemia
What are two forms of Thalassemia, and what is the difference between the two? Alpha (Mild form) Beta (Severe form)
Diagnosed when newborn. Minor form usually requires no treatment. Major form treated with PRBC transfusions. Curable with HSCT only before liver damage has occurred. Death often r/t heart failure Thalassemia
Condition in which excess Fe+ is absorbed in the GI tract. S/S include weakness, lethargy, hyperpigmentation, dyspnea, arrythmias, cardiomyopathy, and psorosis of the liver. Hemochromatosis
High Fe+, high transferrin, and normal CBC indicate what? (Therapeutic phlebotomies indicated to remove blood to reduce Fe). Hemochromatosis
Goal for management of Hemochromatosis is Fe+ lab value of <_____% and Ferratin <______mcg/L 50% 100mcg/L
Increased volume of RBCs. Secondary is caused by excessive production of erythropoetin. D/t decreased O2: Heavy smoker,COPD, high altitudes Polycthemia
Type A and Type B. Only distinguishable difference is in lab tests. A is more common than B. Affects all ethnic groups equally. Hemophilia
Inherited as x-linked trait, so most people affected are male. Females can be carriers, but usually asymptomatic. Usually diagnosed in childhood after having an injury. Hemophilia
Clinical manifestations include hemorrhages, especially into the joints (75% joint related s/s). Bleeding can occur with or without pain. Most dangerous is cranial. Hemophilia
Management of this includes replacement of defective blood factors, FFP, Immunosuppressive therapy, and Plasmapheresis. Hemophilia
Nursing management includes LOTS of education: Coping, Safety, Prophylaxis, Dental Hygiene, Alert ID Hemophilia
Genetic disorder. Deficient in vWF, which is required for factor 8 activity and platelet adhesion at site of injury. Mucosal bleeding is common. Von Willebrand Disease (vWD)
Labs for this disease: WNL platelets, prolonged PT and APTT Von Willebrand Disease (vWD)
Normal hemostatic mechanisms are altered. NOT a common disease. Impaired anticoagulant pathway and fibrinolytic system suppressed, which allows massive amounts of tiny clots to form in the microcirculation. Dissemented Intravascular Disease (DIC)
Paradoxical effect occurs with consumption of platelets and clotting factors which result in bleeding. Dissemented Intravascular Disease (DIC)
Clinical manifestations include: gradual s/s of organ dysfunction, clotting factors and platelets are being consumed by microthromboses and bleeding occurs, which can range from minimal to profuse hemorrhage. Dissemented Intravascular Disease (DIC)
What disease? Early recognition is key. Must treat underlying cause is #1. Must improve oxygenation! Blood product transfution (PRBCs, platelets, FFP) Ultimate goal is to minimize bleeding and promote tissue perfusion. Dissemented Intravascular Disease (DIC)
Type of leukemia: Age of onset: Peak 67 y/o. S/S=Fatigue, weakness, HA, mouth sores AML
Type of leukemia: Age of onset: Peak 4 y/o. S/S=Fever, fatigue, pallor, bleeding, CNS involved ALL
Type of leukemia: Age of onset: Mean 65 y/o Rare <20 y/o. No early S/S. Rare lymphadenopathy. CML
Type of leukemia: Age of onset Avg 72 y/o. No early S/S; HAS lymphadenopathy CLL
Increased production and presence of all blood cells, especially increased RBCs. Onset 65 y/o. Increased blood viscosity, volume. Decreased Fe reserve. Splenomegaly. Polycthemia Vera
Generalized pruritis in 70% of pts. Erythromelagia (burning sensation in fingers and toes). Elevated labs across the board, including uric acid. Polycthemia Vera
Which type of leukemia is most common in children? ALL
What is the difference between autologous and allogenic? Autologous= Self Allogenic= Another donor
Chemotherapy S/E most commonly occur in which three types of tissue? GI, Skin, Bone Marrow
How much blood is removed initially on a newly diagnosed polycthemia patient? 500ml 1-2 times a week
What is the goal Hct for polycthemia patient? <45%
Relatively rare lymphoma and has a high cure rate. Hodgkin Lymphoma
More common lymphoma in men Hodgkin Lymphoma
2 peaks of incidence: 20s and >55 y/o. Veterans w/ agent orange exposure. 5 year survival rate is 88% and the younger the person, the greater the percentage. Hodgkin Lymphoma
One-sided lymphoma and can spread along same side in lymph system. Hallmark pathology is the spleen, GI tract, and liver. Hodgkin Lymphoma
Has the Reed-Sternberg cell Hodgkin Lymphoma
What are "B" symptoms? Fever, drenching night sweat, and unintentional weight loss
Fever, drenching night sweat, and unintentional weight loss are aka what? "B" symptoms
Fever, drenching night sweat, and unintentional weight loss are symptoms of what lymphoma? Hodgkin Lymphoma
Uncommon, localized lymphoma. Incidence increases with age, median age is 65. Unkown etiology. Arise from primarily B lymphocytes. Non-Hodgkin Lymphoma
Lymphadenopathy is most common sign, but may wax and wane. Also has "B" symptoms, but less common. Non-Hodgkin Lymphoma
Which cell type confirms the diagnosis of Hodgkin's Disease? Reed-Sternberg
How does the extent of disease differ between Hodgkin and Non-Hodgkin Lymphoma? Hodgkin=Local Non-Hodgkin= Disseminated
Malignant disorder of plasma cells. Low survival rate. Non-functional Ig cells. Classic s/s= bone pain, back pain, rib pain. Multiple Myeloma
Increased thirst, dehydration, altered LOC, and coma are S/S of what? Hypercalcemia
Epistaxis, HA, paresthesias, blurred vision, thrombus or HF are symptoms of what? Hyperviscosity
Hypercalcemia and hyperviscosity are S/S of what malignant disease? Multiple Myeloma
CRAB is used for Dx of what? Multiple Myeloma
CRAB stands for what? increased Calcium, Renal insufficiency, Anemia, Bone lesions
Specific to Multiple Myeloma, what protein shows up in urinalysis? Bence-Jones
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Created by: mreedy