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N103 GRCC Hematology
N103 Test 2 (GRCC) - Hematologic disorders
| Question | Answer |
|---|---|
| Hematologic disorders -anemic disorders | Abnormally low number of circultating red blood cells, hemoglobin concentration or both. |
| Normal HgB for males | 14-18 |
| Normal HgB for Females | 12-14 (best to be 13-15) |
| Hemoglobin | protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues to the lungs. |
| Person is not making enough red blood cells | Hematologic disorders (anemic disorders): Inadequate production |
| Body is destroying RBC's too early | Hematologic disorders (anemic disorders): Inadequate production |
| Blood loss can be bad. T or F | True. Loss of RBC's may result in an hemotologic disorder- anemia. |
| Iron deficiency is commonly seen in which age group & which sex? | Iron deficiency is common in women of child bearing age. |
| Adverse effect of hematologic disorder | Can effect all major organ systems because there is not enough oxygen to the body. |
| Common symptom of hematologic disorder | Bad memory -because brain is not getting enough oxygen. |
| Pathophysiology | study of the changes of normal mechanical, physical, and biochemical functions, either caused by a disease, or resulting from an abnormal syndrome. |
| Pathophysiology of Hematologic disorders | Altered Hgb synthesis |
| Synthesis | refers to the combining of two or more entities to form something new. |
| Altered Hgb synthesis | Deficiency of iron causes problem when making Hgb. |
| B12 & folic acid deficiencies | Altered DNA synthesis |
| Bone marrow failure | Aplastic anemia |
| Acute or chronic blood loss due to trauma, stab wound, etc. | Causes of increased RBC loss or destruction |
| Hemoroids results in GI blood loss | Causes of increased RBC loss or destruction |
| Drinks can cause GI blood loss | Causes of increased RBC loss or destruction |
| Hemolysis related to bacteria, sickel cell, hemolytic strep. | Causes of increased RBC loss or destruction |
| Increase hemolysis | Blood cells broken down or destroyed prematurely. |
| Normal RBC's | These are disc-shaped and look like doughnuts without holes in the center. They move easily through your blood vessels. |
| RBC's contain Hemoglobin | This iron-rich protein gives blood its red color and carries oxygen from the lungs to the rest of the body. |
| Sickle Cell Anemia | a serious disease in which the body makes sickle-shaped red blood cells. “Sickle-shaped” means that the red blood cells are shaped like a "C." |
| Sickle cells contain abnormal hemoglobin that causes the cells to have a sickle shape? T or F | True. Sickle-shaped cells ("C" shaped) don’t move easily through your blood vessels. They’re stiff and sticky and tend to form clumps and get stuck in the blood vessels. |
| How sickle cell anemia effects the body | The clumps of sickle cells block blood flow in the blood vessels that lead to the limbs and organs. Blocked blood vessels can cause pain, serious infections, and organ damage. |
| sx of anemic disorders | Pale skin, pale mucous membrane, pale nail beds. |
| sx of anemic disorders related to circulation system. | Increased heart rate and increased respiratory rate. (Heart gets larger in size cuz it is overworked) |
| Angina, fatigue, DOE (Dysria or Exertion), and night cramps. | sx of an anemic disorders |
| Angina | Sharp, pressing pain in chest caused by CAD and is brought on by exertion. |
| dysria | Urinating during the night. |
| cerbral hypoxia | sx of anemic disorder where a person has chronic dull headache. |
| Pt has sx of heart problems | Related to severe anemia; check Hgb. |
| Circulation shock with blood loss | sx of anemic disorder, initially body maintains BP, but if bleeding continues, BP will decrease that could cause pt to bleed to death. |
| GI bleed can cause death? T or F | T. Internal bleed that is not visible. Pt maintains BP, but BP will decrease if this is left untreated and may cause pt to bleed to death. |
| Acute blood loss anemia | Loss of a lot of blood all at once. |
| Normocytic anemia | Cells are of normal size, but you have a low number of them. |
| Normochrome anemia | Cells are normal color, size, and shape; Hgb and hemocratic are low due to reduced RBC's. |
| Chronic blood loss anemia | Depleting iron storage in body cells get small and pale; microsystic- small & hypochromic - pale |
| Microsystic anemia | Small RBC's |
| Hypochromic anemia | Pale RBC's - a generic term for any type of anemia in which the red blood cells (erythrocytes) are paler than normal |
| Nutritional anemia | Affect ability of RBC formation- |
| Inadequate diet, malabsorption, increased need | Contributing causes to nutritional anemia. |
| Iron deficiency | Common type of nutritional anemia |
| Vitamin B12 deficiency | Common type of nutritional anemia |
| Folic acid deficiency | Common type of nutritional anemia |
| Megaloblastic anemia | rare disorder -the body doesn't absorb enough vitamin B12 from the digestive tract, resulting in an inadequate amount of RBCs produced; characterized by very large rbc's |
| Most common type of anemia; especially of women in child-bearing age. | Iron deficiency anemia |
| Common in babies who are given too much milk between 8mos- 2yrs; not enough iron in milk | Iron deficiency anemia |
| Red meat: men get majority of iron from red meat- mainly because they eat bigger portions of meat. | Iron Food sources |
| Fortified whole grain in breads and cereals and provides 50 -90% daily requirement. | Iron food sources |
| Dry Fruits | Iron food sources |
| Can only absorb very little iron from spinach. | Not the best iron food source. |
| Causes of iron deficiency | Inadequate intake, malabsorption and body's increase need for iron (usually pregnant women) |
| Menstrual loss- chronic loss - require regeneration. | Iron deficiency anemia due to chronic blood loss. |
| Occult blood loss though GI tract (i.e. ulcers, Nsaids, hemoroids, colon cancer, intestinal cancer) | Iron deficiency anemia due to chronic blood loss. |
| Brittle spoon shape nails | Iron deficiency anemia symptoms. |
| Cheilosis - Iron deficiency anemia symptoms. | Cracks on the corners of the mouth |
| Glossitis - Iron deficiency anemia symptoms. | Smooth sore tongue |
| Pica - Iron deficiency anemia symptoms. | Craving for non food items. Cravings include: chalk, ice, laundry starch, clay. |
| Animal meats & eggs | Avoid Vitamin B12 deficiency by eating such food sources. |
| Macrocytic hyperchromic -Vitamin B12 deficiency | Mis-shaped and fragile rbc's, dark red don't carry enough oxygen. |
| Pernicious anemia - Vitamin B12 deficiency | Failure to absorb vitamin B12, due to a lack of intrinsic factor which is secreted by the stomach. |
| Intrinsic factor | Helps absorb vitamin B12 in small intestine- Some people don't have enough and may result in pernicious anemia. |
| Pernicious anemia | Occurs due to stomach removal, gastritis, chrones disease, irritation and to the elderly. |
| Gradual onset; neuro deficiencies | signs of Vitamin B12 deficiencies |
| Neuro- paresthasia | Numbness, tingling in extremities in leg or feet are a signs of vitamin B12 deficiencies |
| Vitamin B12 deficiencies sx | balance, chiliosis, smooth sore tongue & diarrhea. |
| Treatment for vitamin B12 deficiencies | Increase meat, eggs, dairy products |
| Treatment for vitamin B12 deficiencies for vegetarians | Can take supplements. |
| Parenteral B12 given once per month if pt is lacking intrinsic factor. | Treatment for vitamin B12 deficiencies |
| Folic Acid deficiencies | Fragile megaloblastic cells |
| Chronic malnourishment caused by inadequate intake and common among elderly, alcoholics and drug attics. | Folic acid deficiencies |
| Gradual;progressive weakness or fatigue, no neuro symptoms | sx of folic acid deficiencies |
| SOB & Dyspnea on exertion, palpitation, | sx of folic acid deficiencies |
| Glossitis, diarhhea, & chiliosis | sx of folic acid deficiencies |
| Treatment for pt's with folic acid deficiencies | Diet high in fiber in green leafy veggies, fresh fruits, fortified cereals and breads, meats, may need supplements. |
| Hemolytic anemias | Characterized by premature destruction of RBC's |
| Intrinsic Factor causes Hemolyctic anemias | defect within the red blood cell itself; factors are often present at birth (hereditary). |
| Intrinsic Factor that causes Hemolyctic anemias | Within the cell; Abnormalities in the proteins that build normal red blood cells, and differences in the protein inside a red blood cell that carries oxygen (hemoglobin) |
| Extrinsic Factor that causes Hemolyctic anemia | outside the red blood cell; Side Effects from drugs, bacterial infections outside of cell, or trauma (i.e. crush injury) |
| * Abnormal immune system responses * Blood clots in small blood vessels * Certain infections * Side effects from medications | Extrinsic Factor that causes Hemolyctic anemia |
| Hemolytic anemias - | normocytic (normal size rbc's, but low number) and normochromic (normal size, shape, color, but low Hgb and hematocrit) |
| Sickle Cell anemia | Hereditary, chronic anemia most common among persons of African descent. |
| How does sickle cell anemia work? | RBC look normal, but inside they are "C" shaped, then change into an "S" shape- RBC's collide and hook to each other forming clots all over body. |
| Sickle cell statistics | Less than 1% have the disease, and there is a 25% chance that a pregnant woman will pass it on to their child. |
| What happens when RBC shape changes as a result of sickle cell anemia? | Spleen recognizes abnormal "S" shape RBC's and gets rid of them prematurely |
| Aplastic Anemia | Red bone marrow fails to produce rbc's, wbc's, and platelets |
| Aplastic anemia causative agents | Idiopathic (unknown cause), after viral infection, radiation or causes. |
| Pale, fatigue, headache, excertional dyspnea, tachy, bleeding, bruises and fever. | sx of aplastic anemia. |
| Pancytopenia | Lack of cells; A medical condition in which there is a reduction in the number of red and white blood cells, as well as platelets. |
| Aplastic anemia treatment | If there is a known causative agent (i.e. chemotherapy), then stop it. |
| Aplastic anemia treatment | As a last resort, bone marrow transplant; Some people recover, while others don't. |
| Thalassemia anemia | Inherited; the body makes an abnormal form of Hgb ;Major (fatal) or minor (no symptoms) and occurs in people of Mediterranean decent. |
| Acquired hemolytic anemia | Developed after person is born (i.e. people on dialysis- because of this, RBC's are battered, secondary to machine) |
| G6pd : Glucose -6-phosphate-dehydrogenase | This is an enzyme- lack of this enzyme will cause anemia. |
| Diagnostic tests for anemia | CBC - complete blood count/Includes rbc, wbc, platelets |
| Iron levels and TIBC (total iron binding capacity) | Diagnostic test for anemia |
| Serum ferritin | Iron test; Diagnostic test for anemia |
| Sickle cell test | Blood test: diagnostic test for sickle cell anemia |
| Bone Marrow | Exam; get bone marrow out is a sterile procedure drawn from the hip. |
| Aplastic tx | Can not be treated with medication |
| Nursing responsibilities for meds | Folic acid-prenatal vitamins |
| Intake of iron causes | Dark green or black stool. (Easily mistaken black stool for occult blood) |
| Vitamin B12 | Life long treatment (pernincious anemia); given orally daily or IM monthly (usually the 1st of the month) |
| Hydoxyurea | For sickle cell anemia and is given during crisis. |
| Nursing responsibilities for meds | Inform patient they may need to take meds for at lease 6 months. |
| Side effects of iron supplements | Can cause 30% of pts to have diarrhea; However, most patients have constipation. |
| Can upset stomach when absorbed on an empty stomach; its better tolerated with food. | Iron supplements |
| Don't take with antacids | Iron supplements |
| Iron supplements should be taken with what? | Don't take with milk, it is better absorbed with vit C (orange juice), there are also iron pills that come with vit c |
| Too much iron is toxic for young kids | Iron |
| Pernicous anemia | Vit B12 needs to be taken parternally |
| Red blood cell indices | Are measurements that describe the size and oxygen-carrying protein (hemoglobin) content of red blood cells; Part of the CBC test, looks at shape, color and size of rbc's. |
| Anemia | one of the more common blood disorders, occurs when the number of healthy red blood cells decreases. |
| Hemoglobin | is the protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues to the lungs. |
| Hyperchromic | RBC is low, but the cells themselves are abnormally large and carry abnormally large amounts of hemoglobin, the protein that carries oxygen around the body; causes decreases oxygen into body;sx SOB, neuro, and heart problems. |
| Microcytic | Abnormally small cell as related to iron deficiency. |
| aplastic | Bone marrow fails to produce RBC's |
| hemolytic | Premature destruction of rbc's.; inherited enzyme deficiencies;drugs, bacterial, toxins & trauma. |
| hypochromic | Pale rbc's; r/t iron deficiency |
| macrocytic | Abnormally large RBC's |
| pernicious | Vit B12 deficiency; r/t decrease intrinsic factor (intrinsic factor helps absorb Vit B12) |
| Erythropoietin | A hormone produced by the kidney that promotes the formation of red blood cells in the bone marrow |
Created by:
Wends1984
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