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Exam 3 possible ?s
chpt 30,31,49
| Question | Answer |
|---|---|
| what stimulates hematopoiesis? | erythropoiten |
| what happens to the yellow bone marrow if the pt is anemic | it turns red |
| what is the Gold standard dx? | bone marrow biopsy |
| what is pt teaching in regards to bone marrow biopsy? | pain on aspiration |
| when the liver is not fx, what builds up? | Ammonia (NH3) |
| what is plasma composed of? | 91% water, protein, glucose, hormones, clotting factores, electrolytes, gases, nutrients and wastes |
| what's the difference between bands and segs? | neutrophils segs are more mature |
| what are blast cells? | blast are precursors in the marrow over a period of five days, then become reticulocytes |
| what gives a RBC it's color? | heme |
| sickle cell pts produce abnormal what? | reticulocytes |
| reticulocytes are produced via what system? | negative feedback |
| when a person has kidney failure, what is decreased? | the amount of erythropoiten produced |
| stem cells go through what? | differentiation to become a WBC/RBC/erythrocyte. It becomes a more specialized cell. |
| what is Hct? | it's 3x the amount of Hb- it's the % of packed RBC in whole blood |
| MCH is used to determine what? | iron content |
| MCHC is used to determine what? | monitors the response to therapy- it's the amount of HB in each RBC (Hb/Hct) |
| when do shistocytes appear? | during hemolysis(they are RBC fragments) |
| dehydration does what to the Hct? | causes a false high |
| what happens to K+ w/hemolysis? | since there's usually more inside the cell, they come out- so serum K+ must be checked |
| hypoxia, blood loss & high altitudes cause what? | erythropoisis (increases blood viscosity/Hct) |
| those w/COPD experience what? | constant erythropoises |
| where are monocytes stored? | 30% in the spleen |
| what is in a basophil? | granulocytes consisting of histamine, heparin & seratonin |
| when do bands occur? | during acute trauma, and infx (shift to the left) |
| what type of pt would have a high priority? | one w/low WBC |
| when do u see eosinophils? | during an allergic response, and against parasites (found mostly in lungs and GI) |
| what happens to a person's plt count w/a splenectomy? | it goes up |
| what are macrophages in the liver called? In the bone/lungs? | Kuffer cells (liver), osteoclasts (bone), alveolar macrophages (lungs) |
| what is a normal ANC count? what's abnormal? | normal >1500, neutropenia is < 500 |
| what damages the BM? | chemo- high infx risk |
| what is reverse isolation? | dressing up to keep the pt free from infx (ANC <1000) |
| what are megakaryocytes | precursors to plts |
| what is nadir? | the lowest anount of WBC count after chemo |
| what is the difference w/Nupogen and Epogen | one inc neutrophils, the other inc RBC |
| where is iron absorbed? | the duodenum and upper jejunum |
| how is iron stored? | as heme in Hb or as ferritin and hemosiderin (degrated ferritin)- when RBC dies, macrophages engulf/degrade it, producing hemosiderin. It binds to transferrin or gets stored as ferritin/hemosiderin |
| what are 4 comonentd of hemostasis? | 1. vascular response (PAIN & vasoconstriction to limit loss) 2. platelet plug formation 3. fibrin clot on platelet plug by clotting factors 4.lysis of clot |
| what is the plt stickiness called? | adhesiveness |
| what are plt clumps called? | aggregation/agglutination |
| lysis of a clot happens in what 2 steps? | 1. Antithrombin- interfere w/thrombin 2. fibrinolysis- dissolution of the fibrin clot- usually done through the enzymatic action of plasmin |
| when is the spleen able to have hematopoitic ability? | during fetal development- lost @ birth |
| what are the fx of the spleen? | hematopoietic, filtration, immunologic (lymphocytes, monocytes & immunoglobulins), & storage |
| what would happen if the spleen were removed? | inc risk for infx |
| what could a complication of lymphedema be? and what do u not do? | complication of masectomy or lumpectomy- NO IV or B/P |
| what does the liver produce? | it produces hepcidin- a key regulator of iron balance |
| the elderly have decreased levels of what after middle age? | Hb (dec heme & iron), # of cells, slight dec MCHCq |
| what stays the same in the elderly? | plts, wbc count & differential |
| The elderly are at risk for what? | iron deficiency anemia |
| what is the erythrocyte sedimentation rate (sed rate)? | marker for acute inflammation 9how fast the RBC settle @ the bottom of a centrifuge) |
| dx for iron metabolism entails... | serum iron, total iron-binding capacity (TIBC), serum ferritin, transferrin saturation |
| what are antigens labeled | A & B |
| absence of both antigens is... | Type O |
| presence of both antigens is | Type AB |
| 1/2 the population is what type? | Type O- the universal donor |
| what happens when an Rh negative woman is caring an Rh+ baby? | The 1st pregnancy, nothing happens. The 2nd pregnancy, the mom must take ROGAM to prevent Ab from attacking baby's RBC |
| what nursing intervention is done post BM biopsy? | pressure on site for 10-15 minutes- make sure no bleeding, esp w/ASA and coumadin, have pt lie face down or on their side |
| how much iron should a pt have daily and when? | 150-200 1 hr before meal and w/OJ |
| Never Let Monkeys Eat Bananas | neutrophils 50-70%, lymphocytes 20-40%, monocytes 4-8%, eosinophils 2-4%, basophils 0-2% |
Created by:
arsho453
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