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Hematology
BC3 - Hematology Info
| Question | Answer |
|---|---|
| Components of Blood | Plasma, Serum, Additional cellular elements |
| Plasma | liquid portion of blood; proteins, lytes, clotting factor but mostly water |
| Serum | Clotting factor is removed; pale yellow |
| Cellular Elements of Blood | Erythrocytes, Leukocytes, Platelets |
| Erythrocytes | RBC - carry O2 & CO2 - help buffer; bioconcave disc shaped; flexible to squeeze; should be bright red and all one size |
| Leukocytes | WBC - defense against infection |
| Platelets | clotting - pieces of cells |
| Erythropoiseis | formation of RBC's ; made in the kidneys; produced when the kidneys detect hypoxia |
| Reticulocytes | Immature RBC's; initially made |
| Lifespan of a RBC | 120 days |
| Hemolysis occurs | in the spleen, liver, bone marrow, and lymph nodes; broken down & phagocytized |
| Bilirubin | breakdown product of blood (by-product) |
| Neutrophils | First to arrive; involved in bacterial infection; Produced in 7-14 days; Remain in circulation for 6 hours - very short lived |
| Eosinophils | do not respond to bacterial or viral infection; Allergic response |
| Basophils | Allergic/Inflammatory; Parasitic - do not respond to bacterial or viral infection |
| Monocytes | BIG CELLS - arive 2nd; Can leave circulation and enter tissue - become macrophages |
| Platelets are necessary for | coagulation - they plug holes in body to stop bleeding; made in bone marrow |
| Function of the spleen | Produces RBC's for fetus; Filter - removes old RBC's; Recycles Iron; Stores lymphocytes and monocytes; Stores platelets |
| If spleen is enlarged, it is | under ribs - enlarges downward under left rib cage |
| Lymph System includes | capillaries, ducts, lymph nodes |
| Function of the Lymph System | Carrie fluid from interstitial spaces to blood; Duct empty to veins; Nodes filter bacteria and foreign particles |
| Function of the Liver | Filters dead RBC; Procoagulants - produces clotting factors |
| Geriatric Considerations | tend to loose reserve capacity and RBC's become fragile & don't live long - become anemic; WBC's don't respond as well; have chronic illness = anemia; |
| Children Considerations | RBC's have short life span - don't have same reserve as adults; Inc level of RBC in infants r/t inc need for O2; Increased role of spleen - changes to bone marrow; Newborns & Infants have ^WBC counts |
| Components of a CBC | RBC, Hgb, Hct, Reticulocyte count |
| Components of Differential | MCV, MCH, RBC wt, MCHC, RDW |
| RBC count | 4.7-6.1 in males 4.2-5.4 in females |
| Hgb | 13.5-17.5 in males 11.5-15.5 in females |
| Hct | 40-52 in males 36-48 in females |
| When is a blood transfusion indicated (usually) | Hgb < 8 |
| What happens to Hct if patient is dehydrated | elevates |
| What happens to Hct if patient is over hydrated | decreases |
| If neutrophils are low... | patient may need to be on isolation; neutropenic precautions |
| MCV | mean corpuscular volume |
| What is MCV | average cell volume - size "how big"; important for anemia dx |
| MCH | mean corpuscular hemoglobin |
| What is MCH | average cell hemoglobin - dec MCH=dec Hgb |
| RBC weight | weighs the iron in a cell (iron weighs alot) |
| MCHC | ratio of amount of Hgb in cell to volume - proportion; ^MCHC = too much iron; dec MCHC = dec iron |
| RDW | RBC Distribution Width; should be uniform - if ^, something wrong with RBC, possibly anemia |
| Differential Shift refers to | white cells |
| If Bands are immature | immature WBC's - similar to stab cells |
| "Shift to the left" | more immature than mature (acute) |
| If a "shift to the left" is ongoing | indicates an acute bacterial infection |
| Mature Neurtophils indicate a | chronic problem |
| "Shift to the right" indicates | ongoing - increase infection, inflammation, tissue necrosis, leukemic neoplasis, also trauma/stress |
| Sed rate is (def) | the rate at which RBC's settle in solution( |
| What is sed rate used for | a screening tool or to monitor course of illness |
| Increased sed rate can indicate | Inflammation, neoplasm, infection, necrosis |
| What do you worry about with giving a patient blood | the antibody |
| If a patient has Type A blood they have | A antigen; B antibody |
| If a patient has Type B blood they have | B antigen; A antibody |
| If a patient has AB blood they have | A +B antigens; no antibodies |
| Type AB blood is the universal | recipient |
| A patient that has Type O blood has | neither A nor B antigens; A and B antibodies |
| O blood is the universal | donor |
| What is an antigen | something that triggers and immune response |
| Bone Marrow Examinations | iliac crest; done at the bedside; painful - at risk for bleeding; patient is to ly still and apply pressure for 5-10 minutes |
| Normocytic, Normochromic | Normal cell - Normal color; could indicate lost blood |
| Macrocytic, Normochromic | Big cell - normal color; Not hemoglobin or Fe problem; elevated MCV |
| Microcytic, Jypochromic | Small cells - pale color; Could indicate Fe deficiency anemia; decreased MCV |
Created by:
okrecota
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