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blood & lymph test
blood and lymph
| Question | Answer |
|---|---|
| calculation for blood volume | 0.7 x weight (kg) |
| what is thrombocytopenia? | low platelet count |
| what does Pernicious mean? | deadly fatal |
| what is Pancytopenic? | when all three major blood elements are reduced or absent |
| what is Myeloproliferative? | excessive bone marrow production |
| what is Multiple Myeloma? | immunodeficiency of the bone marrow |
| what is Lymphedema? | lymph vessels are clogged |
| what is Lymphangitis? | inflammation of the lymphatic vessels |
| what is Leucopenia? | low WBC count |
| describe the disorder of Leukemia | too many WBC's accumulating in bone marrow |
| what is Hemarthrosis? | bleeding into the joints |
| what is Heterozygous? | having two different genes |
| what is Homozygous? | having two identical genes |
| what is Hemophilia? | hereditary coagulation disorder caused by lack of factor VIII |
| what is Erythrocytosis? | abnormal increase of circulating RBC's |
| What is Disseminated Intravascular Coagulation? | widestream clotting AND bleeding (losing clotting factors during hemorrhage) |
| what is Aplasia? | blood cell not developing normally |
| Rh factor also known as? | Reese's Factor |
| The lymphatic system helps to mature what? | Lymphocytes (WBC's) |
| Where does Lymph fluid exchange occur? | capillary beds |
| Lymph vessels are connected directly to what? | Circulatory System |
| How many Lymph nodes are in the body? | 500-600 |
| How much blood does the Spleen store? | 500 ml's (1 pint) |
| Which organ produces RBC's before birth? | Spleen |
| Describe the area of the Pulpa in the Spleen. | area that surrounds the lymph follicle |
| Which gland in the body develops the immune system after birth? | Thymus |
| What happens to the Thymus at puberty? | Atrophies, replaced by fat |
| What WBC is the initial responder to any invasion? | Neutrophil |
| What does the Mean Corpuscular Volume (MCV) measure? | the average volume or size of a single RBC |
| What does the Mean Corpuscular Hemoglobin (MCH) measure? | the average amount of Hemoglobin within an RBC |
| What does the Peripheral Smear identify? | examines size, shape, and structure of RBC's, WBC's, and platelets |
| Name one identifying factor of Pernicious Anemia. | B12 deficiency |
| What does the Schilling's Test and Megaloblastic Anemia Profile indicate? | measures the excretion and absorption of Vitamin B12 |
| Gastric Analysis identifies presence of? | Intrinsic Factor (absorption) |
| Describe a Lymphangiography | Contrast medium injected into lymphatic vessels to identify blockage or metastasis |
| What is the most common site for bone marrow aspiration? | Iliac Crest |
| What should you do before ANY contrast injection? | assess kidney function and assess allergies |
| One important nursing intervention post bone marrow aspiration | limit pt activity for 30 minutes |
| Long term iron deficiency leads to what? | Iron Deficiency Anemia |
| Three clinical manifestations of Anemia | Anorexia, Pallor, SOB |
| What is a Reticulocyte? | Immature RBC |
| Age requirement for bone marrow transplant | <50 years old with donor |
| Why would you avoid blood transplant in Anemic patient? | to prevent iron overload and development of antibodies |
| How much blood loss can be tolerated? | <500 ml's |
| Integumentary manifestation of hypovolemic anemia | Pale, cool, moist skin |
| Name a volume expander | Dextran |
| Two types of Crystalloids | NS/LR |
| What is B12 essential for? | blood formation, central nervous system, growth and maturation of body cells |
| Where does the body store B12 reserves? | Liver |
| Etiology of Pernicious Anemia | Autoimmune disorder, affects absorption of B12 via loss of intrinsic factor, long term pathophysiology seen in older adults, leads to many large immature RBC's |
| In which patients are Megaloblasts seen? | Pernicious Anemia |
| Objective manifestations of Pernicious Anemia | Erythematous (raw beef) Tongue, infection of teeth and gums, disorientation, partial/total paralysis |
| Medical management for Pernicious Anemia | long term drug therapy (B12 replacement), folic acid and iron supplements, CBC Q3-6mos |
| Teaching for Anemia patients | space out ADL's, frequent rest periods |
| What is oral leukoplakia? | white patch on tongue |
| Four manifestations of Aplastic Anemia | Repeated infections with high fever, Dyspnea, palpitations, bleeding tendencies |
| Diagnostic test for Aplastic Anemia | Bone marrow biopsy "dry tap" |
| Etiology of Aplastic Anemia | bone stops renewing RBC's and red marrow turns to fatty yellowish marrow |
| What are the two managements for Aplastic Anemia? | Drug Therapy, Marrow Transplant |
| What are the two drugs used for Aplastic Anemia? | Steroids and Androgens |
| Three nursing interventions to prevent bleeding in Aplastic Anemia | stop rectal procedures, shaving, and IM injections |
| Patient teaching for activity intolerance | encourage pt's to engage in activities on a progressive basis |
| Causes of Iron Deficiency Anemia | Chronic bleeding of GI tract, ulcers, alcohol abuse, diverticulosis, tumors, heavy menstruation, subtotal gastrectomy |
| What portion of the GI tract prevents nutrient absorbtion? | lining of the small intestine |
| Common manifestation of Iron Deficiency Anemia | Pallor, Glossitis, SOB, S&S typical to Angina |
| What is Glossitis? | Inflammation and soreness of the tongue |
| What is Phagophagia? | Desire to eat ice, clays, or starches |
| What is Stomatitis? | Inflamed oral cavity |
| Another name for Iron | Ferrous Sulfate |
| Which vitamin helps with absorbtion of iron? | Vitamin C |
| Foods high in iron | organ meats, leafy vegetables, raisins, egg yolk |
| What is the most common genetic disorder in U.S? | Sickle Cell Anemia |
| What makes the RBC sickled? | Hemoglobin S - a defective molecule (normal is Hemoglobin A) |
| What is the number one problem in Sickle Cell Anemia? | PAIN |
| Precipitating factors in Sickle Cell Anemia | Dehydration, Infection, Overexertion, weather changes |
| Why is the abdomen enlarged in sickle cell anemia patients? | pooling of blood in liver, spleen, and other organs |
| Diagnostic test for Sickle Cell Anemia | Hemoglobin Electrophoresis |
| Etiology of Polycythemia | hyperplasia of bone marrow causing increase in erythrocytes, granulocytes, and platelets |
| What is the difference between primary and secondary Polycythemia? | Secondary caused by hypoxia rather than defect in evolution of RBC's, physiologic response to hypoxia not pathologic |
| Multiorgan involvement predisposes the patient to what? | infarctions of vital organs |
| Manifestations of Polycythemia | Splenomegaly, Hepatomegaly, Venous distention, platelet dysfunction causing esophageal varices, epistaxis, GI bleeding, petechiae |
| Subjective assessment with Polycythemia | Sensitivity to hot and cold, itchy skin, vertigo, tinnitus |
| Objective assessment with Polycythemia | Dermatological changes, HTN |
| Medical management for Polycythemia | removal of blood (500-2000 ml's) until levels normalize, drug therapy to decrease bone marrow response |
| What is phlebotomy? | process of blood removal |
| Primary intervention for secondary Polycythemia | maintain adequate oxygenation |
| Primary intervention for Polycythemia Vera | ensure adequate hydration |
| What is the major complication of Polycythemia Vera | THROMBOSIS |
| Jehovas Witnesses may receive what kind of blood? | Autologous |
| Manifestations of Agranulocytosis | ulcerations of the mucous membranes, flu-like symptoms, bronchial pneumonia & UTI in later stages |
| Diagnostic procedures for Agranulocytosis | bone marrow biopsy, WBC differential, cultures |
| What are neutropenic precautions? | preventing fresh fruit, plants, sick visitors and staff |
| Management for Agranulocytosis | Medication, diet, and rest |
| Etiology of Leukemia | increased WBC's invade organs, bones, and lymph nodes |
| ANYTHING THAT AFFECTS BONE MARROW AFFECTS WHAT? | CNS |
| Causes for Leukemia | exposure to radiation, genetics, viruses |
| What are the four classifications of Leukemia? | ALL, AML, CLL, CML |
| Possible first sign of Leukemia | enlarged lymph nodes, painless splenomegaly |
| Patient has been sick for a while but unaware | Leukemia |
| What are diagnostic tests looking for in Leukemia? | increased WBC's in blood, tissue, bones, and organs |
| Subjective complaints with Leukemia | pain in bones and joints, bruising alot |
| Objective findings with Leukemia | occult blood in stool, bleeding of mucous membranes, infection |
| Management of Leukemia | killing excessive WBC's with chemotherapy |
| Chlorambucil, Hydroxyurea, Corticosteroids | Drugs used for Leukemia |
| Where is bone marrow harvested from? | Hip Bone |
| Acute Lymphocytic Leukemia survival rate | 4-6 mos untreated, increased to 5 years with drug therapy, 50% of kids can be cured |
| Acute Myelogenous Leukemia survival rate | remission with 75% of patients, 25% of patients experience 5 year remission |
| Chronic Lymphocytic Leukemia survival rate | early stage 10-12 years, late stage 18 months |
| Etiology of Multiple Myeloma | tumor in middle of marrow moving outward, immunodeficiency disease |
| Indicator of Multiple Myeloma | recurrent bacterial infections |
| What does CRAB stand for in Multiple Myeloma | Calcium Levels, Renal Failure, Anemia, Bone Damage |
| Main complaint in pt's with Multiple Myeloma | BONE PAIN with movement |
| Primary marker for Multiple Myeloma | Bence Jones protein (immunoglobulin) found in blood or urine |
| Antineoplastic drugs interfere with | cell creation |
| Preparation for bone marrow transplant | 4-10 days extreme chemotherapy, marrow transfusion takes 30 days to take hold and function (high risk for infection during this period) |
| What does the fibrinolytic system do? | ensure clotting does not become uncontrolled, dissolves the clot to reestablish perfusion |
| What are the four steps of coagulation homeostasis? | Vessel Spasm, Platelet Plug, Clotting Cascade, Fibrinolysis |
| How long do the vessel spasm effects last | 30 minutes |
| What converts Prothrombin to Thrombin? | Thromboplastin |
| What is the action of Thrombin? | degrades fibrinogen into fibrin |
| What is the action of Tissue Plasminogen Activator? | converts plasminogen into plasmin |
| What is the action of Plasmin? | dissolves fibrin, thereby dissolving the clot |
| What is Thrombocytopenia? | platelets reduced |
| What fraction of platelets is circulating vs stored? | 1/3 stored in spleen, 2/3 circulating |
| Manifestations of Thrombocytopenia | petechiae, bruising, significant/spontaneous bleeding based on severity |
| Name four causes for Thrombocytopenia | recent viral infection, medications, alcohol, history of bleeding tendencies |
| Objective signs of Thrombocytopenia | bleeding gums, epistaxis, tarry dark foul smelling stool, GI bleeding |
| Medical treatment for Thrombocytopenia | CORTISONE, platelet transfusion, plasmapheresis, splenectomy |
| Nursing interventions for Thrombocytopenia | prevent infection, gentle handling, stool softeners and high fiber diet, soft toothbrush, gentle nose blowing |
| What is the difference in Hemophilia A and Hemophilia B? | Hemophilia A most common type (Factor VIII absent), Hemophilia B (Factor IX absent) |
| Christmas disease also known as? | Hemophilia B |
| Manifestations of Hemophilia | large ecchymosis into tissues, muscle deformities, immobile joints, hemarthrosis, excessive bleeding |
| Medical management for Hemophilia | transfusion of missing factors (VIII & IX) |
| Why should a Hemophiliac avoid obesity? | weight puts extra pressure on joints with potential for bleeding |
| Etiology of DIC | over stimulation of clotting and anti-clotting processes, unnecessary clotting in capillaries and lack of clotting where needed |
| Manifestations for DIC | bleeding noted in 3 unrelated sites, diaphoresis with cold and mottled digits |
| What is hemoptysis? | Blood in cough |
| Objective signs for DIC | pulmonary embolism, pulmonary edema, confusion, seizures, hypotension, decreased or absent peripheral pulses |
| What does a positive D-dimer reveal? | elevated levels of fibrin breakdown products |
| Why is medical management for DIC always treating underlying cause? | because DIC is always secondary |
| What is indicated for volume replacement in DIC? | Crystalloids, Transfusions, Vitamin K, Heparin, Aminocaproic Acid, Anti-thrombin III |
| Why is blood pressure not taken in DIC patients? | to minimize subcutaneous bleeding |
| Six medications that have a thrombocytopenic effect | Asprin, Digitalis, Furosemide, NSAIDS, Oral Hypoglycemics, Penicillins |
| What is the cause of Thrombocytopenia? | usually idiopathic |
| What is Von Willibrand's Disease? | abnormally slow coagulation of blood and spontaneous episodes of bleeding |
| What is the medication becoming the treatment of choice for mild Hemophilia? | Desmopressin |
| Calculation for MAP | diastolic x 2 + systolic divided by 3 = MAP |
| Minimum MAP to maintain perfusion | >60 MAP |
| Lymphangitis is caused by what? | acute streptococcal or staphylococcal infection |
| What is myalgia? | muscle pain |
| Manifestations of Lymphangitis | fine red streaks in groin or axilla, not localized, chills fever and local pain |
| What is Lymphadenopathy? | swollen lymph nodes |
| Management for Lymphadenopathy | antimicrobial drugs for infection and hot packs for comfort |
| Diagnostic test to differentiate lymphedema from venous disorders | Lymphangiography |
| Manifestations for Malignant Lymphoma | Pruritus, anemia, weight loss, susceptibility to infection, pleural effusion, bone fractures, paralysis |
| What does Coombs' test reveal? | positive result for antiglobulin (autoimmune response) |
| Lab results for Malignant Lymphoma | increased RBC's, bone scan revealing fractures lesions and tumor infiltration, increased calcium |
| What percentage of water and protein are in the blood? | 90% water, 10% protein |
| What does monoclonal mean? | single cell |
| cytoxan, oncovin, prednisone, adriamycin, bleomycin, methotrexate | chemotherapy agents |
| What is Rituxan? | monoclonal antibody therapy to eliminate malignant cells and induce remission |
| What are autologous grafts? | transplants taken directly from the recipient |
| What are allogenic grafts? | transplants from donor tissue |
| What are Tumor Necrosis Factor and Interferon used for? | Immune system stimulator in bone marrow transplants |
| Traditional regimen for Hodgkin's disease | MOPP |
| What does MOPP stand for? | Mustargen, Oncovin, Matulane, Prednisone |
| What does ABVD stand for? | Adriamycin, Blenoxane, Velban, DTIC-DOME |
| What is Neupogen used for? | stimulates proliferation and differentiation of neutrophils |
| Three nursing interventions for Hodgkins | soothing baths, control fever and perspiration, meticulous skin care |
| How many stages exist for Hodgkins Lymphoma? | 4 |
| What is differentiated in the staging of Hodgkins Lymphoma? | Stage I: single lymph node, Stage II: two lymph nodes on same side of diaphragm, Stage III: abnormal lymph nodes on both sides of diaphragm, may involve spleen, Stage IV: disseminated involvement of one or more tissues with identifiable organ sites |
| What does attenuated mean? | weakening the degree of virulence of a disease organism |
| What is an Antigen? | substance recognized by body as foreign that can trigger an immune response |
| What is cellular immunity dominated by? | T cells |
| What is Humoral immunity dominated by? | B cells |
| What is innate immunity? | body's first line of defense, protects the body against the external environment |
| What is Lymphokine? | chemical factor released by T cells to engage macrophages and prepare them for attack |
| What is plasmapheresis? | removal of plasma that contains contaminants |
| Innate Immunity also know as | non-specific immunity, external |
| Which immunity is the body's last line of defense? | Humoral Immunity |
| What are CD4 cells? | T-helper cells that assist B cells to secrete appropriate antibody |
| What is Lupus? | occurs when body produces antibodies against its own cells, attacks RBC's WBC's and organs |
| What is Raynauds Syndrome? | blue extremity tips, cold hands, bad circulation, cool and clammy |
| What is the most common complication of Lupus? | Anemia |
| What is the Rheumatoid Factor test used for? | to rule out Rheumatoid Arthritis |
| What is citrate used for? | anticoagulant, may cause hypocalcemia |
| What does a cell count <200 indicate? | host has AIDS |
| What do CD4+Lymphocytes help with? | recognize and defend against foreign invaders |
| What is ELISA used for? | to detect certain bacterial antigens and antibodies |
| What is Kaposi's Sarcoma? | a rare cancer of the skin, blue red or purple raised lesions |
| What is Pneumocystis Carinii Pneumonia? | unusual pulmonary disease caused by a fungus |
| What is a retrovirus? | virus that carries it's genetic material in RNA and replicates by converting RNA into DNA |
| What is seroconversion? | development of detectable level of HIV antibodies in the blood |
| What is IV Retrovir used for? | to prevent transmission of AIDS |
| What is the gold standard for HIV? | Western Blot (analyzes small amounts of antibodies) |
| Most common HIV? | HIV1 (HIV2 is less virulent) |
| What types of manifestations occur with HIV patients? | flu-like symptoms |
| When does Seroconversion take place? | 5 days to three months aafter exposure |
| Another name for CD4 | T-helper cell |
| Another name for CD8 | T-suppressor cell |
| What is a normal CD4 level? | 600-1200 |
| What are the differences in A1, A2, and A3 | A1: CD4 >500, A2: CD4 @ 200-499, A3: CD4 <200 |
| After exposure, how long does it take to detect HIV antibodies? | 1-12 weeks |
| Manifestations of HIV | non-productive cough, progressive SOB, pneumonia, vesicular eruptions, shingles, rash |
| GI Manifestations of HIV | watery diarrhea, abdominal pain, weight loss, gastritis, esophagitis |
| What are the diagnostic tests for HIV? | ELISA, Enzyme Immunoassay, Viral Load, CD4 count, CBC |
| What is IGG used for? | to boost immunity |
| What does the Titer check? | levels of immunity |
| What are thimerisol, neomycin, gelatin, and egg protein? | preservatives that most vaccines carry |
| Signs of allergic reaction after immunization | swelling of eyes face or nares, fever over 103F, dyspnea, Hives, convulsions |
| medications to prevent transplantation reactions | Imuran, cyclosporine, mycophenolate |
| medications to prevent acute organ rejection | basiliximab, daclizumab, sirolimus |
| Prevention of ALLOGENIC liver transplant | Tacrolimus |
| What side effect is the classic sign of steroid use? | Moon Face |
Created by:
raoullopez
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