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blood & lymph (14)
functions, sabs, dx, disrorders, patho
| Question | Answer |
|---|---|
| Disseminated Intravascular Coagulation | |
| bleeding into a joint space | Disseminated Intravascular Coagulation |
| Hemophilia A | hereditary coagulation disorder; caused by lack of antihemophilic factor VIII, which is needed to convert prothrombin into thrombin through thromboplastin component |
| Heterozygous | having two different genes |
| Homozygous | having two identical genes inherited from each parent for a given hereditary characteristic |
| Leukemia | malignant disorder of the hematopoietic system in which an excess of leukocytes accumulates in the bone marrow and lymph nodes |
| Lymphangitis | inflammation of one or more lymphatic vessels or channels that usually results from an acute streptococcal or staphylococcal infection in an extremity |
| Lymphedema | primary or secondary disorder characterized by the accumulation of lymph fluid in soft tissue, resulting in edema |
| Multiple Myeloma | malignant neoplastic immunodeficiency disease of the bone marrow |
| Myeloproliferative | excessive bone marrow production |
| Pancytopenic | deficient condition of all three major blood elements (red cells, white cells and platelets) results from bone marrow being reduced or absent |
| Pernicious | capable of causing great injury or destruction; deadly fatal ion; deadly fatal |
| Reed-Sternberg cell | Atypical histiocytes; large abnormal, multinucleated cells in the lymphatic system, found in Hodgkin’s disease. |
| Thrombocytopenia | An abnormal hematologic condition in which the number of platelets is reduced to fewer than 100,000/mm3 |
| Anemia | A disorder characterized by RBC and hemoglobin and hematocrit levels below normal range is known as? |
| Plasma | 55% Contains 90% water 10% proteins |
| Blood - Normal Function (3) | Transports oxygen and nutrients to cells and waste products away from cells Regulates the acid-base balanceProtects the body against infection and prevents blood loss |
| Erythrocytes (RBC)Proper production | healthy bone marrow adequate vitamins (B12 & B6) and minerals in the body stimulated by a feedback mechanism noting decreased oxygenation Hematocrit – volume of RBC |
| Erythrocytes (RBC) Normal level | 14 to 18 g/dL men 12 to 16 g/dL women |
| Leukocytes (WBC)Conduct body defense from foreign invaders Produced in the bone marrow Normal | Normal 5000 – 10,000 per mm3 Two broad categories: granulocytes agranulocytes Differential WBC count Examine different WBC’s |
| Granulocytes - phagocytes - cells that surround and "eat" invaders , what is a neurtophil? | Neutrophils - make up 70% of WBC Initial responder to any invasion Ingest bacteria & dispose dead tissue 6 day supply in body “seg” mature ~ “band” immature |
| what is a basophil and Eosinophil? | Basophils - key in the inflammatory response Eosinophils - key in allergic responses |
| Leukocytes (WBC) are agranulocytes, what are monocytes? | Monocytes - circulate in blood and work similarly to neutrophils Engulf foreign antigen Macrophages – (mature monocytes) live in tissue (i.e., alveolar macrophages in the lung and Kupffer cells in the liver) |
| what are lymphocytes? | Lymphocytes – directly kill invaders and produce antibodies T cells B cells |
| Platelets, Thrombocytes | Produced in the red bone marrow Assist in clotting formation Normal 150,000 – 400,000 per mm3 Hemostasis (stop to prevent hemorrhage) Vessel spasm Platelet plug formation Clot formation |
| Blood Types, ABO system | ABO system of typing Type A Type B Type AB – universal recipient Type O – universal donor |
| Determined by presence/absence of specific antigens outer surface of RBC | Rh Factor Positive – on outer surface Negative – missing Wrong Rh – antibodies develop |
| Lymphatic System | Subdivision of cardiovascular system Consists of lymphatic vessels, lymph fluid and lymph tissue |
| Lymphatic System - Functions | Maintain fluid balance Produce (mature) lymphocytes WBC produced in the bone marrow but matured in lymph tissue Absorption and transportation of lipids from the intestine to the stream |
| Lymph fluid | Excess fluid & protein - remain in tissues not transported by blood Without lymph drainage, volume overload in tissues Lymph fluid transported back to blood stream through the lymphatic vessels |
| Lymphatic vessels | Vessels connect lymph nodes and collect lymph fluid Connected to the circulatory system for return lymph fluid to blood |
| Lymph tissue | Lymph nodes Tonsils Spleen Thymus |
| Lymph Nodes – functions | Filter impurities from the lymph Produce lymphocytes (WBCs) 500 – 600 in body |
| Tonsils – functions | Protect the body against invasion Produce lymphocytes and antibodies Trap bacteria and may become enlarged |
| Spleen – location | Located in left upper quadrant, just below the diaphragm Highly vascular |
| Spleen – Functions | Reservoir for blood. Stores approximately 500ml Matures lymphocytes, monocytes and plasma cells (B cells) Destroys worn out RBCs Removes bacteria by phagocytosis (macrophages) Produce RBCs before birth |
| Thymus | Located between the lungs in the mediastinum Functions in utero and for several months after birth to develop the immune system Matures T cells Atrophies at puberty |
| What WBC is the initial responder to any invasion? | Neutrophils |
| Lab and Diagnostic Tests | Complete Blood Count (CBC) Red Cell Indices Differential Count Peripheral Smear Schilling Test & Anemia Profile Gastric Analysis Lymphangiography Bone Marrow Aspiration or Biopsy |
| Complete Blood Count (CBC) | Detects disorders & provides data for the diagnosis and evaluation Includes RBC & WBC count hematocrit and hemoglobin level erythrocyte (RBC) indices differential white cell count Examine peripheral blood cells |
| Red Cell Indices | Measure size and hemoglobin content of erythrocytes. Mean corpuscular volume (MCV) size Mean corpuscular hemoglobin (MCH) weight Mean corpuscular hemoglobin concentration (MCHC) Percentage of hemoglobin |
| Mean Corpuscular Volume (MCV) | The average volume or size of a single RBC |
| Differential Count | Actual cell count of leukocytes Identifies the number and percentage of individual types: Neutrophils, basophils, eosinophils Monocytes, macrophages Provides the physician with diagnostic information |
| Peripheral Smear | Often accompany differential WBC count Permits examination of the size, shape, and structure of individual RBCs, WBCs and platelets Most informative of all hematologic tests |
| Schilling Test and Megaloblastic Anemia Profile | Schilling Test and Megaloblastic Anemia Profile |
| Schilling Test and Megaloblastic Anemia Profile | Absorption in the stomach is dependent on intrinsic factor produced by gastric mucosa Patients with large resections of stomach may not produce adequate intrinsic factor to prevent pernicious anemia |
| Schilling Test and Megaloblastic Anemia Profile | Measures excretion of Vitamin B12 after parenteral administration Normal findings are excretion of 8% to 40% of radioactive vitamin B12 within 24 hours |
| Gastric Analysis | Evaluates presence of intrinsic factor In pernicious anemia: gastric secretions minimal pH remains elevated after histamine injection Proper function of parietal cell cause increase in ph with histamine |
| Lymphangiography | A radiological examination used to detect metastatic involvement of the lymph nodes Contrast medium is injected into a lymphatic vessel of the foot or hand, followed by radiological visualization of the lymphatic system |
| Bone Marrow Aspiration or Biopsy | Bone marrow aspiration or biopsy is specific for establishing the diagnosis and for treatment response. Iliac crest most commonly used, although the sternum can also be used |
| Bone Marrow Aspiration or Biopsy | Bone marrow Soft & semi-fluid aspirated through a needle Most commonly performed: Marked anemia Neutropenia Acute leukemia Thrombocytopenia |
| What is the most common site for bone marrow aspiration or biopsy? | Iliac Crest |
| Nursing Interventions and Patient Teaching | Before any diagnostic testing: Determine patient knowledge of procedure Reviews the test procedure Teaches/assesses understanding Patient’s participation before and during procedure Discomfort that might be experienced |
| Nursing Interventions and Patient Teaching | Before any diagnostic testing: Inspects specimen for correct labeling and immediately forwards to the lab When tests involve a puncture: Assess for excessive bleeding Apply pressure Apply pressure dressing to the site as needed |
| Nursing Interventions and Patient Teaching | Before any diagnostic testing: Monitors vital signs during recover Notifies physician regarding adverse responses Analyzes and reports test results promptly |
| Lymph Node Biopsy | Teach/assess understanding of procedure: Conscious sedation Witness consent from |
| Lymphangiography | Teach/assess understanding of procedure: Conscious sedation Procedure in Radiology/ Special procedures Witness consent from Renal function (contrast) Allergies iodine |
| Ultrasonography, CT, MRI | Teach/assess understanding of procedure: conscious sedation (may) Performed to visualize size, structure and flow through the spleen or lymph nodes No special preparation is required |
| Bone scan | Teach/assess understanding of procedure: Performed to identify bone metastasis Radioactive isotope injected into vein and body Scans performed in Nuclear Medicine No special preparation required |
| Bone Marrow Aspiration | Teach/assess understanding of the plan: Approximate time for the bone marrow aspiration Allow patient time for questions & verbalize fears/concerns Witness consent form |
| Bone Marrow Aspiration | Verify history of allergies (patient & records) local anesthetics latex Obtain a sterile bone marrow aspiration tray Add local anesthetic (type & strength) |
| Identify appropriate site proper position the client Suggest distraction techniques avoid focusing on the pressure discomfort associated with puncturing the bone | Bone Marrow Aspiration |
| Bone Marrow Aspiration | Label the specimen and ensure delivery to laboratory Maintain standard precautions Limit activity for approximately 30 min after procedure |
| Bone Marrow Aspiration | Monitor puncture site Bleeding Unusual pain at site Infection Report finding |
| What must be checked before performing lymphangiography? | Renal function Allergies |
| The Nursing Process | Anxiety, related to diagnosis (actual/potential) or diagnostic test Patient verbalizes understanding of need for procedure and has a manageable anxiety level |
| Anxiety Nursing Interventions | Provide privacy, reassurance and information to all patients Allow patient to verbalize fears/concerns regarding procedure and prognosis Provide additional education, as needed |
| The Nursing Process | Knowledge deficit related to test, patient preparation and recovery Patient verbalizes understanding of procedure, preparation and expected recovery |
| Knowledge deficit Nursing Interventions | Provide patient education regarding specimen collection Explain procedures and provide written instructions to the patient for procedure preparation |
| Name a nursing diagnosis appropriate for the patient with a disorder of the blood or lymphatic system. | Anxiety or Knowledge deficit |
| Summary | A: Define key terms related to the blood and lymphatic system. B: Review the normal function of the blood and lymphatic systems. C: Identify laboratory and diagnostic tests used in the diagnosis of blood and lymphatic disorders |
Created by:
redhawk101
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