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alteration

immunology and hematology

QuestionAnswer
A platelet count less than 100,000/ml is called what? thrombocytopenia
thrombocytopenia can cause this? abnormal bleeding
Petechiae and purpura are caused by this? small vessel bleeding caused by thrombocytopenia
Fatal bleeding can be caused by thrombocytopenia if the level is less than? 10,000/ml
Nursing diagnosis for thrombocytopenia? ineffective protection, risk for bleeding, impaired oral mucous membranes
Tissue hypoxia is a problem with which disorder? anemia
The RN will notice pallor of the skin, mucous membranes and nail beds with this disorder? anemia
Heart rate and respiratory rate rise to compensate for cardiac output and tissue oxygenation in this disorder? anemia
Angina, fatigue, dyspnea on exertion and night cramps are common symptoms of this disorder? anemia
Cerebral hypoxia can cause these symptoms? dizziness, headache and dim vision
Rapid blood loss associated with anemia can cause? Increased heart rate, respiratory rate and decreased blood pressure
Nursing diagnosis of anemia include? activity intolerance, impaired oral mucous membranes, risk for decreased cardiac output and self-care deficit
A decrease in total circulating WBC's is linked to what disorders? neutropenia and leukopenia
Clients with neutropenia and leukopenia are at risk for this? increased infections
Clients with neutropenia and leukopenia may be placed in this? isolation
The patient has a risk for infection diagnosis what are the nursing interventions? promptly report any signs of infection, institute infection protection methods, monitor vitals every 4 hours, monitor neutrophil levels and explain that isolation and other interventions are only temporary
What type of infections develop with nuetropenia and leukopenia? opportunistic, bacterial, fungal and protozoan
Infections that are associated with neutropenia and leukopenia are associated with these body systems? respiratory tract, mucous membranes of the mouth, GI tract and vagina
Malaise, chills and fever are common signs and symptoms of this disorder neutropenia and leukopenia
Extreme weakness and fatigue are manifestations of this disorder? neutropenia and leukopenia
Infections associated with disorders are treated with what? antibiotics
If chemotherapy is causing neutropenia, what will happen? chemo is temporarily stopped
the primary concern with a patient with immunodeficiency is what? infection
have resuscitation equipment available while doing skin allergy testing in case of what? allergy may induce an anaphylactic reaction
For a client with an autoimmune disease such as SLE what lab tests would you want to monitor? BUN & creatinine for renal impairment
Monitor chemotherapy clients WBC closely for what? risk for neutropenia
what does a shift to the left represent? an increased number of immature neutrophils in the blood
infection is a major cause of death in which patients? immunosuppressed
What can cause an older adult to develop autoimmune disorders? the aging process
What is desensitization? a weekly process of introducing increasing amounts of known allergy subdermally
Immunity develops when the body recognized foreign bodies as what? non-self
Which condition is caused by a type 1 IgE hypersensitivity reaction? anaphylaxis
A patient is taking Retrovir, what adverse reaction should she be aware of? leukopenia
The order of administering antigens in allergy testing is based on the prevention of anaphylaxis, which method would the RN use first? prick test because the smallest amount of allergen enters the blood stream
A hypersensitivity response is suspected when a blood product is infusing, what priority intervention would the nurse perform? replace all tubing and attach a new line with NS
What is natural active immunity? Acquired by infection with an antigen, resulting in the production of antibodies, example chickenpox and hepatitis A
What is artificial active immunity? acquired by immunization with an antigen,such as a live virus, examples are MMR, polio, DTP and Hep B
What is natural passive immunity? Acquired by transfer of maternal antibodies by the placenta or breast milk
What is artificial passive immunity? acquired by admission of antibodies or antitoxins in immune globulin, example gamma globulin injection following hep a exposure
How long should the RN observe the patient following a vaccine? 20-30 minutes to observe for possible adverse reactions
What are the 5 factors that may impair healing? malnutrition, vitamin deficits, tissue hypoxia, impaired blood supply, impaired inflammatory and immune processes
When a patient receives gamma globulin following hep a the RN can expect the patient to develop which type of immunity? acquired passive immunity
What is the priority RN intervention in a patient with an infection? obtain a specimen for culture and sensitivity
When administering medications, the RN would know that which medication inhibits prostaglandin synthesis? aspirin
Thalassemia affects which cultures? Mediterraean, Asians & African Americans
Thalassemia causes what to happen to the hemoglobin? decrease
Thalassemia causes what organ to work harder? the spleen
Thalassemia has systemic effects including what? increased RBC destruction, fractures (bone marrow is thinner) and organ failure due to hemolysis and accumulation of iron
A patient with neutropenia is not to have what brought into their room? fresh flowers or fruit
Remember that the suffix -cidial means what? to kill
Titers are done how? diluted to see how many times it can dilute before no response
What can cause changes in the immune system? steroids, immunosuppressants, chemo drugs, polutants, stress, aging process and health status
A patient with an immune disorder will present with what symptoms? enlarged lymphnodes, joint pain and general appearance of weakness
Allergic rhinitis and hay fever are mediated by what? IGe
What are the signs and symptoms of an anaphylaxic shock? itching in palms and scalp, vasodilation, decreased BP, shock, smooth muscle contraction, closing of the bronchis, swelling larynx, fluid loss from capillary permeability
anaphylaxis is which type of hypersensitivity Type 1
Type 2 hypersensitivity is know as what? cytotoxic (hemolytic reactions during blood transfusions)
Type 3 hypersensitivity is known as what? Immune complex
Immune complex causes what signs and symptoms systemic response, fever, rash, joint and muscle aches, swelling lymphnodes
A type 3 hypersensitivity can occur from what? penicillin, animal based drugs & vaccines
Type 4 hypersensitivity is called what? Delayed
What is an example of a type 4 delayed hypersensitivity? latex allergy
What is avoidance therapy? staying away from the causative allergy
What does an antihistamine do? decreases secretions and vasoconstriction
What do decongestants do? vasoconstriction and reduces edema
What do steroids do? reduce inflammation
Mast cell stabilizers do what? prevent but do not treat hypersensitivity
Leukotrines work against what? inflammation
Desensitization does what? dilutes, process known as titers
To identify allergies what labs will be ordered? WBC with differential, will show increased esinophils in patients with type 1
The RAST test will show what? increased IgE in specific allergens
Blood type and cross match are ordered before what? any blood transfusion
Immune complex assays are ordered for which type of hypersensitivity? Type 3
Complement assay is useful in which disorder? Immune complex
What is hyperplasia? increase in the number or density of normal cells
hyperplasia occurs in response to what? stress, increased metabolic demands or elevated levels of hormones
hyperplasia cells are under normal or loss of DNA control normal
Metaplasia is what? cells going into areas where they don't belong
metaplasia is under normal DNA or loss of DNA control normal
dysplasia represents what? loss of DNA control
metaplasia is a protective response to what? adverse conditions
dysplastic cells show a differentiation in what? size, shape, appearance and a disturbance in normal arrangement
What is anaplasia? loss of a cell into an immature or undifferentiated cell type
anaplasia is loss of dna control or normal loss
What are describers of malignant neoplasms? no borders, rapid growers, invasive and non-cohesive
What are some consequences of cancer? GI tract obstruction, increased metabolic rate, altered taste and smell and anorexia
Cancer can cause these symptoms? stress, bleeding, depression, lowered bone marrow and leukocytes and impaired immune system
Cancer also causes motor sensory deficits as evidenced by? compression of nerves, impaired cognitive function and bone fractures
Hormonal manipulation in cancer therapy does what? controls but does not cure cancer, it mimics the hormone causing problems
hormonal manipulation is used to stop what? growth
When a patient is under chemo they may develop mucositis and skin changes, what are the RN interventions? assess oral cavity q4hr, soft bristle tooth brush, no alcohol mouth wash, normal saline rinse before and after meals
Xerostomia is what? excessive dryness of mucous membranes
Chemotherapy can cause many concerns for the patient, what are some of the RN diagnoses? anxiety, disturbed body image, anticipatory grieving, risk for infection and injury, imbalanced body nutrition:less than required, impaired tissue integrity
To prevent cancer patients can? avoid carcinogens, high fat diet and know the 7 warning signs of cancer
What are the 7 warning signs of cancer unusual bleeding/discharge, a sore that does not heal, change in bowel or bladder habits, lump in breast or other part of body, nagging cough, obvious change in moles, difficulty swallowing
What is the ABCD rule in regards to moles asymmetry, border, color and diameter
What is the life span of a RBC? 120 days
what are some age related changes? CRT increases, hair thinner, hairless legs, increased risk for infection, lower protein equals lower fibrogen, dizziness and orthostatic troubles
What is the normal hemoglobin value for women? 12-16 g/dL
What is the normal hemoglobin for men? 13.8-18 g/dL
What is the normal hematocrit for women? 38-47%
what is the normal hematocrit level for men? 40-54%
What is a normal WBC level? 4,000-11,000
what is a normal platelet count? 150,000-400,000
an IV bolus would do what to the hematocrit concentration? decrease it
a patient with a fluid volume deficit would have what effect on hematocrit? increased value
Neutrophils do what? active phagocytes they are the 1st to respond to site of injury
what indicates a shift to the left immature (bands) of neutrophils
Eosinophils are found where? mucosa of intestines and lungs, their numbers increase during allergic reactions and parasitic infections
Neutrophil numbers increase during what? inflammation
Basophils contain what? histamine, heparin and other inflammatory mediators
Basophils increase when? during allergic and inflammation
Which anemia causes CNS manifestations? vitamin b 12 deficiency
which is the most common anemia iron deficiency
without iron the body can not make what hemoglobin
what should a patient take with iron replacement drugs vitamin c
aplastic anemia can lead to what pancytopenia
polycythemia is a RBC concentration greater than what number? 55%
When draining blood for polycythemia how much should the RN drain? 300-500mL
A patient with an acute infection shows a shift to the left on WBC, what does this indicate? increased band neutrophils
A patient admitted with MRSA should be under which isolation? contact precautions
The T cells of the immune system adapt to kill which type of cell? intracellular organisms
How would the RN describe thrombocytosis? increased platelets
An RN is making the diagnosis of risk for infection, who is she making that for? the infected patient, health care workers and other patients
what does the RN primarily monitor when giving antibiotics? hypersensitivities and teaching
The 7 warning signs of cancer spell what to help us remember? CAUTION
A patient with colon cancer has cells from the colon travel to his liver, what is this process called? metastasis
A patient is receiving external radiation, what would the RN teach the patient? do not rub the area, do not use lotions, creams, do not wear tight clothing or belts and stay away from the sun and extreme cold or hot
A patient experiences bone marrow depression as a result of chemotherapy, what would the RN expect to see? low platelet count
tumor lysis syndrome can cause high levels of uric acid, what would the RN give the patient? allopurinol
What is a characteristic of oncogenes? they promote cell growth when activated
What are sources of iron? meat, eggs, dried fruits, greens, oatmeal, bran, brown rice, dried beans
what are sources of folic acid? green veggies, liver, milk, yeast, eggs, kidney beans and wheat
what are sources of vitamin b 12 liver, kidney, shrimp, meats, eggs, cheese, milk
what should you dose prior to chemotherapy antiemetics to prevent N/V
avoid invasive procedures to prevent bleeding related to what disorder? thrombocytopenia
in assessing a patient with moderate anemia, what would the RN expect to see? complaints of SOB with exercise
nutritional deficiency anemia related to absorption would include which of the following? numbness and tingling of extremities
which RN diagnosis is priority for bone marrow patient? ineffective protection, risk for infection
the RN observes a newly admitted patient with reddish purple spots and bruising, what lab test does this support? a low platelet count, increasing the risk of bleeding and bruising
Assess the cancer patients pain, it is what they say it is, which means? never undermedicate the cancer patient
After a transplant the patient has no what? natural immunity
Infection is a major cause of death in which immune type patients? immunosuppressed
a client with a latex allergy needs to be questioned for which food allergy bananas
a schilling test is done to determine the clients ability to do what with vitamin b 12 Absorb it
Epogen injections cause the stimulation of RBC therefore causing what to rise? hematocrit
Vitamin B 12 is non toxic because it is water or fat soluble? water
A client with aplastic anemia should be monitored for what? bleeding and bruising
Children with iron deficient anemia are more prone to infection because of what? decreases in bone marrow functioning
what is the normal WBC level? 4,000-11,000
what is the normal platelet level 150,000-400,000
what is a womans normal hemoglobin level? 12-16
what is a man's normal hemoglobin level 13.5-18
what is a normal level for hematocrit in woman? 38-47%
what is a normal hematocrit level in men? 40-54%
what triggers the development of red blood cells? hypoxia
What is the type of anemia where the red cells are destroyed due to a toxin or virus? aplastic anemia
Manifestations of this body system are seen in B12 anemia but not folic acid anemia? neurologic
What is any protein that is non-self? antigen
A way of expressing the concentration of an antibody in the blood titer
medication to constrice blood vessels in allergic reaction epinepherine
These WBC's are elevated with an allergic reaction eosinophils
These WBC's cause obvious signs of inflammation basophils
These WBC's are elevated with bacterial infection neutrophils
What can be characterized by a hemoglobin greater than 18 and a hematocrit greater than 55 polycythemia
What is one of the cardiovascular manifestations of anemia? tachycardia
what is a medication that lowers inflammatory response steroid
What is a medication used to prevent vasodilation and capillary leak? antihistamine
Fatigue is a nursing diagnosis common with which two disorders? cancer and anemia
Growth of cells not needed for normal development or replacement is called what? neoplasia
Patients with thrombocytopenia are at a risk for what? bleeding
what are treatment options for thrombocytopenia? platelets transfusion, plasmapheresis, immunosuppressive drugs and steroids, splenectomy if necessary
what is pancytopenia? reduced WBC's, RBC's and platelets
The spleen is the site of what? platelet distruction and antibody production
Polycythemia is more common in this male culture? jewish
Polycythemia usually results as hypoxia due to these factors? smoking, high altitudes and heart disease
with polycythemia the blood is thick also called what? viscous
What are the steps in an anaphylasic reaction? assess airway, call rapid response team, administer o2, start iv and infuse ns, administer benadryl or epinephrine finally document
In which anemia will you see PICA, smooth sore tongue, brittle nails and cheilosis? iron deficiency
alcohol, drugs and pregnancy can all be caustic with which anemia folic acid
vitamin b12 deficiency is also known as? pernicious anemia
what diagnostic tests will you do with b12 deficiency? schilling test, rhomburg test and CBC
In a patient with vitamin b12 anemia you can expect to see what? red tongue, tingles, and proprioception (balance issues)
what are the signs of polycythemia? chronic hypoxia, hypertension, tinnitus, blurred vision, plethora (darkening of lips, feet, ears and fingernails, enlarged spleen, weight loss and night sweats
Created by: bkgrota