Details Title: 130 Nursing - RBCs Disorders Description: RBC disorders / Anemia Test #1 Total Flash Cards: 134 Created: 01/11/2008 16:04:01		New Users: To study from this flashcard set, or to create your own your own study flash cards, REGISTER HERE. Existing Users: CLICK HERE. Additional Medical Flashcards
Cards in this set: Term An abnormally low number of circulating RBCs, low Hemoglobin or both is known as: Definition Anemia   Term Morphologic implies: Definition what happens to the cell characteristics during anemia Term The underlying cause of anemia is also call the Definition Etiology Term Name an example of an anemia from an "acute blood loss" reason? Definition Loss of a leg   Surgical Trauma     Term Name a chronic blood loss cause of anemia: Definition Women with menopause or someone with cancer Term Low RBC production is caused by 2 leading reasons: Definition Bad diet   and   Bone Marrow failure Term Why would a person with renal disease have anemia? Definition Because erythropoeitin from the kidneys is not being produced to stimulate RBC production Term What type of blood cell are the most abundant in the body? Definition Erythrocytes Term These are bi-concave shaped: Definition Erythrocytes Term What gives blood its red color? Definition Hemoglobin Term Where does erythropoeisis begin? Definition In the red bone marrow and completed in the blood or the spleen Term How long does RBC production take? Definition 3-5 days Term What physical condition stimulates RBC production: Definition Hypoxia Term An RBC lives about how long? Definition 120 days Term From stemcell to RBC, how long does it take?    And what precipitates this process? Definition 3-5 days   hypoxia stimulates RBC production Term When RBCs are destroyed, what two things get recycled? Definition Iron and Amino Acid Term When RBCs are destroyed, they are lysed where in the body? Definition Spleen, Liver, Bone Marrow and Lymph Nodes Term Destoyed RBCs are converted into what substance? Definition Bilirubin Term Name 5 effects of aging regarding RBCs: Definition 1. RBC production is slower 2. Iron deficiency is common 3. Lower Plasma levels 4. Less Effective immune system 5. Automimmune disorders become more common   (LOW:RBCprod-Iron-Plasma-Immune- & more auto immune disorders) Term What determines and tells the kidneys to produces Erythropoeitin to stimulate RBC production? Definition Hypoxia in the Brain, causes the brain to send the message to the kidneys Term WHere again is RBC destruction usually?  Definition In the spleen and liver Term The following lab test Hb/Hct shows HIGH or LOW values when anemia is present? Definition LOW Term Anemia Signs & Symptoms: SPOON SHAPED NAILS   What type of anemia is this associated with? Definition IRON Deficiency Term Sickle Cell is associated with what population? Definition African Americans Term Whats the normal lab value range for:   RBC Definition 4.2 - 5.14   Term Whats the normal lab value range for:   HGB Definition 11.7 - 17.4 Term Whats the normal lab value range for:   HCT Definition 38 - 49   (38 Special sings for the San Francisco 49-ers) Term Whats the normal lab value range for:   RDW Definition 11.6 - 14.8 Term Whats the normal lab value range for:   PLT Definition 150 - 450     Term Whats the normal lab value range for:   WBC Definition 4.5 - 11 Term MCV stands for Definition Mean Corpuscular Volume Term RDW stands for what? Definition Red Blood Cell Distribution Width.     (a wide width indicates an immature RBC/reticulocyte, and a smaller width means its mature!) Term HGB stands for/indicates what? Definition Indicates the amount of 02 carrying capacity of a heme unit Term RBC lab test stands for what? Definition Actual # of RBCs in the blood Term MCHC? Definition Mean Corpuscular Heme Concentration Term A higher than normal ESR signifies what? Definition clumping of RBCs, meaning faster sinking....   this means infection and disease state b/c protiens bind to the RBCs and they clump and sink fast. Term In coagulation studies, what drug impacts PTT test? Definition Heparin Term In coagulation studies, what drug impacts PT test? Definition COUMADIN Term INR means Int'l Normalized Ratio...  what are normal INR readings? Definition Normal person:  1   Person on coagulants:   2 to 3   Person with atrial problems:   3 to 4   (an INR is always ordered with a PT test) Term What is a D-dimer test? Definition It confirms presence of FSP (Fibrin Split Products)   Normal D-dimer = <250 ug/L   If its higher, you got pulmonary embolism, intravascular diseas, thrombosis, neoplastic disease or Pregnancy.  Term What does LOW HCT mean? i.e. Causes of  Definition Anemia Hemodilution Massive Blood Loss Term What does HIGH HCT mean? i.e. Causes of  Definition POLYCYTOTHEMIA   HEMOCONCENTRATION (can be from dehydration or blood loss) Term An increased platelet count over 450 means what? Definition THROMOBOCYTOSIS (can result from hemorrhage, cancer, anemia or inflammation) Term What does LOW Hb (Hgb) mean? i.e. Causes of  Definition If Low, anemia, hemorrhage or fluid retention (caused by hemodilution) Term What does HIGH Hb (Hgb) mean? i.e. Causes of  Definition If elevated over that 17.4 cap, then it suggests Hemoconcentration from POLYCYTHEMIA or DEHYDRATION Term What is Hb interference?? Definition They're very high white blood cells counts that resist lysys, falsely elevating Hb values.  Term What does LOW RBC mean below 4.2 to 5.14?  i.e. Causes of  Definition Anemia, fluid overload, or hemorrhage Term What does HIGH RBC mean OVER 4.2 to 5.14?  i.e. Causes of  Definition POLYCYTOTHEMIA Term Red Cell indices (aka erythrocyte indices) provied important informatino about Hb concentration, weight and size of an average RBC.     Name the 3 indice and descriptions: Definition MCV - ratio of HCT to RBC indicating RBC avg size   MCH - ratio Hb weight to RBC count, indicates avg RBC weight   MCHC - conc of hb in 100ml packed RBCs Term MCV range is 82 - 98   MCH range is 26 - 46   MCHC range is 31 - 37 Definition If LOW  MCV or MCHC, means microcytic, hypochromic anemias caused by low iron, thalassemia, or b6 anemia   If HIGH, macrocytic anemia caused by FOLIC or B12 deficiency.  Term INR (int'l normalized ratio) does what? Definition can indicate cirrhosis, hepatitis, Vit K deficiency, anticoagulation problems, or massive blood transfusion Term PROTHROMBIN time that is slower than the 10-14 second  range may indicate what? Definition hepatic disease or deficiencies in factors 5,7,VIII, or means they're taking thinners Term Of the anemias, which is the most common form of anemia? Definition Iron Deficiency Term When the body breaks down RBCs too fast, this type of anemia is called Definition Hemolytic Anemia Term 3 anemias caused by DECREASED erythrocyte production: Definition Iron deficient, Thalassemia and Sideroblastic Term Anemias from poor DNA synthesis can lead to megaoblastic anemias.... examples are: Definition Vit B12 and Folic Acid Term T/F:    30% of the world, and 5-10% of the "over-45" US population have Iron-deficiency anemia Definition TRUE Term Lack of erythrocyte-producion building blocks results in _________ anemias. Definition APLASTIC Term 1 mg of Iron is lost daily thru feces, sweat & urine...   TRUE/FALSE Definition TRUE Term Pregnant women lose 2mg per day. Menstrating women lose 1.5 per day.   Of what? Definition IRON Term Iron absorption occurs in what part of the body? Definition duodenum Term Cobalamin and Folic acid's role in Erythropoiesis is? Definition RBC Maturation Term Iron and Vitamin B6's role in Erythropoiesis is? Definition Hemoglobin synthesis Term Amino acid's role in Erythropoiesis is? Definition Synthesis of nucleoproteins Term Vitamin C's role in Erythropoiesis is? Definition Aids in Iron Absorption Term In IRON-deficient anemia, the most common findings is/are: Definition PALLOR & GLOSSITIS   (also chelitis- inflamed lips) Term The best time to take iron supplements is when? Definition 1 hour before meals when the duodenal mucosa is MOST acidic Term Whats a concern regarding liquid iron supplements? Definition Can stain teeth Term 3 side effects of iron ingestion are: Definition heartburn, constipation, diarrhea   (give patients stool softeners ALONG with iron) Term TIBC stands for Definition Total Iron Binding Capacity Term What a nurse needs to know about iron injections: Definition 2ml max per injection 19-20 guage needle 2-3" length give in upper outer quadrant of buttocks Z-TRACK it!   Speed of injection:  1 ml/min (if IV, saline flush the line after) Term Which anemias are considered NORMOCYTIC and NORMOCHROMIC?   (hint: means normal size and normal color)   Mainly, what are the causes of loss of NORMO RBCs? Definition Blood loss Hemolysis Kidney disease Cancers Refractory Anemia Aplastic Anemia Sickle Cell Pregnancy Term You have anemia and your RBCs are MACROCYTIC and NORMOCHROMIC.... what causes this? Definition Low B12, Low FOLIC, liver disease, and post splenectomy Term You have anemia and your RBCs are MICROCYTIC and HYPOCHROMIC.... what causes this? Definition Low IRON, Thalassemia and Lead Poisoning Term Thalassemia minor and major... whats the difference? Definition The patient has ONE Thalassemia gene in MINOR, they have TWO in MAJOR Term Thalassemia symtoms develop in childhood and the #1 signs are Definition PALLOR and JAUNDICE Term What is HEMOCHROMATOSIS? Definition Iron Overloading (comes from too many transfusions and is corrected with Desferal, a chelating agent thta binds to iron) Term Thalassemia patients should take Zinc & Vit C... why? Definition Chelation therapy for the hemochromatosis (iron overloading) using IV deferoxamine makes you lose C and Zinc Term In Sickle Cell, if both parents have the trait, what % in the child is the chance of having that trait?      Also how about the % for disease? Definition 25% of disease....   25% of no disease or trait 50% of carrying the trait! Term Unused Blood should be returned to the lab in 30 minutes or less.    What increments of time to check blood transfusions? Definition at 5 minutes, 15, 30, 45, etc Term Hemoglobinurea is? Definition Excess amounts of the protein part of hemoglobin which the kidney has to filter.. you pee red color. Term Blood tranfusion Administration rules:  What 3 things do you do, and whats the rule of double checking? Definition Has to be checked by 2 nurses   1. check ID of client 2. correct ABO and RH factor 3. Not expired blood Term Blood should tranfuse over how many hours?  Definition 2-3 hours      Anything after 4, the blood can spoil. Term Complications of Blood Administration are? Definition Fever Rash Hemolytic Reaction Anaphylactic Reaction (life threatening) Circulatory Overload Term If you detect a fever, chills or chest pain, or low BP during blood administration, what should you do? Definition Stop transfusion, call MD, treat symptoms, and resume once comfortable. Term If you get an urticarial reaction during blood transfusion, what should you do? Definition Stop transfusion, treat symptoms with BENADRYL, Call MD, and resume once comfortable. Term During a transfusion, what do you do if you get a hemolytic reaction?    (hint: manifested by back & chest pain, fever, SOB, and IMPENDING DOOM) Definition This is a fatal reaction due to imcompatible blood.  RBCs are going to war! STOP INFUSION an Call MD   Keep vien open with NS Term During a transfusion, what do you do if you get a Anaphylactic reaction?    (hint:  allergic reaction) Definition Its an allergic reaction to immunoglobulins, which happens IMMEDIATLY upon infusion.    You'll see GI cramping, vomiting and diarrhea   MAIN ISSUE:  Cardiopulmonary Arrest.  BEGIN CPR Term During a blood transfusion, what do you do if you have circulatory overload?  And what causes it? Definition Its caused by too much too fast!   STOP INFUSION, Call MD Prepare to give diuretics to quell chest pains, cough, FROTHY sputum, crackles and wheezes and increased HR   RESUME infusion later and MUCH SLOWER Term Hemochromatosis is? Definition Its an autosomal recessive disease causing over-absorption of IRON, too much in the tissues.   Common in northern Europeans. Term Hepatomegaly, Diabetes, Bronzing skin color, Arthritis, Cardiomyopathy and "tiny balls" are manifestations of? Definition Hemochromatosis Term Hemochromatosis is treated how? Definition You take out 500ml of blood weekly for 2-3 years.  Term POLYCYTHEMIA is what? What types are there? Definition Excess RBCs (or an HCT over 55) REALLY THICK BLOOD that causes CLOTS   Types:  Primary - 40-70yo Jewish men (Vera) Secondary - elevated erythropoeitin levels  Term What would cause 2ndary Polycythemia? Definition Hypoxia signals brain to tell kidneys to produce more erythropoeitin   Usually high altitudes, smoking, or lung disease is the environmental cause Term Whats D-Dimer? Definition Thrombi (clot) formation Term Whats Hyperuricemia? Definition High Uric Acid Term In Polycythemia, the 3 diagnostic tests are: Definition D-dimer (to find clots) Hyperuricemia (high uric acid d/t RBC lysis) High HGB and HCT in proportion to the RBCs Term Polycythemia S&S are? Definition Headaches, blurred vision, weakness, vertigo,pruritis, pain, Plethora, wieghtloss, thrombotic episodes and Splenomegaly (vera type) Term Worst case complications from polycythemia are: Definition Stroke, HA, DVT, Embolism, Ulcers, Gout, and Bleeding and Bruising Term How is polycythemia treated?  Definition Periodic phlebotomy (blood reduction), low dose aspirin, and HYDREA (a myelsuppressive agent) Term Whats that drug for POLYCYTHEMIA treatment again? Definition HYDREA- a myelsuppressive agent Term Nursing care for POLYCYTHEMIA includes: Definition Give small meals, Monitor bleeding Low Sodium, Low Iron, HIGH CALORIE diet Fluids (3 litres per day) Term PLATELET DISORDERS:   What are unique to cell fragments? Definition They dont have a nucleus and can not replicate Term PLATELET DISORDERS:   What is the normal amount of platelets? Definition 250,000 to 400,000 per ML   (think a $250-$400 plate dinner) Term PLATELET DISORDERS:   Life of a platelet? Definition 8 to 10 days.  Term PLATELET DISORDERS:   What are the 5 stages of HEMOSTASIS? Definition 1. Vessel Spasm 2. Platelet Plug Formation 3. Coagulation 4. Clot retraction 5. Clot dissolution   (think VP CCC -vice pres of craven community college)     Term PLATELET DISORDERS:   Thrombocytopenia is what?  And what is the # lab range indicating this? Definition Its LOW PLATELET COUNT   Anything less than 150,000 per ml Term PLATELET DISORDERS:   Thrombocytopenia is due to what 3 causes? Definition 1. Decreased production 2. Increased amount in spleen 3. Accelerated destruction   (aint makin 'em fast enough, spleens hoggin 'em, and they be getting blown up faster) Term PLATELET DISORDERS:   3 Types of Thrombocytopenia Definition 1. Immune T. Purpura 2. Thrombotic T. Purpura 3. Heparin-induced T. and Thrombosis     Term PLATELET DISORDERS:   Thrombocytopenia S&S? Definition Bleedin' Petichiae Purpura Ecchymoses After injection, they keep bleedin' Internal Bleeding Term PLATELET DISORDERS:   Thrombocytopenia Diagnostic tests:   Definition PT, PTT and INR   and takin a peek at the platelet count under a microscope   Low H&H, Low RBC too... cause if they're Bleedin' a lot 'cause of no platelets, then this will follow. Term PLATELET DISORDERS:   Thrombocytopenia medical treatment includes: Definition Chemo, Steroids, IV Immunoglobulins and a Splenectomy   And Transfusions of Blood, PLatelets and Vitamin K Term PLATELET DISORDERS:   Thrombocytopenia nursing interventions... name a couple..... Definition Bleeding precautions  Teach S&S of bruising Avoid trauma and ASA drugs Limit activities during episodes Term PLATELET DISORDERS:   With Thrombocytopenia, S&S of bleeding are: Definition BLACK tarry stools BLOOD in urine Petechiae Bruise easily Bleeding nose and gums PAINFUL JOINTS Term PLATELET DISORDERS:   HEMOPHILIA is a rare inherited disorder of low levels of one missing clotting factor.  Name the 3 different Hemophilia types? Definition Type A   Type B   VonWillebrand's disease   (A Big Willebrand) Term PLATELET DISORDERS:   In Hemophilia TYPE A, what is the missing factor? Definition Factor VIII   (think Factor Aight) Term PLATELET DISORDERS:   In Hemophilia TYPE B, what is the missing factor? Definition Factor IX   (think Factor Bix) makes no sense but you'll remember it! Term PLATELET DISORDERS:   In Hemophilia TYPE VonWillebrand, what is the missing factor? Definition Factor vW   (think:  Mr. VonnWillebrand drives a VW) Term PLATELET DISORDERS:   In Hemophilia, what are the manefestations? Definition Hemathrosis (blood in the joints) Bruising Bleeding Pain or paralysis Term PLATELET DISORDERS:   With Hemophilia, what diagnostic tests are used? Definition PT Thrombin time Platelet count PTT Bleeding time Factor assays   (so...  PT&PTT, clot&bleed time, Factor tests) Term PLATELET DISORDERS:   How is Hemophilia treated? Definition You marry outside of the British Royal family.   OR   Give Clotting Factor & Desmopressin Acetate too raise levels during surgeries Term What causes DIC? Definition Major Trauma, Cancer, or pretty much any overwhelming infection, even snakebite.    When you have something major, it releases thrombin and "unrestricted clotting".   When you used all the clot factors up... YOU DEAD! Term Early S&S of DIC are: Definition Petechiae & Purpura Ecchymosis Joint Pain Bleeding from puncture sites, mucosa, & GI tract Term Late S&S of DIC? Definition N/V SOB Oliguria (low urine output) Muscle & Back Pain Shock, Convulsions, Coma Bright light at the end of a tunnel lined with dead relatives Term When assessing a patients nutritional-metabolic pattern related to hematologic health, the nurse should check for     Definition Skin texture & color...   i.e. petichiae Term During a transfusion, the nurse should have someone take over her other patients for how many minutes? Definition 15 minutes, by nursing procedure. Term What solution does a nurse prime blood tubing with prior to transfusion? Definition 0.9 Sodium Chloride Term Fresh Plasma should infuse how fast and for how long? Definition As fast as patient can tolerate and within 2 hours of thawing Term Infuse blood at what speed maximum during the first 15 minutes of transfusion? Definition 2ml/minute Term In the emergency room with a sickle cell patient, which  of the following is priority to control the sickling process? 02 IV fluids Morphine Acetamenophen Definition IV fluids!      Because once in crisis, 02 cant control it.  Its better for pending crisis. Term Are Iron Supplements acceptable for Sickle Cell patients? Definition Its not necessary or needed. Term A patient asks what they can take to decrease or cure Sickle Cell Disease.... Which of the following can do this? a) Hemodialysis b) Hydroyurea (Hydrea) c) Hemopoetic Stem Cell Transplantation (HSCT) d) Frequent Blood Transfusion Definition b) Hydroyurea (Hydrea) c) Hemopoetic Stem Cell Transplantation (HSCT)   The others dont cure, they just treat the complications of sickle cell episodes. Term Iron stored in the body is in the form of  __________ and ___________ Definition Ferritin and Hemosiderin Term Definition