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Alterations Lp 5 Hematology
Med surg 120 final
96
Nursing
Undergraduate 1
10/10/2014

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Term
Red bone marrow is produced where?
Definition
In flat and irregular bones; at the end of long bones, pelvis, vertebrae, sacrum, sternum ribs, flat cranial bones, and scapulae.
Term
Describe stem cells in bone marrow?
Definition
Non-differentiated, immature blood cell that is able to renew. Known as the hematopoietic stem cell
Term
Differentiation of blood cells are stimulated by ..
Definition
cytokines, granulocyte colony-stimulating factor (G-CSF), erythropoietin, thrombopoietin, thyroxine, corticosteroids.
Term
The spleen filters and store...
Definition
monocytes, lymphocytes, immunoglobins (plasma), and 30% of platelets
Term
How many RBC in male?
Definition
4.3-5.7
Term
How many RBC (erythrocytes)in a female?
Definition
3.8-5.1
Term
How many thrombocytes (platelets)?
Definition
150,000 - 400,000
Term
How many WBC (Leukocytes)?
Definition
4,000 - 11,000 (4-11)
Term
What is the life span of an erythrocyte (RBC)?
Definition
120 days
Term
Where are antibodies made?
Definition
plasma
Term
Hemoglobin count?
Definition
11.7 - 16.0
Term
Hematocrit count?
Definition
0.35 - 0.47
Term
Where are antigen markers located?
Definition
On the outer surface of every cell
Term
RBC in Female?
Definition
3.8 - 5.1
Term
RBC in Male?
Definition
4.3 - 5.7
Term
Neutrophil count?
Definition
0.50 - 0.70
Term
Basophil count?
Definition
0-0.2
Term
Monocyte count?
Definition
0.04 - 0.08
Term
What type of blood has not antigens?
Definition
Type "O"
Term
What blood type is known as the Universal recipient and why?
Definition
AB because it has no antibodies= no reaction
Term
What blood both A and B antibodies?
Definition
"O"
Term
Type "O" can only receive what blood type?
Definition
"O"
Term
IF I have a reduction in erythrocyte (RBC)count causing me to not make RBC, resulting in a reduced quality of hemoglobin, a reduced volume of packed RBC and hematocrit. Grouped by morphology size, shape, and color...what do I have???
Definition
Anemia
Term
What are the S&S of Anemia?
Definition
Pallor, white inside of eyelid and mucus membranes, a sensitivity to cold, dyspnea, palpitations, and fatigue.
Term
Iron deficiency anemia S &S
Definition
Pallor burning of lips (glossitis) tongue (cheilitis)
Term
Who are more likely to have Iron deficiency anemia?
Definition
30% of the population, the young, those with a poor diet, and reproductive age women
Term
What are the causes of iron deficiency anemia?
Definition
malabsorption, GI duodenum surgery, blood loss, hemolysis.
Term
What is usually given for those with iron deficiency anemia?
Definition
Iron 150-300mg daily before meals with orange juice
Term
What are some foods that can help boost iron?
Definition
liver, spinach, carrots, whole wheat, and legumes.
Term
What is Thalassemia anemia?
Definition
A genetic recessive inadequate production of normal (hemoglobin) and an absent or reduced alpha beta chain globin that is mild to severe.
Term
What is the treatment for Thalassemia anemia?
Definition
Periodic transfusion, chelating agent to bind excess iron to sponge up excess iron. May also need Zinc and Vit C
Term
What ethnic groups are usually affected by Thalassemia?
Definition
Those who's of Mediterranean Sea origins (Asia, Middle East, Africa).
Term
What is the treatment for Thalassemia?
Definition
Blood transfusions in conjunction with chelating agents that bide to iron such as: oral deferasirox (Exjade), or deferipron (Ferriprox) or deferoxamine (Desferal).
Term
What is Megaloblastic anemia?
Definition
A group of disorders caused by impaired DNA synthesis and by the presence of Large RBC. Resulting in defective RBC maturation with fragile cell membranes
Term
What are the possible causes of Megaloblastic anemia?
Definition
genetic errorsin the metabolism of V-B12 (cobalamin, folic acid deficiency or just the result of DNA RNA errors
Term
What is the treatment for Megaloblastic anemia?
Definition
B-12 and folic acid supplements.
Term
What is Cobalamin Anemia?
Definition
(B-12)A lack in the intrinsic factor that is secreted by the parietal cells of the gastric mucosa. This (I.F.) is needed for the absorption of V-B12 (a pernicious anemia).
Term
What are the S&S of Cobalamin Anemia?
Definition
Paresthesia (numbness of hands and feet)and sore beefy red shiny tongue.
Term
W
Definition
Term
What can cause Cobalamin anemia?
Definition
missing intrinsic factor, small bowel surgery, alcohol
Term
Treatments for Cobalamin anemia?
Definition
a diet high in meat, eggs, cheese. Otherwise IM injections monthly and V-B12 shots.
Term
What causes Folic Acid deficiency anemia?
Definition
Dietary deficiency of leafy green vegetables and citrus fruits,fish, organ meats, legumes. Malabsorption syndromes, drugs interfering with the absorption or use of folic acid such as Methotrexate, phenobarbital and Dilantin, increase requirement, alcohol abuse, anorexia, hemodialysis patients because it is lost during dialysis. And bowel resection
Term
What are the S&S of Folic Acid deficiency Anemia?
Definition
Dyspepsia, smooth red beefy tongue
Term
How is Folic Acid deficiency anemia treated?
Definition
With folic acid supplements.
Term
Aplastic, hypoplastic, or pancytopenic Anemia
Definition
A decrease in all blood types
Term
Hypoplastic Anemia
Definition
Term
Causes of Aplastic Anemia?
Definition
Either congenital or acquired due to chemotherapy (most common cause).
Term
What is the treatment for Aplastic Anemia?
Definition
bone marrow transplant or stop chemotherapy treatment.
Term
What are the nursing interventions for sickle cell disease?
Definition
Prevent crisis: dehydration, stress, infection, low O2 stats.
Term
What are the S&S of Sickle cell disease?
Definition
Clumping of cells with hypoxia of any tissue. May cause ischemia of spleen, lungs, kidneys, brain, creation of jaundice.
Term
What is the treatment plan for Sickle Cell?
Definition
pain relief, morphine, hydromorphone, PCA, fluids, o2, transfusion.
Term
What is Thrombocytopeia?
Definition
a reduction of platelets below 150,000.
Term
Von Willebrand (clotting) Factor
Definition
The most important protein mediating platelet adhesion to damaged endothelial cells. Lacks factor VIII coagulation protein highest disorder 1/100 autosomal.
Term
What lab value will be elevated with thrombocytopenia?
Definition
BUN^
Term
What are the S&S of Thrombocytopenia?
Definition
purpura, petechiae, spontaneous bleeding
Term
Common causes of thrombocytopenia?
Definition
Heparin Induced, ASA (especially in rheumatoid Arthritis patients). chemotherapy radiation. Helicobacter pylori.
Term
What is Hemophilia?
Definition
An X-linked recessive genetic disorder caused by a defective or deficient coagulation factor.
Term
Discribe the genetic link to Hemophilia~
Definition
Female carriers parent causes 50% of males born to them to have the disease. 50% of their female offspring will be carriers. Male parents with the disease = all male children will be disease will be disease free and all female children will be carriers.
Term
What are the S&S of hemophilia?
Definition
long prolonged bleeding-hemmorrhage
Term
What test are to be done to diagnose hemophilia?
Definition
Intrinsic pathways, VIII, IX, X, XII and VWF. If blood slows down and becomes static activated.
Term
What is the treatment for hemophilia?
Definition
replacement factors given before surgery dental work, after injuries for A ad WVF, vasopressin (DDAVP) as nasal spray. Pack bleeding joints in ice (to cause vasorestriciton).
Term
Amicar, a drug used to treat Hemophilia does what?
Definition
Antifibrinolytic therapy to stabilize the clots. Stays put!
Term
causes of Hemolytic Anemia
Definition
Physical, hemodialysis, heart-lung machine, artif
Term
What are the s&s of hemophilia?
Definition
long prolonged bleeding-hemmorrhage
Term
How to test for Hemophilia?
Definition
Testing blood for intrinsic pathway factors VIII, IX, X, XII, VWF
Term
Treatment for hemophilia?
Definition
Replacement factors given before surgery, dental work, after injuries, for a WVF: Vasopressin (DDAVP) as a nasal spray. Pack bleeding joints on ice, amican: antifibrinolytic therapy stabilizes clot so it will stay put.
Term
neutropenia
Definition
S&S Fever >100.4, LOW WBC
TX: determine cause and make sure you wash hands around this pt, they need HEPA filter, antibiotics, and neulasta (WBC stimulant). They should be put into isolation.
Term
How does a person feel when they take neulasta?
Definition
Bones will ach
Term
What is Leukemia?
Definition
Blood cell cancer, a proliferation of immature cells. Malignant -effects blood forming tissues, bone marrow, lyph spleen, and is fatal is untreated.
Term
AML (Acute Myelogenous Lukemia)
Definition
in adults, 85% uncontrolled myeloblast. Adults have 15% survival rate, and children have a 95% survival rate.
Term
CML (chronic myelogenous Lukemia)
Definition
clonal stem cells..immature cells blast granulocytes. 60% success rate if in children, 25% if in adults.
Term
Leukemia Treatment
Definition
Chemo radiation, bone marrow transplant, stem cell translation (Remission is the goal).
Term
Induction therapy
Definition
Aggressive initial treatment of Leukemia...70% achieve remission
Term
Intensification
Definition
Treatment of Leukemia using the same drug with higher dose given over several months.
Term
Consolidation
Definition
Leukemia thereof after remission 1-2 additional courses to keep leukemia away.
Term
Maintenance
Definition
After remission of leukemia, a low dose med every 3-4 weeks over years.
Term
What are the nursing implementation's for a patient with Leukemia?
Definition
Be supportive of the patient in the sick role.
Compliance
infection protection (neutropenia)
Expert blood draws/IV starts
absolute caring
nutrition
Term
What is Hodgkin's?
Definition
Makes up about 11% of all lymphomas. It is a malignant condition characterized by proliferation of abnormal giant, multinucleated cells, called Reed-Sternberg cells, which are located in lymph nodes. Normal reticular fiber cells are destroyed.
Term
What age is Hodgkins most common?
Definition
15-35 and above 50 years of age
Term
What causes Hodgkins lymphoma?
Definition
Epstein Barr genetic toxins
Term
How is Hodgkin's diagnosed?
Definition
Usually begins in cervical node 2/3rds spreads to the liver, alcohol ingestion causes pain at site.
Term
What is the s&s of Hodgkin's?
Definition
Weight loss, fatigue, fever, night sweats, chills, tachycardia hepatomegaly,, spleenomegly, Microcytic hypochromic anemia, Leukocytosis, increased platelets.
Term
What is the location of stage I Hodgkin's?
Definition
Node
Term
What is the location of stage II Hodgkin's?
Definition
Nodes and same side of diaphragm
Term
What is the location of stage III Hodgkin's?
Definition
Nodes on both sides of diaphragm
Term
What is the location of stage IV Hodgkins?
Definition
Nodes on both side of diaphragm plus other sites, lungs, liver, bone.
Term
Non-Hodgkin's Lymphoma
Definition
No specialized cells but resides in lymph system characterized by painless lymph node enlargement. Widely disseminated at the time of diagnosis. Same staging used, but prognosis is not as good.
Term
What is the treatment for Non-Hodgkin's Lymphoma?
Definition
Chemo and sometimes radiation, Rituxan, a monoclonal antibody against the CD antigen NHL. Rituxan causes Lysis and cell death once it bindes to cells.
Term
Multiple Myeloma
Definition
Neoplastic plasma cells of B cells or T cells origin invade and destroy bone with a 2 year survival if untreated.
Term
Is Multiple Myeloma more common in Men or Women?
Definition
twice as common in men age 40 -70 and Africans more common than whites
Term
What causes Multiple Myeloma?
Definition
Unknown; however, it is possible that exposure to radiation, organic chemicals (benzene), metals, herbicides, and insecticides may play a role. Genetic factors and viral infection may also influence the risk of development. (HIV EBV)
Term
How is multiple myeloma diagnosed?
Definition
Lab test showing a production of abnormal and excessive IgG, IgA, IgD, IgE immunoglobins and IL-4,5,6. Cytokines causing bone destruction. MRI, PET and CT scans show distinct lytic areas of bone erosions; generalized thinning of bones; or fractures, especially in the vertebrae, ribs, pelvis, and bones of the thigh and upper arms.
Term
S&S of multiple myeloma
Definition
Pain throughout bones as tumors grow. hypocalcaemia fractures, nerve damage from bone collapse, Elevated serum calcium.
Term
If a patient with Multiple myeloma had pain throughout their bones, what would the treatment be?
Definition
gentle weight bearing to build new bone, chemo, and radiation to kill tumor.
Term
If a patient with multiple myeloma had a hypocalcaemia fracture or nerve damage from bone collapse, what would the treatment be?
Definition
Give Aredia to inhibit bone breakdown, give high load calcium to force new calcium into the bones.
Term
If a patient with multiple myeloma had an elevated serum calcium, what would the treatment be?
Definition
give Lasix and 1.5 - 2.0 liters fluid, allopurinol (uric acid) to prevent kidney shutdown.
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