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Hematologic and Immunologic Disorders 2
Hematologic and Immunologic Disorders 2
63
Nursing
Undergraduate 2
02/21/2012

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Cards

Term
What is a normal INR level?
Definition
1-3
Term
If INR is high, what usually can not be done.
Definition
Surgery
Term
-needs a signed consent
-usually done with conscious anesthesia, an outpatient setting, or during surgery
-Post-Op: monitor for signs of infection and bleeding, avoid aspirin
Definition
Bone Marrow Aspiration
Term
What spots can a bone marrow aspiration be done at?
Definition
Sternum
Tibia
Illiac Crest (main spot)
Term
What are the 3 reasons for a blood transfusion?
Definition
1. replace or maintain blood volume
2. preserve O2 carrying function of blood
3. increase or maintain coagulation abilities of blood
Term
What are the different types of transfusions?
Definition
Packed Red Blood Cells
Platelets
Fresh Frozen Plasma
Term
What does packed red blood cells have in it and when is it give?
Definition
RBC's w/o plasma

Given to pt w/o a normal blood volume or RBC's also if HgB and Hct is decreased.
Term
When should blood be given to a pt?
Definition
within 2-4 so bacteria doesn't start to grow
Term
What is sometimes given after a blood transfusion and why?
Definition
Lasix: because of so much fluid being put into the body
Term
What pt's usually get platelets?
Definition
chemo
hematologic disorders
open heart surgery
post-op bleeding
Term
What pt's are given blood plasma?
Definition
pt's with defective blood clotting(hemophilia)
after receiving packed RBC's
Term
Whys is plasma given slower?
Definition
it has a lot of volume
Term
What are some nursing responsibilities when giving blood?
Definition
-get vs before transfusion (baseline)
-2 RN's check blood before given
-infusion monitored by RN (15mins)
-blood must be infuse between 2-4 hours
Term
How long do you have to given blood after it has been delivered?
Definition
30mins
Term
If a pt has a negative reaction to a transfusion what must you do?
Definition
1. stop the transfusion
2. start normal saline
3. call the doctor
Term
This reaction has to do with the antigen: antibody incompatibility?
Definition
Hemolytic Reaction
Term
What are S/S of hemolytic reaction?
Definition
- N/V
- Fever/Chills
- Increased Respiration
- Chest Pain
- Oliguria
- Hematuria (bloody urine)
- Low back pain
Term
What are S/S of an allergic reaction during a blood transfusion?
Definition
- Urticaria (hives)
- Pruritus (itching)
- Fever
- Anaphylactic shock
Term
What are S/S of anaphylactic shock?
Definition
- SOB
- Wheezing
- Confusion
- Pallor
- lungs and bronchioles can swell shut
Term
What is a complication from a transfusion which is a really high fever?
Definition
Pyogenic Reaction
Term
What are S/S of pyogenic reaction?
Definition
- fever
- chills
- nausea
- headache
- flushing
- tachycardia
- palpitations
Term
What are S/S of circulatory overload?
Definition
- cough
- increased pulse
- SOB
- edema
Term
With someone with a history of circulatory overload what should be done?
Definition
Give Lasix between and after
Term
What is a treatment that can not cure a disease but makes is tolerable?
Definition
palliative care
Term
What is a generalized term for blood disorders?
Definition
Blood Dyscrasias
Term
Production of RBC's in bone marrow up to 10 million?
Definition
Polycythemia Vera
Term
facts about polycythemia vera?
Definition
- chronic disease occurs in middle age to elderly
- seen in men more then women
- high risk for thrombi
- may cause hyperviscosity (thicker blood)
- may cause hypervolemia (higher volume of blood)
Term
S/S of polycythemia vera?
Definition
- plethoric (reddish complexion)
- headache
- fatigue
- night sweats
- pruritus (itching)
- parenthesis (numbing or tingling of skin)
- dyspnea
- ringing in ears
- blurred vision
Term
Treatment for polycythemia vera?
Definition
suppression of bone marrow: puts pt at risk for infection
-chemo
- removal of blood (better treatment)
Term
While treating polycythemia vera what often develops?
Definition
Leukopenia (low WBC's)
Thrombocytopenia (low platelets)
Term
What is a lower than normal RBC count and HgB?
Definition
Anemia
Term
S/S of anemia?
Definition
- pallor
- decreased activity tolerance
- orthostatic hypotension
- vasoconstriction of the skin, kidney, and peripheral blood vessels
- tachycardia
Term
What is a complete failure of the bone marrow, not making enough or any RBC's?
Definition
Aplastic Anemia
Term
Facts about aplastic anemia?
Definition
- congenital or acquired
- life threatening
- 50% chance of living
- high risk of infection
- adverse reaction to rheumatoid arthritis
- pt will be on isolation if sick
Term
A decrease if RBC's, WBC's, and platelets ?
Definition
Pantocytopenia
Term
S/S of aplastic anemia?
Definition
- pallor
- extreme fatigue
- tachycardia
- SOB
- hyptension
- prolonged/ spontaneous bleeding caused by decrease platelets
- frequent infections that do not resolve caused by decrease WBC's
Term
Interventions for aplastic anemia?
Definition
- identify cause and remove
- bone marrow transplant is treatment of choice
Term
This disorder is when marrow makes adequate amount of cells but destroyed once released into circulation.
Definition
Autoimmune Hemolytic Anemia
Term
What are some caused of autoimmune hemolytic anemia?
Definition
- certain infections
- drug reactions
- cancers
- seen in infants who have the Rh factor but mothers do not
Term
S/S of autoimmune hemolytic anemia?
Definition
- pallor
- extreme fatigue
- tachycardia
- SOB
- hypotension
- jaundice caused by high bilirubin
Term
Treatment for autoimmune hemolytic anemia?
Definition
- blood transfusion: given cautiously
- treatment starts with corticosteroids
- immune suppressors
- remove spleen
Term
This is the most common anemia?
Definition
Iron Deficiency Anemia
Term
Facts about iron deficiency anemia?
Definition
- 90% in women
- iron is stored in utero depleted within first 6 months of life
Term
How much of iron is found in Hgb?
Definition
2/3
Term
Where is iron stored in the body?
Definition
- bone marrow
- spleen
- liver
- muscles
Term
Causes of iron deficiency anemia?
Definition
- diet low in iron
- unable to make adequate amt of HgB with enough iron
- excessive menstrual bleeding
- repeated pregnancies with blood loss
- blood loss in GI tract
- body can't digest or utilize iron
Term
S/S of iron deficiency anemia?
Definition
- fatigue
- orthostatic changes
> HR
< BP
- pica
- dyspnea
- palpitations
- loss of appetite
- brittle, poorly shaped nails
- sore tongue
- difficulty swallowing
- HgB <10
- iron levels decreased
Term
Treatment for iron deficiency anemia?
Definition
- iron supplements
- Vit C : help absorb iron
- eat foods with iron
Term
This is caused by a deficient vit B12?
Definition
Pernicious Anemia
Term
Facts about pernicious anemia?
Definition
- incurable
- affects middle age and older persons
- may cause gastrectomy problems
Term
What happens with a vit B12 deficiency?
Definition
- pt lacks intrinsic factors secreted by stomach necessary to absorption of vit B12
- B12 is necessary for production of RBC's and nervous system function
- rate of destruction of RBC's greater than rate of production
Term
S/S of pernicious anemia?
Definition
- fatigue
- pallor
- weakness
- sore tongue
- numbness of hands/feet
Term
Treatment of pernicious anemia?
Definition
-monthly vitamin B12 injections
Term
This is due to loss of blood?
Definition
Hemorrhagic Anemia
Term
A sudden loss of large amounts of blood?
Definition
acute hemorrhagic anemia
Term
A slow bleed over a long period of time?
Definition
chronic hemorrhagic anemia
Term
S/S of acute hemorrhagic anemia
Definition
- thirst
- increased pulse
- decreased BP
- pallor
- clammy skin
- mental confusion
Term
S/S of chronic hemorrhagic anemia
Definition
- fatigue
- normal pulse
- decreased BP and increase Pulse with exertion
- orthostatic hypotension
- pallor
- headache
- menstrual disturbances
Term
A genetic hemolytic disorder affecting men and women? Abnormal HgB molecule which causes cells to take on a sickle shape when oxygen levels decrease.
Definition
Sickle Cell Anemia
Term
Facts about sickle cell anemia?
Definition
- almost only in African Americans
- 1 in 10 carry the trait
- both parents have to have the trait
Term
S/S of sickle cell anemia?
Definition
- fever/chills
- anemia
- thrombi
- leg ulcers : bad circulation
- jaundice : high billirubin
- pain in chest, bone, and joints
- high rates of maternal complications
Term
Treatment for sickle cell anemia crisis?
Definition
- complete bedrest
- analgesics
- IV fluids
- encourage fluids
- ted hose
Term
A medication only given to sickle cell anemia?
Definition
Hydroxuria
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