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Med surg III UNIT 6
objective 3-4 hematology
66
Nursing
Undergraduate 1
04/07/2012

Additional Nursing Flashcards

 


 

Cards

Term
What does the Hct and Hgb tell you about anemia
Definition

tells you about anemia that has occured with in 20-90 days.

There may be a dilay in seeing recovery as well. Until new  RCB's are produced.

Term
What is the best method of monitoring a pts recovery from anemia
Definition

 

Reticulocyte count (immature RBC's)-

will increase with treatment

 

or

RDW- RBC distribution with increases

once recovering

 

Term

What categories are anemia classified as?

 

What is it based on?

Definition

mild 10-14, mod 6-10, severe  <6

 

Hgb level

Term
After an acute blood loss how long will it take to get an acute view of the Hgb and Hct values?
Definition
48-72 hours
Term
What is the anemia of chronic disease?
Definition

anemia that is seen in the elderly with multiple comorbidities and those with chronic conditions.

 

Indications: ↓ Fe, ↑ TIBC (total iron binding capacity)

and ↑ferritin

Term
What genetically transmitted anemia's will complicate and acute situation?
Definition
sickle cell, thalassemia
Term

Anemia

INTEGUMENTARY MANIFESTATIONS:

Definition

Pallor, especially of the ears, the nail beds, the palmar creases, the conjunctivae, and around the mouth

• Cool to the touch

 • Intolerance of cold temperatures

 • Nails become brittle and may lose the normal convex shape; over time, nails become concave and fingers assume club-like appearance

Term

Anemia

CARDIOVASCULAR MANIFESTATIONS

Definition

Tachycardia at basal activity levels, increasing with activity and during and immediately after meals

• Murmurs and gallops heard on auscultation when anemia is severe

• Orthostatic hypotension

Term

Anemia

RESPIRATORY MANIFESTATIONS

Definition

Dyspnea on exertion

• Decreased oxygen saturation levels

Term

Anemia

NEUROLOGIC MANIFESTATIONS

Definition

Increased somnolence and fatigue

• Headache

Term
Immunohemolytic Anemia result from...
Definition
immune system products (e.g., antibodies) attack a person's own RBCs for unknown reasons.
Term

In Iron Deficiency Anemia RBCs are


(size)?

Definition
small (microcytic)
Term
In iron deficiency anemia, serum ferritin values are:
Definition

LOW

 

less than 10 n g/mL (normal range is 12 to 300 ng/mL).

 

Term
Iron deficiency anemia  can result from:
Definition
blood loss, poor GI absorption of iron, and an inadequate diet.
Term
Any adult with iron deficiency shouldALWAYS be evaluated for: 
Definition
abnormal bleeding, especially from the GI tract.
Term
The management of iron d efficiency anemia involves increasing the oral intake of iron from food sources such as:
Definition
red meat, organ meat, egg yolks, kidney beans, leafy green vegetables, and raisins
Term
Vitamin B12 deficiency causes anemia by inhibiting:
Definition

folic acid transport and reducing DNA synthesis in precursor cells to RBC

 

These precursor cells then undergo improper DNA synthesis and increase in size

Term

Vitamin B12 Deficiency Anemia is called


(size of cells)

Definition
megaloblastic or macrocytic anemia because of the large size of these abnormal cells.
Term
Vitamin B12 deficiency results from
Definition

poor intake of foods containing vitamin B12. This can occur with vegetarian diets or diets lacking dairy products.

 

small bowel resection, diverticula, tapeworm, or overgrowth of intestinal bacteria

Term
pernicious anemia is caused by
Definition
deficiency of intrinsic factor (a substance normally secreted by the gastric mucosa), which is needed for intestinal absorption of vitamin B12.
Term
foods rich in vitamin B12
Definition
animal proteins, eggs, nuts, dairy products, dried beans, citrus fruit, leafy green vegetables
Term
Aplastic anemia is a deficiency of-
Definition

circulating red blood cells (RBCs)

 

because of failure of the b one marrow to produce these cells.

Term

Labs:      MCV                  MCH                RDW

 

 

PTs:         ↓                        ↓                      ↑



based on these values what type of anemia

does the pt have

Definition
Iron deficiency anemia
Term

Labs:      MCV                  MCH                RDW

 

 

PTs:         ↑                    norm                      ↑



based on these values what type of anemia

does the pt have

Definition
Pernitious or B12 
Term

Labs:      MCV                  MCH                RDW

 

 

PTs:         ↓                        ↓                   norm



based on these values what type of anemia

does the pt have

Definition
Thalacmia
Term
If your pt has a elevated neutrophil count what might you assume?
Definition
the presences of a bacterial infection
Term
If your pt has a elevated lymphocyte count what might you assume?
Definition
viral infection
Term
if your pt is having an allergic reaction what WBC will be elevated?
Definition
Eosinophils and Basophils (and stress)
Term
What do monocytes do 
Definition

clean up debris from infection 

can indicate infection is resolved

Term
What is neutropenia
Definition

neutrophils < 15%

indicates sever disease



Term
What drugs can cause neutropenia
Definition

Abx: sulfonamides, Aminoglycosides

Anti-retovirals

chlopromazine

Cimetadine

phenytion

Methymazole

Term
What drug does vitamin K block?
Definition
Coumadin
Term
What labs need to be drawn your pt is on Comedian?
Definition

Prothrobin time (PT)

  INR

Term
When a pt is on coumadin what do you want there PT range to be?
Definition
1.5-2 X the norm
Term
what it the thariputice range for a pt on heprin?
Definition
1.5-2.5 X norm
Term
What labs should be drawn when a pt is on heprin?
Definition
PTT
Term
What is the antagonist for heprin?
Definition
Protamine Sulfat
Term

Coumadin

What is the Most important patient education: 

Definition
Teach patients to monitor for bleeding, to modify behavior to avoid injuries, and to avoid greatly increased vitamin K intake.
Term
When would a pt be diagnosed with thrombocytopenia
Definition

when plaitlets are < 250,000

severe when < 100,000

Term
What  is HIT
Definition

heparin induced thrombocytopenia

 

autoimmune triggered by heparin reaction platelets are destroyed 

Term
Why do pt's typically receive PRBC's
Definition

to ↑ O2 carrying capacity

or

correct anemias

Term
Why do pt's typically receive FFP
Definition

intravascular vol. expansion

increase clotting factors

Term
Why do pt's typically receive platelets
Definition
restore clotting ability
Term
Why is giving blood components better then giving whole blood
Definition

more spicific treatment of the condition

reduced risk of transfution reactions

a single unit donated can treat multiple patients

Term
What is natural immunity
Definition
protection to a person that is given by being a member of the species 
Term
What is active acquired immunity
Definition

your immune system has been activated to produce antibodies against a specific antigen

 

(Immunizations)

Term
What is passive acquired immunity
Definition

a person receives a foreign antibody

 

(breast feeding, IGg)

Term
What is Humeral immunity
Definition

involves the B lymphocytes

produces specific antibodies, plasma cells and memory cells

 

Term
What is cell-mediadted immunity
Definition

involves the T-lymphocytes

identifying pathogens and triggering the 

Humoral system 

Term
What is the complement system?
Definition
the antigen antibody coplex that ends product is stimulation of coagulation, mast cells, and platelets.
Term

What is Histocompatability Class I

Definition

found on all cells and tissues 

involes groups  A B C

Term
What is Histocompatability Class II
Definition

found on B lymphocytes and microphages

involes the D and DR groups

Term
What is Histocompatability Class III
Definition

found on RBC's and complement used for blood typing

involves groups A, B, and O

Term

 

What is a Type I – (Allergic / Anaphylactic) 

Immune Reactions

 

Definition
hypersensitivity reactions are IgE-mediated responses which occur relatively rapidly following exposure to a previously-encountered antigen.  
Term

What is a Type II – (Cytotoxic)

 

Immune Reactions

Definition
 are caused by antibodies which react with self-antigens, and the direct toxicity which results in this interaction.  
Term

What is a Type III – (Immune Complex)

 

Immune Reactions

Definition
antibody-mediated, but they involve the deposition of pre-formed immune complexes and resultant complement activation.  Immune complexes GN's such aslupus nephritis and post-strep glomerulonephritis are the classic examples here. 
Term

What is a Type IV (Cell-mediated / Delayed)

 

 

Immune Reactions

Definition
mediated predominantly by T-cells, which explains why the lag time from exposure to immune response is somewhat delayed compared to the other immune reaction types.
Term

What is Autoimmune dysfunctions?

 

Definition
The body fails to self from nonself and attacs the body
Term

What is the Original insult therory of Autoimmune dysfunctions

Definition
virus caused 
Term

What is the  Genetic factor theory of Autoimmune dysfunctions

 

Definition
familial HLA alter immune function
Term
What is the  Alloimmunity theory of Autoimmune dysfunctions
Definition
exposure to tissue not their won but in the same species
Term

What are Primary Immunodeficiencies

Definition
congenital - falty B cells or T cells
Term
What are secondary Immunodeficiencies
Definition

diseas prossess- HIV, Lupis

Aging-↓  T cell function

malnutrition- ↓ # and function of lyphocytes

stress- releases cortisole → ↓ T cell responce

trauma- ↓ chemotaxis, phagocytosis and anitbody production

Term
What complaints may a pt have if they are Immunocompromised
Definition
fever, fatiuge, lymmphadenopathy,bleeding
Term
What are risk factors for becoming Immunocompromised
Definition
pre-existing disease, meds, ect
Term

What can the nurse do to pormote the protection of patient who is Immunocompromised

 

Definition

Environmental controls

promote skin integrity, nutritional status, pulmonary toilet

and prevent injury          

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