Term
| What is intrinsic factor? |
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Definition
| A hormone secreted by the gastric mucosa |
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Term
| What does intrinsic factor control? |
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Definition
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Term
| What does intrinsic factor combine with? |
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Definition
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Term
| What lack of vitamin and hormone causes pernicious anemia? |
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Definition
| Without intrinsic factor, B12 cannot be absorbed therefor pernicious anemia takes place. |
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Term
| What is iron deficiency anemia? |
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Definition
| The body's iron stores are depleted and there is no iron available for hemoglobin synthesis. |
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Term
| What effects the body's iron storage? |
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Definition
-Age
-Sex
-Rate of growth
-Balance of iron intake and loss |
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Term
| What is the most common type of anemia in all age groups? |
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Definition
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Term
| Who has lessened iron because of their accelerated growth rate? |
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Definition
-Preggers
-Children
-Adolescents |
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Term
| What is the most common cause of iron DA in regular adults? |
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Definition
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Term
| In women, why is iron DA so common? |
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Definition
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Term
| Why are alcoholics at risk for iron DA? |
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Definition
| Causes chronic blood loss in the GI tract |
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Term
| How is Iron DA medically managed? |
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Definition
ORAL
-Ferrous suflate
-Ferrous gluconate
-Ferrous furmarate
IV
-Iron Dextram |
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Term
| If you take iron by mouth, what is important to note? |
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Definition
-Use Straw to not stain teeth
-Take with Vitamin C to increase absorption
-DO NOT TAKE WITH DAIRY!
-Take on empty stomach
-Increase fiber
-Stools will become dark
-Can cause positive fecal blood test
-Can take 6-12 months to correct |
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Term
| What is important to note about injectable iron? |
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Definition
-Small test dose to check for anaphylaxis
-Can cause pain and stain skin
-Use z-track method
-Do not rub injection site
-IV is preferred route |
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Term
| What causes anemia in renal disease? |
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Definition
| A mild shortening of erythropoetin lifespan which causes a general deficiency of it |
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Term
| What does a deficiency in EPO cause? |
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Definition
| Less RBC to be produced AKA anemia in renal disease |
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Term
| What vitamin deficiency is associated with Renal Anemia? |
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Definition
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Term
| What is the treatment for Renal Anemia? |
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Definition
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Term
| What are the side effects associated with Renal Anemia? |
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Definition
-Fluid overload
-Hypertension
-Increase in hematocrit and BP |
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Term
| What is megaloblastic anemia? |
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Definition
There is a deficiency in vitamin b12 or folic acid that causes an identical change in bone marrow and peripheral blood changes because both of these vitamins are needed for normal DNA synthesis.
Tis causes abnormally large (megaloblastic) and bizarre red blood cells and myeloid cells upon bone marrow analysis. |
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Term
| What causes megaloblastic anemia? |
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Definition
| A lack of Vitamin B12 OR Folic Acid |
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Term
| What are the physical manifestations of megaloblastic anemia? |
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Definition
-Mild jaundice
-Vitiligo (loss of skin pigmentation)
-Gray hair
-Smooth, red, sore tongue |
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Term
| Why is vitamin B12 deficiency hard to catch with megalobalstic anemia? |
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Definition
| If folate deficiency is present, the neurological symptoms of b12 deficiency may not be present. MUST BLOOD TEST FOR BOTH LEVELS! |
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Term
| Why are RBC transfusions contraindicated in severe megaloblastic anemia? |
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Definition
| The body has compensative over time by expanding the total blood volume. This overflow of fluids can cause pulmonary edema and fluid overload. |
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Term
| What are the nursing considerations for megaloblastic anemia? |
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Definition
-Pay attention to ambulation/gait
-Eat small amounts of food due to sore tongue
-Encourage mouth care
-Bland diet
-Alcohol induced anemia so be careful |
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Term
| What is the mechanism hemolytic anemia? |
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Definition
The erythrocytes have shortened lifespans so their number in circulation are reduced which causes a reduction in available oxygen which causes hypoxia. Hypoxia stimulates the kidneys to make more erythropoetin to make more RBCs that are released prematurely as retinocytes.
If the destruction continues, the hemoglobin is broken down excessively and heme is converted to bilirubin and excreted in the bile. |
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Term
| What causes autoimmune hemolytic anemia? |
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Definition
Antibody-related
Alloantibodies result from the immunization of a person with foreign antigens (Rh - receives Rh+) |
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Term
| What do antigens do to the blood in A.H.A? |
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Definition
Usually causes the immediate destruction of sensitized erythrocytes either in the blood vessels or the liver.
Most common causes is a hemolytic transfusion rxn. |
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Term
| How is AHA medically managed? |
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Definition
-High doses of corticosteroids until the hemolysis stops
-Severe cases may need a blood transfusion
-Spleenectomy may be performed if corticosteroids don't work
-Give immunosuppresants if spleenectomy is contraindicated or corticosteroids don't work
- |
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Term
| What are the NIC for AHA? |
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Definition
-Teaching about disorder
-Vaccinations after spleenectomy
-Careful monitoring of diabetes in long term steroid use
-Taper don't stop abruptly |
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Term
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Definition
| Hereditary anemias that are HYPOCRHOMIC, MICROCYTOSIS, HEMOLYSIS, AND ANEMIA. |
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Term
| What is hypo chromic? (Thal) |
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Definition
| Abnormal decrease in the hemoglobin content of erythrocytes |
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Term
| What is microcytosis? (Thal) |
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Definition
| Smaller than normal erythrocytes |
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Term
| What are the highest ethnicities of incidence of thalassemia? |
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Definition
-Mediterranean
-African
-SE Asian |
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Term
| What is the difference between Beta and Alpha Thal? |
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Definition
| Alpha: Mainly in ppl of Asian and Middle Eastern people. Milder than beta forms because anemia is not as severe. |
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Term
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Definition
| Packed Red Blood Cells that are given for certain anemias and blood loss. |
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Term
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Definition
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Term
| What are the side effects of Filgastrim/Neupogen? |
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Definition
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Term
| How is the bone pain associated with Filgastrim treated? |
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Definition
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Term
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Definition
Refers to an increased number of RBC caused by hyper proliferation of myeloid stem cells.
Hematocrit elevated to 55% male/50% female |
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Term
| What is a hallmark symptom of polycythemia? |
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Definition
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Term
| What are the levels of hematocrit to note? |
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Definition
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Term
| What are the manifestations of polycythemia? |
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Definition
-Ruddy complexion
-Splenomegaly
-Increased blood volume (dizziness, tinnitus, fatigue, parenthesis, blurred vision)
-Increased blood viscosity (angina, claudication, dyspnea, thrombophlebitis)
-Elevated BP
-Uric acid can be elevated
-Pruritis due to increased basophils and exposure to water
- |
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Term
| What risks are associated with polycythemia? |
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Definition
CVA
MI
Thromboitc complications from thick blood |
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Term
| How is polycythemia medically managed? |
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Definition
-Phlebotomy (removing enough blood to diminish viscosity and maintain hct below 45-42%) This makes them iron deficient, thus unable to produce more RBC
- Hydroxyurea can cause a severe decrease in the number of blood cells in your bone marrow. This may cause certain symptoms and may increase the risk that you will develop a serious infection or bleeding.
-Possible aspirin therapy for anticoagulation and pain |
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Term
| What are the NIC for polycythemia? |
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Definition
-Education on thrombotic complications and decreasing your risk
-Avoid iron supplements
-Use of mild soaps for pruitis, avoid hot water |
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Term
• The nurse is preparing to administer packed RBC to a patient. Which of the following actions should the nurse take prior to administration? Select all that apply.
o A.) Obtain informed consent from patient.
o B.) Check vital signs.
o C.) Maintain NPO
o D.) Verify blood product with another licensed provider.
o E.) Verify patient’s HIV status. |
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Definition
o A.) Obtain informed consent from patient.
o B.) Check vital signs.
o D.) Verify blood product with another licensed provider. |
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Term
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Definition
Rapid, continuous turnover of WB cells.
Too many WBC
Secondary polycythemia. |
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Term
| What is the common feature of leukemia? |
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Definition
| Unregulated proliferation of WBC in the bone marrow that are released too early (leukocytosis). This leaves little room for other cells to be produced (Pancytopneia). |
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Term
| What are the classifications of leukemia? |
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Definition
-Acute
-Chronic
-Myeloid
-Lymphoid |
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Term
• The nurse is caring for patient receiving Heparin therapy. The nurse knows to discontinue the heparin based on which lab value?
o A.) Platelet count is 350,000 down from 400,000 yesterday.
o B.) APTT value of 80 up from ______ yesterday.
o C.) Platelet count is 350,000 up from 300,000.
o D.) APTT value of 80 is down from _______ yesterday. |
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Definition
o A.) Platelet count is 350,000 down from 400,000 yesterday.
Down 50,000 |
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Term
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Definition
| Results from uncontrolled proliferation of immature cells derived from the lymphoid stem cells. |
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Term
| Who is ALL most common in? |
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Definition
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Term
| What is the pathophysiology of ALL? |
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Definition
Immature lymphocytes proliferate in the marrow and impeded the development of normal myeloid cells. Normal hematopoesis is interrupted so there is not a lot of leukocytes, erythrocytes, and platelets.
THERE IS ALWAYS A HIGH PORTION OF IMMATURE CELLS. |
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Term
| What are ALL's affect on other organ systems vs. regular leukemia? |
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Definition
Manifestations of ALL's organ effects are more common than in regular leukemia.
PAIN!!!!!
Bone pain
Liver pain
Spleen pain
Can infiltrate CNS and testes
Testicular Swelling
Headache
Visual Changes
Vomiting |
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Term
|
Definition
-Corticosteroids
-Vinca alkaloids
-Prophylactic chemotherapy in subdural space + head
-Imatinib |
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Term
| What are the NIC with ALL? |
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Definition
-Prevention of infection
-Bleeding
-Management of symptoms like nausea and pain.
-fertility preservation and prevention of pregnancy |
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Term
| What is Hodgkin's Lymphoma? |
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Definition
Rare!
Neoplasms in the lymphoid tissue - more specifically a SINGLE NODE!
Reed-Sternbeg Cell - large tumor cell that is morphologically unique and is immature lymphoid.
Derived from B-Lymphocytes |
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Term
| What are the symptoms associated with Hodgkin's Lymphoma? |
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Definition
| B symptoms that mimic TB: Night sweats, weight loss |
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Term
| What are the manifestations of Hodgkin's? |
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Definition
painless, inflamed nodule above the diaphragm.
-Pruritis
-Cough
-Jaundice
-Abdominal Pain
-Bone pain
-Mild anemia |
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Term
| What labs are drawn of Hodgkin's? |
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Definition
-CBC
-Platelet
-ESR
-Lactate dehydrongenase
-Bone marrow biopsy is perfumed if there are signs of improvement
-Bone scans |
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Term
| How is Hodgkin's treated? |
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Definition
| Combination of chemotherapy and radiation therapy |
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Term
| What is the consideration for older adults when administering PRBC? |
|
Definition
FLUID OVERLOAD!W
HEART FAILURE!
PULMONARY EDEMA! |
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Term
| What is multiple myeloma? |
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Definition
• A malignant disease of the most mature form of B lymphocyte, the plasma cell:
o Results in production of high levels of ineffective immunoglobulins |
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Term
| What is the most common symptom of myeloma? |
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Definition
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Term
| What does treatment of m. myeloma focus on? |
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Definition
| corticosteroids and chemotherapy |
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Term
| What is elevated and lowered in m. myeloma? |
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Definition
Calcium ELEVATED
Phosphorus LOWERED
Calcium blood level is HIGH because of bone break down, phosphorous is inverse. |
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Term
| What is used to treat bone breakdown in myeloma? |
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Definition
| Ambulation, hydration, and calcitonin! |
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Term
| What is needed for bone marrow biopsy? |
|
Definition
-Explanation of procedure
-Antianxiety med if necessary
-Informed signed consent |
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Term
| What teaching is involved post biopsy? |
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Definition
-Do not submerge in bathtub 24 hours after procedure
-May be mild pain 1-2 days post op
-Take mild analgesic
-Avoid aspirin for bleeding risk |
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Term
| What are the 2 major risks associated w/ bone biopsy? |
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Definition
|
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Term
|
Definition
| Lymphocytes derived from the Thymus. Immunological fxn. |
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Term
| What happens in hypoproliferic anemia? |
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Definition
| The marrow cannot produce adequate numbers of erythrocytes |
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Term
| What are the types of hypo proliferative anemia? |
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Definition
-Iron deficiency: not enough iron -> can't make RBC
-Anemia in Renal: not enough EPO -> can't make RBC
-Anemia of chronic disease: disease causes not enough RBC
-Aplastic: damage to bone marrow -> can't make RBC, WBC, or PLT
-Megaloblastic: RBC are too big so blood is really thick -> no room for more RBC so you can a few really big ones |
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Term
| What does aplastic anemia cause? |
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Definition
| Severe anemia, neutropenia, thrombocytopenia |
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Term
| What is the main fxn of t lymphocytes? |
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Definition
Immune response that kills foreign cells directly or by releasing a variety of substances that enhance activity of phagocytic cells.
So cellular immunity |
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