Shared Flashcard Set

Details

Hematologic problems
NU 350 test 3 (1.5)
151
Nursing
Undergraduate 3
02/23/2010

Additional Nursing Flashcards

 


 

Cards

Term
What are the two types of blood dyscrasias?
Definition
Nonmalignant
Malignant
Term
What is anemia?
Definition
The deficiency in the number of RBC's, the quality of HgB and/or the volume of RBC's which can lead to hypoxia
Term
What is used to determine the severity of anemia?
Definition
HgB levels
Term
What are some interventions for anemia?
Definition
Blood or blood transfusions
Drug therapy
Volume replacement
O2 therapy
Dietary modification
Lifestyle changes
Term
What are the two classifications of anemias?
Definition
Morphologic
Etiologic
Term
What is morphologic anemia?
Definition
abnormal shape, size, color etc.
Can be found with objective data
Term
What is etiologic anemia?
Definition
Has an underlying cause such as chemotherapy or blood loss
Term
What causes clinical manifestations of anemia?
Definition
Caused by body's response to tissue hypoxia
Term
What are the integumentary manifestations of anemia?
Definition
Pallor (v HgB, v blood flow to the skin)
Jaundice (^ serum Bili)
Puritius (^ serum and akin bile salt)
Term
What are the cardiopulmonary manifestations of anemia?
Definition
Additional attempts by the heart and lungs to provide adequate O2 to the tissues
^ HR
^ Stroke volume
Term
What are the RBC levels for mild anemia?
Definition
10-14 g/dl
Term
What are the clinical manifestations of anemia?
Definition
May exist without symptoms
Possible symptoms (Palpitations, dyspnea, diaphoresis)
Term
What are the RBC levels of moderate anemia?
Definition
6-10g/dl
Term
What are the clinical mainfestations of moderate anemia?
Definition
Increased cardiopulmonary symptoms during rest
Term
What is the RBC level for severe anemia?
Definition
<6 g/dl
Term
What are the clinical manifestations of the integument during severe anemia?
Definition
Pallor
Jaundice
Puritis
Term
What are the clinical manifestation of the eyes during severe anemia?
Definition
Icteric sclera (brown spots)
Term
What are the clinical manifestations of the mouth during severe anemia?
Definition
Shiny, smooth tongue
Term
What are the clinical manifestations of the CV system in severe anemia?
Definition
Tachycardia
Systolic murmur
Angina
MI
Term
What are the clinical manifestation of the pulmonary system in severe anemia?
Definition
Dyspnea
Tachynea
Orthopnea
Term
What are the neurologic clinical manifestations of severe anemia?
Definition
HA
Vertigo
Irritably
Depression
Term
What are the GI clinical manifestations of severe anemia?
Definition
Anorexia
Heapaticmegaly
Spleenamegaly
Sores in the mouth
Difficulty swallowing
Term
What are the musculoskeletal clinical mainfestations of severe anemia?
Definition
Bone pain
Weight loss
Sensitive to cold
Term
What subjective data should a nurse get to assess anemia?
Definition
Health hx
Medications
surgery or other treatments
Term
What objective data should a nurse get to support anemia?
Definition
General
Integumentary
Respiratory
Cardiovascular
Gastrointestinal
Neurologic
Term
What are common reasons for anemia in older adults?
Definition
Chronic disease
Nutritional deficiencies
Term
Why are the S/S often unrecognized in older adults?
Definition
Mistaken for normal aging changes
Term
What is the life span of a RBC
Definition
120 days
Term
What are 3 alterations in erythropoiesis that decrease RBC production (results in anemia)?
Definition
Decreased hemoglobin synthesis
Defective DNA synthesis in RBCs
Diminished availability of erythrocyte precursors
Term
What is one of the most common chroinc hematologic disorders?
Definition
Iron-deficiency anemia
Term
Who is affected by iron-deficiency anemia?
Definition
Young
Old
Pregnant
Low socioeconomic status
Term
What does iron deficiency anemia develop from?
Definition
Inadequate dietary intake
Malabsorption
Blood loss: usually GI or GU bleed
Hemodialysis
Term
What are the top two common clinical manifestations of iron-deficiency anemia?
Definition
Pallor
Glositis
Term
What are common diagnostic studies for iron-deficiency anemia?
Definition
Lab
Stool guaiac test
Endoscopy
Clonoscopy
Term
What are common LAB tests for iron-deficiency anemia?
Definition
HgB
Hct
MCV
MCHC
reticulocytes
Serum iron
Bili
Platelets
Term
What food have high levels of iron?
Definition
Green leafy veggies
Red meat
Liver
Term
How long does iron therapy last?
Definition
2 to 3 months after the HgB levels return to normal
Term
What is thalassemia?
Definition
An autosomonal genetic disorder of inadequate production of normal HgB
Term
What are the common ethnic groups to get thalassemia?
Definition
Near the Mediterranean sea and equatorial regions of Asia and Africa
Term
What also occurs with thalassemia?
Definition
Hemolysis
Term
What problem causes abnormal HgB synthesis in thalassemia?
Definition
problem with globulin protein
Term
What is it called when there is one thalassemic gene?
Definition
Thalassemia minor
Term
What is it called when there are two thalassemic genes?
Definition
Thalassemia major
Term
What are the clinical manifestations of thalassemia minor
Definition
Frequently asymptomatic
Moderate anemia: Splenomegaly; Mild jaundice
Term
What are the clinical manifestations of thalassemia major?
Definition
Life threating
Develops by age of 2
Physical and mental growth often retarded
Pale
Symptoms develop in childhood 31-3
Splenomegaly
Hepatomegaly
Jaundice
Chronic bone marrow hyperplasia
Expansion of bone marrow space
Term
What is the treatment for thalassemia major?
Definition
Blood transfusions with IV deferoxamine (Desferal): a kilating agent that binds to the iroion when is given; over 25 will have hep C and HIV
Term
What are megaloblastic anemias?
Definition
Group of disorders caused by DNA synthesis
Term
What are the majority of megaloblastic anemias resulted from?
Definition
Cobalamin (vitamin B12)
Folic acid
Term
What are megaloblastic anemias characterized by?
Definition
Macrotic cells
Term
What is the intristic factor?
Definition
Protein secreated by the arietal cells of the gastric mucosa
Term
What is the use of the intrinstic factor?
Definition
Coabalamin absorption in the small intestine
Term
What are the causes of coalamin deficiency?
Definition
Pernicious anemia: most common
Gastritis and Gastrectomy
Chronic alcoholism
Nutritional deficiencies
Hereditary enzymatic defects
Term
What causes pernicious anemia?
Definition
An absence of intrensic factor: results in v Hydrochloric acid
Term
What is required fro intresensic factor secretion?
Definition
Acidic environment
Term
What are some causes of decreased HCl that leads to decreased instrenic factor secretion
Definition
GI surgery
Long term use of H2-histiamine receptor blockers
Term
What are the manifestations of coalamin deficiency?
Definition
General symptoms of anemia
Sore tongue
Anorexia
Nausea
Vomiting
Abdominal pain
Neuromuscular manifestations
Term
What are the neuromuscular manifestations of cobalamin deficiency?
Definition
Weakness-general and muscle
Paresthesias of the hands and feet
↓ Vibratory and position senses
Ataxia
Impaired thought process
Term
What diagnostic studies are used for cobalamin deficiency?
Definition
RBC's are large & abnormally shaped
Decreased serum cobalamin levels
Normal serum folate levels and decreased cobalamin levels suggest megaloblastic anemia due to cobalamin deficiency
Schilling test: radioactive cobalamin and administer to pt; asscss about in urine
Term
What is nursing management for cobalmin deficiency?
Definition
Familial disposition
Watch for injuries from lack of heat and pain sensations
Ensure treatment compliance
Term
What is another name for folic acid deficiency?
Definition
Folate anemia
Term
What is folic acid required for?
Definition
DNA synthesis
RBC formation and maturation
Term
What are common causes of folic acid deficiency?
Definition
Poor nutrition
Malabsorption syndrome
Drugs
Alcohol abuse and anorexia
Lost during hemodialysis
Term
What are foods high in folic acid?
Definition
Green Leafy veggies
Citrus fruits
Whole grain
Liver
Term
What are the clinical manifestations of folic acid deficiency?
Definition
Similar to cobalamin deficiency
Insidious onset
GI disturbance, dyspesai, glossy tounge
Absence of neurologic problems
Term
How is folic acid deficiency treated?
Definition
Replacement therapy (1mg)
Term
What are the causes of Anemia of chronic disease?
Definition
End-stage renal disease
Chronic liver disease
Chronic inflammation
Malignant tumors
Chronic endocrine diseases
Term
What is found in anemia of chronic disease?
Definition
^ serum ferritin
^ iron stores
Normal folate
Normal cobalamin
Term
How is anemia of chronic disease treated?
Definition
Treatment of the underlying cause
Rarely blood transfusions
Erythropoietin therapy
Term
What is aplastic anemia?
Definition
Not enough of any blood product
v WBC
v RBC
v Plateltes
Term
What is the etiology of aplastic anemia?
Definition
Low incidence
Manageable with erythropoietin or blood transfusion
Can be critical
Term
What critical conditions can aplatic anemia cause?
Definition
Hemorrhage
Sepsis
Term
What are the two types of aplastic anemia?
Definition
Congenital
Acquired
Term
What is congenital aplastic anemia?
Definition
Chromosomal alterations
Term
What is acquired aplastic anemia result from?
Definition
Ionizing radiation
Chemical agents
Viral and bacterial infestions
Prescribed medications
Term
How does aplastic anemia present?
Definition
Abruptly
Week-months
Varies from mild to severe
Fatigue & dyspnea
Term
What are the symptoms of aplastic anemia caused from?
Definition
Suppression of any or all bone marrow elements
Term
How is aplastic anemia diagnosed?
Definition
Decreased HgB, WBC, Platelets, reticulocyte
Bleeding time prolonged
RBC indices are normal
Term
What is the main nursing management for aplastic anemia?
Definition
Preventing complications from infection and hemmorrhage
Term
What is the prognosis for aplastic anemia?
Definition
Poor, 75% is fatal
Term
What are the treatment options for aplastic anemia?
Definition
Bone marrow transplantation
Immunosuppressive therapy
Term
What are some causes of acute blood loss?
Definition
Trauma
Complications from surgery
Disruption of vascular integrity
Term
What are some concerns from acute blood loss?
Definition
Hypovolemic shock
Reduced plasma volume
Diminished O2 because of fewer RBC's
Term
What are the clinical manifestations of acute blood loss?
Definition
Pain
Shock (major complication)
Numbness & tingling in the lower extremities
Term
What causes the clinical manifestations in acute blood loss?
Definition
Body's attempt to maintain an adequate blood volume and O2
Term
What are diagnostic studies used for acute blood loss?
Definition
RBC's but does not adequately asses problems for 2-3 days
Term
What care is given to those with acute blood loss?
Definition
Replacing blood volume
Identifying source
Stopping blood loss
Correcting RBC loss
Term
What is nursing care for those with acute blood loss?
Definition
Monitor blood loss
No need for long-term treatment
Term
What are causes of chronic blood loss?
Definition
Bleeding ulcer
Hemorrhoids
Menstrual and postmenopausal blood loss
Term
How is chronic blood loss managed?
Definition
Identifying source
Stop bleeding
Possible use of supplemental iron
Term
What is hemolytic anemia?
Definition
Destruction or hemolysis of RBCs at a rate that exceeds production
Term
What is the 3rd major cause of anemia?
Definition
Hemolytic anemia
Term
What is intrinsic hemolytic anemia caused by?
Definition
Abnormal hemoglobin
Enzyme deficiencies
RBC membrane abnormalities
Term
What is extrinsic hemolytic anemia caused by?
Definition
Acquired
Term
What are the sites of hemolysis in hemolytic anemia?
Definition
Intravascular
Extravascular
Term
What are some clinical manifestations of hemolytic anemia?
Definition
Jaundince
Enlarged spleen and liver
Accumulation of HgB molecules in renal tubules
Term
What is sickle cell disease?
Definition
Autosomal recessive disorder characterized by abnormal form of HgB
Term
What is sickle cell disease?
Definition
Autosomal recessive disorder characterized by abnormal form of HgB
Term
What is the prognosis of Sickle cell disease?
Definition
Incurable and often fatal by middle age
Term
What causes fatality in sickle cell disease?
Definition
Renal and pulmonary failure
Term
What are the clinical manifestations of sickle cell disease?
Definition
Pain
Sickling crisis
Anemic
v exercise tolerance
Term
What are the symptoms of a sickling crisis?
Definition
Pain
Pallor
Jaundice
Pale mucous membranes
Activity intoleranec
Term
How is sickle cell disease managed?
Definition
Alleviate symptoms
Pain assessment
Avoid high altidues
Provide O2
^ fluids
Treat infections promptly
Term
What is polycythemia?
Definition
abnormal production in erythrocytes
Body makes too many RBC's which makes blood thick which forms clots
Term
What are the two types of polycythemia?
Definition
Polycthemia Vera
Secondary polycythemia
Term
What is polyctheica vera?
Definition
Bone marrow disorder characterized by an increaes in erthocytosis, leukocytosis, & thrombocytosis
Term
What is secondary polycythemia?
Definition
Caused by any source of hypoxia
Term
What are the s/s of polycythemia?
Definition
HA, HTN, vertig, tinnitus, blurred vision, epistaxis, ecchymosis, GI bleed, thromboembolism, intermittent claduiction, angina, CHF< hepatmegaly, spleenomegaly
Term
What diagnostic tests are used for polycythemia?
Definition
HCT >53%
^ total RBC
^ WBC/basophila
^ platelets, uric acid, alkaine phosphate, vit B12
Term
What are the major defects in hemostasis
Definition
Thrombocytopenia
Hemophilia
Disseminated intravascular coagulation DIC
Term
What is Leukemia?
Definition
Malignant cancer of the bone marrow and blood
Term
What are the 4 types of leukemia
Definition
Acute
Chronic
Myelogenous
Lymphocytic
Term
What is acute leukemia?
Definition
Progress abruptly
Cells don't develop normally & never function
Term
What is chronic leukemia?
Definition
Slowly worsen
Mature cells, carry out normal function
Term
What is the defect is lymphocytoic leukemia?
Definition
B-cells
Term
What is the defect is myeloid or myelogeneous leukemia?
Definition
Granculocytes
Term
What are the risk factors for leukemia?
Definition
Hereditary and genetic factors
Drugs to tx other types of cancers
Exposure to high doses of radiation
Chemicals
Certain viruses and diseases
Term
What are the four types of chemotherapy for leukemia?
Definition
Induction
Intensification
Consolidation
Maintenance therapy
Term
What are the side effects of chemotherapy?
Definition
Leukopenia, Thrombocytopenia, Anemia, N&V, Diarrhea, alopecia, stomatitis, renal toxicity, hepatic toxicity, cardiac toxicity, anorexia
Term
What does nursing care include in leukemia/chemotherapy?
Definition
Physical quality
Psychosocial
Spiritual
Term
What is the most common type of leukemia in adults?
Definition
Acute myelogenous leukemia
Term
What are the clinical manifestations of acute myelogenous leukemia?
Definition
Comes on fast
Serious infections
Bleeding
Term
What gender is chroinc myelogeneous leukemia more common in?
Definition
men
Term
What are the clinical manifestaions of chronic myelogenous leukemia?
Definition
Stays stable, can go to an acute agressive, don't have long to live, can be controlled
Term
How long does chronic myelogeneous leukemia last?
Definition
Several months to years
Term
What leukemia is common in young children?
Definition
Acute lymphocytic leukemia
Term
What is the 5 year survival rate with acute lymphocytic leukemia?
Definition
Children: 80%
Adults: 40%
Term
What are the clinical manifestations of acute lymphocytic leukemia?
Definition
Abrubt, bleeding, fever, progressive weakness, fatigue, bone or join pain, bleeding
Term
What are lymphomoas?
Definition
Neoplasmas of the cells of lymphoid orgin
Term
What are the 2 major types of lymphoma?
Definition
Hodgkin's lymphoma
Non-hodgkin's lymphoma
Term
Who is affected in hodgkin's disease?
Definition
Twice as many men then women 15-25 over 50 most common
Term
What is the hallmark sign of hodgkin's disease?
Definition
Reed-Sternberg cell
Term
What are the clinical manifestations of hodgkin's disease?
Definition
Weight loss
Fever
Night sweats
Term
What diagnostic studies are used for hodgkin's disease?
Definition
Biospy (Lymphnode, bone marrow)
Pet scan, MRI, CT, etc (staging)
Term
What care is given for Hodgkin's disease?
Definition
Intensive chemo, radiation depends on site & presence of resistance, monitor infection & bleeding
Term
What is found in stage I hodgkin's disease?
Definition
Limited to a single node and contiguous structures or a single extralymphatic organ or site
Term
What is found is stage II hodgkin's disease?
Definition
Involves more than a single node or group of contiguous nodules, but is confided to one side of the diaphragm only
Term
What is found is stage III hodgkin's disease?
Definition
Disease is present both above and below the diaphragm and may include solitary involvement of the spleen, one extralymphatic site, or both
Term
What is found in stage IV Hodgkin's disease?
Definition
Disease has disseminated diffusely to one or more extralymphatic sites with or wihout associated lymph node involvement
Term
What is the prognosis of hodgkin's disease?
Definition
Untreated this disease is progressive
Death is likely in 1-3 years w/o treatment
Term
What is the cause of non-hodgkin's lymphona?
Definition
Unknown; possible immunosuppresant therapy
Term
What are the clinical manifestations of non-hodgkin's lymphoma?
Definition
Painless lymphnode enlargement
Can come and go
Don't find until it spreads
Term
What treatment is used for non-hodgkin's lymphoma?
Definition
Chemo and radiation
Term
What organ is primarily affected by multiple myeloma?
Definition
Bone
Term
What are the clinical manifestations of multiple myeloma?
Definition
Develops slowly
Not found until bone pain
Term
What diagnostic studies are used for multiple myeloma?
Definition
Lab
Radiology
Bone marrow
Term
What care is given for multiple myeloma?
Definition
Hydration to produce good urinary output
Term
What is the prognosis for multiple myeloma?
Definition
Poor
Pt lives 2 years after diagnosis w/o treatment
Term
What is myelodysplastic syndrome?
Definition
Bone marrow does not function normally
Not enough are made
Occurs most often in older people
Term
How is myelodysplastic syndrome developed?
Definition
Following treatment with drugs or radiation
Unknown cause
Term
What are the S&S of myelodysplatic syndrome?
Definition
Anemia
Infection or bleeding
Term
What diagnostic studies are used for myelodysplastic syndrome?
Definition
CBC
Bone marrow biopsy
Supporting users have an ad free experience!