Term
|
Definition
| Formation of red blood cells |
|
|
Term
|
Definition
|
|
Term
|
Definition
Breakdown of hemoglobin
*May be associated with increased hemolysis
*Leads to jaundice |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
150,000-400,000
<150,000: Thrombocytopenia
<20,000: spontaneous bleeding
(Thrombocytosis: high platelet count) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Cell that is normal in size |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Cell that has normal coloration |
|
|
Term
|
Definition
| Cell that is pale in color |
|
|
Term
| High hemoglobin levels could indicate this: |
|
Definition
|
|
Term
| WBC differential count: shift to left |
|
Definition
| Indicates an increased number of immature cells and signals infection. |
|
|
Term
| Increased immature neutrophils: |
|
Definition
| infection or inflammation |
|
|
Term
| Increased immature eosinophils: |
|
Definition
|
|
Term
|
Definition
| Low white blood cell count: increased risk for infection. |
|
|
Term
|
Definition
High white blood cell count that indicates
inflammation or infection |
|
|
Term
Bone marrow aspiration:
Why would someone have one of these? |
|
Definition
To evaluate bone marrow function.
May aid in diagnosis of anemia, thrombocytopenia, lymphoma, other cancers or evaluate the effectiveness of chemotherapy. |
|
|
Term
Bone marrow aspiration:
Psychosocial aspect |
|
Definition
Patient will be experiencing fear, anxiety and often a knowledge deficit.
Nurse's role: provide comfort and support |
|
|
Term
Bone marrow aspiration:
Procedure |
|
Definition
1. Pre-medicate (anti-anxiety, maybe Ativan)
2. Position patient on stomach for a posterior iliac crest procedure (on back for a sternal procedure)
3. Physician will numb the site with lidocaine.
4. Large, hollow needle will go into patient all the way to the bone
5. Pressure is applied to the site until bleeding has stopped.
6. Cover site with a doubled gauze square, tape in place.
7. Have the patient roll over onto his back and remain in that position for 30 minutes.
8. Advise patient that an ice pack to the area may help with the soreness. |
|
|
Term
| Anemia: classifications [BIDE] |
|
Definition
1. Blood loss
2. Increased RBC destruction
3. Decreased RBC production
4. Erythrocyte trauma |
|
|
Term
|
Definition
Acute or chronic blood loss:
Trauma, hemorrhage
GI bleed
Menorrhagia |
|
|
Term
| Increased RBC destruction |
|
Definition
Sickle cell
Splenomegaly
Infection |
|
|
Term
|
Definition
Iron deficiency anemia
Thalassemia
Chronic inflammation
Vitamin B12 absorption
Bone marrow failure |
|
|
Term
|
Definition
Dialysis: hemolytic uremia syndrome
Cardiopulmonary bypass |
|
|
Term
Anemia, clinical manifestations:
Respiratory |
|
Definition
|
|
Term
Anemia, clinical manifestations:
Urinary |
|
Definition
| Hemoglobinuria (high concentration of hemoglobin in the urine) |
|
|
Term
Anemia, clinical manifestations:
GI |
|
Definition
Diarrhea
Anorexia
Nausea
Gallstones
Splenomegaly
Abdominal pain |
|
|
Term
Anemia, clinical manifestations:
Musculoskeletal |
|
Definition
Night cramps
Bone pain
Joint pain
Bone deformity and fractures |
|
|
Term
Anemia, clinical manifestations:
Neurologic |
|
Definition
Paresthesias
Proprioception deficits
HA
Fainting
Forgetfulness
Pain
Behavioral disturbances (e.g.pica) |
|
|
Term
Anemia, clinical manifestations:
CV |
|
Definition
Tachycardia
Palpitations
Systolic murmur
Ventricular hypertrophy
Angina
Could lead to heart failure |
|
|
Term
Anemia, clinical manifestations:
Integumentary |
|
Definition
Pallor
Jaundice
Petechiae
Purpura
Spoon-shaped nails
Cheilosis: scaling and fissures at corners of the mouth
Sore, beefy-red tongue
Chronic leg ulcers |
|
|
Term
|
Definition
Most common type!
Low RBCs
Low Hgb/Hct
Microcytic/hypochromic |
|
|
Term
Iron Deficiency Anemia:
Etiology |
|
Definition
Excessive blood loss from chronic bleeding
Inadequate dietary intake: < 1 mg per day
Malabsorption syndromes
Increased iron requirements: pregnancy, lactation
Partial/total gastrectomy
Chronic diarrhea |
|
|
Term
Iron Deficiency Anemia:
Nursing management |
|
Definition
Preventive education
Nutritional counseling
Drug interactions
Oral supplement (ferrous sulfate)
IV supplement (iron dextran) |
|
|
Term
| Ferrous sulfate administration |
|
Definition
Oral supplement
Liquid, dilute with some OJ
Use a straw |
|
|
Term
| Iron dextran administration |
|
Definition
IV
Give a test dose first to make sure patient can tolerate it.
Monitor for anaphylaxis. |
|
|
Term
Vitamin B12 deficiency:
Etiology |
|
Definition
[B12 is required for DNA synthesis.]
Strict vegetarians
Malabsorption
Absence of intrinsic factor: pernicious anemia |
|
|
Term
| Malabsorption of Vitamin B12 |
|
Definition
This patient eats it, but it goes right through him without being absorbed.
*Crohn's
*Ileal resection
*Gastrectomy |
|
|
Term
|
Definition
Absence of intrinsic factor
*abnormality of the gastric mucosa
*atrophy of the stomach wall: leads to a failure to secrete intrinsic factor. |
|
|
Term
Vitamin B12 deficiency:
S/S |
|
Definition
Anemia: weak, listless, fatigue
Smooth, red, sore tongue
Mild diarrhea
Confusion
PARESTHESIAS in the extremities (lower legs, feet, from the waist down). These are reversible if treated within the first 6 months of symptoms. |
|
|
Term
Vitamin B12 deficiency:
Testing |
|
Definition
| Schilling Test: used to differentiate between pernicious anemia and intestinal malabsorption. |
|
|
Term
| Folic Acid (folate) deficiency |
|
Definition
[Folate is required for DNA synthesis.]
Occurs in patients who are chronically malnourished. |
|
|
Term
Folic Acid (folate) deficiency:
Etiology |
|
Definition
Chronic malnutrition
Elderly
Alcoholism
Drug addiction
Pregnancy |
|
|
Term
Folic Acid (folate) deficiency:
S/S |
|
Definition
Pallor
Progressive weakness/fatigue
SOB
Heart palpitations
Glossitis, cheilosis, diarrhea
NO NEURO SYMPTOMS |
|
|
Term
|
Definition
*Destruction of RBCs
*Cell membrane defects that cause the cell to take on abnormal shapes (sickle cell, thallassemia) |
|
|
Term
|
Definition
Crescent-shaped RBCs: sickling
They get stuck on each other: clumping which causes obstruction leading to a vaso-occlusive crisis. |
|
|
Term
Sickle Cell Anemia:
Symptoms |
|
Definition
Pallor
Fatigue
Jaundice: producing more bilirubin r/t destruction of RBCs
Dehydration |
|
|
Term
Sickle Cell Anemia:
Crisis |
|
Definition
Occluded circulation
Tissue ischemia/infarction
Edema in the area
Impaired erythropoiesis
Sequestration of increased amounts of blood in the liver or spleen. |
|
|
Term
Sickle Cell Anemia:
Crisis-Pain |
|
Definition
Abdominal
Long bones
Hand Foot syndrome
Joints |
|
|
Term
Sickle Cell Anemia
Crisis - Complications |
|
Definition
Infections
Stroke
URIs
Leg ulcers
Splenomegaly |
|
|
Term
Sickle Cell Anemia
Crisis - Treatment (HOP to it!) |
|
Definition
Hydration
Oxygenation
Pain relief/control |
|
|
Term
Sickle Cell Anemia
Crisis - Triggers |
|
Definition
Exercise
Cold weather
High altitude
Stress
Infection
Anesthesia
Dehydration |
|
|
Term
|
Definition
Autosomal recessive defect
Characteristic bull's eye shaped target cells |
|
|
Term
|
Definition
Mild to moderate anemia
Mild splenomegaly
Bone marrow hyperplasia
BRONZE SKIN COLOR |
|
|
Term
Thalassemia:
Bone marrow hyperplasia |
|
Definition
Increased hematopoiesis that leads to a fracture pattern:
Bones get thin, then they expand, then they thin, repetitive pattern. |
|
|
Term
|
Definition
| Bone marrow doesn't make enough new blood cells: pancytopenia |
|
|
Term
|
Definition
T-cell attack on the bone marrow: body's immune system attacks its own cells by mistake.
Idiopathic: 50%
Toxins: arsenic, nitrogen mustard, benzene.
Chemotherapy/radiation
Viral infections: HIV, Mono |
|
|
Term
Aplastic anemia:
Diagnosis |
|
Definition
CBC
Iron levels
Serum ferritin
Sickle cell tests
Hgb electrophoresis
Bone marrow aspiration |
|
|
Term
|
Definition
FATIGUE
PALLOR
BLEEDING
Progressive weakness
Exertional dyspnea
Headache
Tachycardia
Heart failure |
|
|
Term
Aplastic anemia:
Treatment |
|
Definition
Transfusions: once the labs being to normalize, stop the transfusion (they are now making cells on their own.)
Neutropenic precautions
Thrombocytopenic precautions |
|
|
Term
|
Definition
Iron dextran: IV
Folic acid supplements: Vitamin B6
Hydroxyurea: used for reduction of pain with sickle cell crisis
Epogen: used in chronic renal failure to stimulate RBC production
Teach patient about adequate nutrition |
|
|
Term
|
Definition
Meat: beef, chicken, clams, oysters, pork loin, turkey, veal
Egg yolk |
|
|
Term
Sources of nonheme iron
[BBBB FOG] |
|
Definition
Beans(dried), bran flakes, brown rice, bread (whole wheat)
Fruits (dried)
Oatmeal
Greens |
|
|
Term
|
Definition
| Lentils, pinto beans, garbanzo beans, spinach, black beans, navy beans, kidney beans, collard greens, turnip greens, lima beans. |
|
|
Term
|
Definition
Meats, liver, fresh shrimp/oysters
Eggs, milk, cheese |
|
|
Term
|
Definition
Neoplastic stem cell disorder characterized by overproduction of RBCs and to a lesser extent WBCs and platelets.
Blood viscosity is increased: thicker blood! |
|
|
Term
|
Definition
HYPERTENSION
PLETHORA
SEVERE PRURITUS: Painful itching of fingers/toes
Headache, tinnitus, blurred vision
Splenomegaly
Extreme pain
Intermittent claudication
Hypermetabolism: weight loss and night sweats
GI bleeding |
|
|
Term
|
Definition
| Dark redness of the lips, feet, ears, fingernails, and mucous membranes. |
|
|
Term
Polycythemia vera:
Nursing care |
|
Definition
Periodic phlebotomy
Hydroxyurea: suppress bone marrow function
Patient education: smoking cessation, hydration, prevention of blood stasis, report symptoms of thrombosis immediately. |
|
|
Term
|
Definition
| Removing 300-500 mL of blood to keep blood volume and viscosity within normal levels. |
|
|
Term
|
Definition
Platelet count < 150,000
< 20,000: spontaneous bleeding |
|
|
Term
Thrombocytopenia:
Etiology |
|
Definition
Decreased production
Increased sequestration in spleen
Accelerated destruction |
|
|
Term
Thrombocytopenia: Primary
ITP (immune thrombocytopenia purpura) |
|
Definition
Idiopathic
Autoimmune
Accelerated platelet destruction |
|
|
Term
|
Definition
Bleeding from small vessels and mucous membranes
Petechiae
Purpura
Epistaxis
Hematuria
Excessive menstrual bleeding
Bleeding gums |
|
|
Term
Thrombocytopenia: Primary
Thrombotic Thrombocytopenia Purpura (TTP) |
|
Definition
Occlusion of arterioles and capillaries of the microcirculation
Same S/S as ITP PLUS Neurological symptoms:
Headaches
Seizures
Altered LOC |
|
|
Term
Thrombocytopenia: Secondary
HIT |
|
Definition
Heparin-induced thrombocytopenia that develops as a result of an abnormal response to heparin therapy.
*Usually unfractionated (greater risk), but may be low-molecular weight as well. |
|
|
Term
Thrombocytopenia: Secondary
HIT S/S |
|
Definition
Bleeding
Arterial thrombosis: pallor, cool skin, no pulse distal to occlusion
Venous thrombosis: edema, redness, warmth of affected area. |
|
|
Term
Thrombocytopenia: Secondary
HIT - Diagnosis |
|
Definition
CBC with platelet count
Antinuclear antibodies
Serologic studies
Bone marrow biopsy |
|
|
Term
Thrombocytopenia: Secondary
HIT - Medications |
|
Definition
Oral glucocorticoids (Prednisone)
*High dose for a long time.
Immunosuppressive drugs
REMOVE all sources of heparin, including flushes |
|
|
Term
Thrombocytopenia: Secondary
HIT - Treatment |
|
Definition
Platelet transfusion
Plasmapheresis
Splenectomy |
|
|
Term
|
Definition
| Plasma exchange therapy: patient's plasma is removed and replaced with fresh frozen plasma to remove autoantibodies, immune complexes and toxins. |
|
|
Term
|
Definition
x-linked recessive disorder
Hemophilia A (classic)
Von Willebrand's disease
Both are FACTOR disorders. |
|
|
Term
|
Definition
Hemarthrosis: bloody effusion within a joint
Easy bruising with minor trauma
Bleeding from gums
Prolonged bleeding after minor injuries |
|
|
Term
|
Definition
Give FACTOR
FFP: Factor VIII and IX (NO platelets)
Desmopressin acetate (DDAVP) |
|
|
Term
|
Definition
Causes release of Factor VIII by body
Raises blood levels for several hours
Often given prior to a procedure |
|
|
Term
| Disseminated Intravascular Coagulation (DIC) |
|
Definition
Widespread intravascular clotting and bleeding.
Clinical syndrome that develops as a result of a wide variety of other disorders (underlying disease) |
|
|
Term
Disseminated Intravascular Coagulation (DIC):
Triggers |
|
Definition
Bacterial infection (sepsis)
Trauma
Cancer
Shock
OB complications
Toxins
Allergic reactions |
|
|
Term
Disseminated Intravascular Coagulation (DIC):
Lab Tests |
|
Definition
Focusing on bleeding times
High PT
High PTT
Low platelets
D-dimer test |
|
|
Term
Disseminated Intravascular Coagulation (DIC):
Treatment |
|
Definition
Based on what is happening to the patient:
Heparin
Clotting factors |
|
|
Term
Disseminated Intravascular Coagulation (DIC):
pathophysiology |
|
Definition
Progressive decrease in platelet count
S/S of thrombosis in involved organs
Clotting factors and platelets are consumed to form thrombi which leads to bleeding. |
|
|
Term
Disseminated Intravascular Coagulation (DIC):
S/S |
|
Definition
Bleeding from everywhere!
Petechiae, ecchymosis, bruising
Bleeding gums
Bleeding wounds
Injection sites are oozing
Catheter areas are bleeding
Epistaxis
Joint pain
Conjunctival hemorrhage
Tachycardia
Acute respiratory distress
Melena
Retroperitoneal bleeding: increased abdominal girth
Hematuria
Anxiety, restlessness, decreased mentation, altered LOC, HA
Visual disturbances |
|
|
Term
| Bleeding precautions: when to implement |
|
Definition
When using anticoagulants
Liver disease is present
Platelets fall below 150,000
Hemophilia is present
Using thrombolytic medications |
|
|
Term
|
Definition
Malignant disorder of WBCs that is usually chronic
Ratio of RBC and WBC is reversed
Malignant, immature WBCs are present in the:
*bone marrow
*circulation
*liver, spleen, and lymph nodes |
|
|
Term
|
Definition
A - anemia, Hgb. is low
N - neutropenia, risk for infection
T - thrombocytopenia, risk for bleeding |
|
|
Term
|
Definition
Pallor
Tachycardia
Fatigue/malaise/lethargy
DOE
Bruising, petechiae
Bleeding gums
Infection symptoms: fever, night sweats, oral ulcers, frequent, recurrent infections |
|
|
Term
|
Definition
Acute lymphoblastic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia |
|
|
Term
| Acute lymphoblastic leukemia (ALL) |
|
Definition
| Young children AND adults: CNS involvement |
|
|
Term
| Chronic lymphocytic leukemia (CLL) |
|
Definition
Older adults
Insidious onset |
|
|
Term
| Acute myeloid leukemia (AML) |
|
Definition
| Older adults; toxins, treatment of other cancers |
|
|
Term
| Chronic myeloid leukemia (CML) |
|
Definition
| Adults, slow to develop, but becomes aggressive after 3-4 years. |
|
|
Term
|
Definition
Chemotherapy (single or combination)
Colony-stimulating factors
Bone marrow transplant
Stem cell transplant |
|
|
Term
| Bone marrow transplant (BMT) |
|
Definition
This patient will be in isolation r/t high risk for infection.
Allogenic: donor tissue
Autologous: (bone marrow rescue) uses the patient's own marrow after radiation or chemotherapy. |
|
|
Term
|
Definition
This patient will be in isolation r/t high risk for infection.
Alternative to BMT
Complete replacement of WBC, RBC, and platelets from donor
Possible rejection: graft vs host disease |
|
|
Term
|
Definition
| Malignancy of lymph tissues with increased lymphocytes |
|
|
Term
|
Definition
Initiates in a single lymph node or single lymph chain
Presence of Reed-Sternberg cells
Orderly and continuous spread
Rarely extranodal involvement |
|
|
Term
|
Definition
Painless enlargement of one or more lymph nodes in the neck
Pruritus
Based on location of tumor
Mild anemia, neutropenia, fatigue |
|
|
Term
|
Definition
May arise from T cells, B cells or tissue macrophages.
More common form and worse prognosis than Hodgkin's.
More difficult to treat
Involves other organs
NO Reed-Sternberg cells
Diffuse and unpredictable spread, no set pattern
Early extranodal involvement
Bone marrow involvement |
|
|
Term
Non-Hodgkin's lymphoma
Organ involvement |
|
Definition
Abdominal pain: nausea/vomiting
CNS: headaches, altered LOC, seizures, peripheral or cranial nerve symptoms. |
|
|
Term
|
Definition
Chemotherapy
Stem cell transplant: < 60 years old
Radiation therapy if an early diagnosis |
|
|
Term
| Lymphoma treatment complications |
|
Definition
Permanent sterility
Bone marrow depression
Secondary cancers
Cardiac injury |
|
|
Term
|
Definition
| Plasma cells multiply uncontrollably and infiltrate the bone marrow, lymph nodes, spleen and other tissues. |
|
|
Term
| Multiple myeloma: Incidence/Risk factors |
|
Definition
Risk increases with age
Often associated with low socioeconomic status |
|
|
Term
|
Definition
Insidious onset
BONE PAIN: primary symptom
Hypercalcemia: calcium is coming out of the bones
Neuro dysfunction: lethargy, confusion, weakness |
|
|
Term
| Multiple myeloma: diagnosis |
|
Definition
X-rays: look at the bones
Bone marrow biopsy
Labs
Bence-Jones protein is present in the urine
Biopsy of lesions |
|
|
Term
| Multiple myeloma: Treatment |
|
Definition
Chemotherapy
Stem cell transplant
Treatment of electrolyte imbalances |
|
|
