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LSUE-Nursing
Hematologic/ Qualey
198
Nursing
Undergraduate 4
11/03/2012

Additional Nursing Flashcards

 


 

Cards

Term
ecchymoses
Definition

bruising

 

Term
aplastic anemia
Definition

a disease with a deficiency of all of the formed elements of blood (specifically RBC, WBC, & platelets),

representing a failure of the cell-generating capacity of bone marrow

Term

disseminated intravascular coagulation

(DIS)

 

Definition
a grave coagulopathy resulting from over-stimulation of clotting and anticlotting processes in response to disease or injury
Term
erythropoiesis
Definition
(the process of red blood cell production) is regulated by cellular oxygen requirements and general metabolic activity
Term
anemia
Definition
a deficiency in the number of erythrocytes(red blood cells), the quantity of hemoglobin, and/or the volume of packed RBCs (hematocrit).
Term
fibrinolysis
Definition
a continual process resulting in the dissolution of fibrin to maintain blood in its fluid form
Term
hematopoiesis
Definition
blood cell production that occurs within the bone marrow
Term
hemolysis
Definition
destruction of RBCs by monocytes and macrophages removes abnormal, defective, damaged, and old RBCs from circulation.
Term
hemochromatosis
Definition
an autosomal recessive disease characterized by increased intestinal iron absorption and, as a result, increased iron deposition
Term
hemolytic anemia
Definition
an anemia caused by destruction of RBCs at a rate that proceeds production
Term
hemophilia
Definition
hereditary bleeding diorders caused by defective or deficient clotting factors
Term
Hodgkin's Lymphoma
Definition
a malignant condition characterized by proliferation of abnormal giant, multinucleated cells, called Reed-Strenberg cells, which are locatedin lymph nodes
Term
leukopenia
Definition
an abnormal decrease in the number of total white blood cells to <4000/ uL
Term
Neutophil
Definition
Its cell function is phagocytosis, expecially during the early phase of inflammation
Term
iron-deficiency anemia
Definition
a microcytic hypochromic anemia caused by inadequate supplies of iron needed to synthesize hemolglobin; characterized by pallor, fatigue, weakness
Term
leukemia
Definition
a broad term given to a group of malignant diseases characterized by diffuse replacement of bone marrow with proliferating leukocyte precursers
Term
lymphoma
Definition
malignant neoplasm originating in the bone marrow and lymphocytic structures resulting in proliferation of lymphocytes
Term
megaloplastic anemia
Definition
a group of disorders caused by impaired DNA synthesis and characterized by the presence of large red blood cells
Term
multiple myeloma
Definition
a condition in which malignant neoplastic plasma cells infiltrate the bone marrow and destroy bone
Term

myelodysplastic syndrome

(MDS)

Definition
a group of related hematologic disorders characterized by a change in the quantity and quality of bone marrow elements
Term
neutropenia
Definition
an abnormal reduction of neutrophil count to <1000/uL
Term
Non-Hodgkins Lymphoma
Definition
a heterogeneous group of malignant neoplasms involving lymphoid tissue
Term
pancytopenia
Definition
marked decrease in the number of red blood cells, white blood cells, and platelets
Term
pernicious anemia
Definition
a progressive megaloblastic macrocytic anemia resulting from inadequate gastric secretion of intrinsic factor necessary for absorption of cobalamin
Term
petechiae
Definition
small purplish lesions
Term
polycythemia
Definition
an abnormal condition with excessive levels of red blood cells
Term
reticulocyte
Definition
an immature erythrocyte
Term

sickle cell disease

(SCD)

Definition
a group of inherited, autosomal recessive disorders characterized by the presence of an abnormal form of hemoglobin in the erythrocyte
Term
thrombocytopenia
Definition
a reduction of the platelet count
Term
thalassemia
Definition
an autosomal recessive genetic disorder of inadequate production of normal hemoglobin
Term
thrombocytosis
Definition
a condition marked by excessive platelets; a disorder that occurs with inflammation adn some malignant disorders
Term
thrombocytopenia
Definition
a reduction of the platelet count
Term
eosinophil
Definition
Its cell function is phagocytosis (not as effective as neutrophil); allergic response; protection from parasitic infections
Term
Basophil
Definition
Its cell function is the inflammatory response and allergic response; release of bradykinin, heparin, histamine, serotonin, limited phagocytosis
Term
Name the granulocytes
Definition
Neutrophil, Eosinophil, Basophil
Term
Name the agranulocytes
Definition
Lymphocyte, Monocyte
Term
Lymphocyte
Definition
Its cell function is cellular and humoral immune response
Term
Monocyte
Definition
Its cell function is Phagocytosis; cellular immune response
Term
Normal iron metabolism method
Definition
Iron is ingested in the diet or from supplements. Macrophages break down ingested RBCs. Iron is returned to blood bound to transferrin or stored as ferritin or hemosiderin.
Term
segmented neutrophil or polysegmented neutrophil
Definition
mature neutrophil
Term
Name the essential nutrients necessary for erythropoiesis
Definition
protein, iron, folate (folic acid), cobalamin (Vitamin B12), riboflavin (vitamin B2), and pyridoxine (Vitamin B6).
Term
Name 3 functions of blood
Definition

transportation, regulation, protection

 

(pg. 643 Table 30-1)

Term

Name the 6 elements of the hematological system.

 

Definition
Bone marrow, blood, iron metabolism and clotting metabolism, spleen, lymph system, liver
Term

Bone marrow

 

Definition
a soft material that fills the central core of bones, 
Term
Name the 2 types of bone marrow
Definition
yellow (adipose) and red (hematopoietic)
Term
Red bone marrow
Definition
Blood cell production (hematopoiesis) actively occurs here
Term
Which 3 types of blood cells develop from a stem cell within the bone marrow
Definition
RBCs, WBCs, Platelets
Term
What is the 4th product that is developed in the bone marrow?
Definition
Plasma that keep blood products suspended and moving int he blood vessels
Term
Approximately ____ % of blood is plasma
Definition
55
Term
What is the primary function of erythrocytes (RBCs)?
Definition
transport of gases (both Oand CO2) and assistance in maintaining acid-base balance
Term
Primary function of thrombocytes (platelets)
Definition
initiate the clotting process by producing an initial platelet plug in the early phases of the clotting process
Term
Patients with this are far more susceptable to bacterial infections. Usually seen in aplastic anemia, cancer, paticularly blood CA, and with chemotherapy
Definition
Neutropenia
Term
The possible etiology of Low Hb level (anemia) will show what skin finding
Definition
pallor of skin or nail beds
Term
The possible etiology of Increase Hb (polycythemia) may show what skin finding
Definition
flushing of the skin
Term
An accumulation of bile pigment caused by rapid or excessive hemolysis or liver damage may show which skin finding
Definition
Jaundice
Term
Reduced Hb, excessive concentration of deoxyHb in blood may show what finding in skin
Definition
cyanosis
Term
Scratching from intense puritis may show what skin finding
Definition
Excoriation
Term
Hodgkins Lymphoma, cutaneous lymphomas, infiltrative lymphomas, and increased bilirubin may show which skin finding
Definition
Pruritis
Term
Sickle cell disease may show which skin finding
Definition
Leg ulcers
Term
Most congenital etiologies; some diappearing spontaneously may show which skin finding
Definition
Angioma- benign tumor consisting of blood or lymph vessels
Term
Dilation of small vessels may show which skin finding
Definition
Telangiectasia- small angioma w/ tendacy to bleed; focal red lesions, coarse or fine red lines
Term
Elevated estrogen levels as in pregnancy or liver disease may show which skin finding
Definition

Spider Nevus- spider appearance usually develops on

neck, face, or chest

Term
Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma show which skin findings
Definition
Purpura, Ecchymosis, Hematomas
Term
Multiple myeloma that has infiltrated tissue shows which skin finding
Definition
Plasmacytoma- a tumor arising from abnormal plasma cells
Term

Acute myelogenous leukemia that has infiltrated the skin shows which skin findings
Definition
Chloroma- a tumor rising from myeloid tissue and containing a pale green pigment
Term
Anemia, extreme leukocytosis, polycythemia, thrombocytopenia, and excessive clotting may cause which visual abnormalities
Definition
blurred vision, diplopia, visual field cuts
Term
Epistaxis may be caused by
Definition
patients with low platelet counts that bends down, tries lifting heavy items, or w/ intesnse valsalva maneuver
Term
Neutropenia;inability of impaired leukocytesto combat oral infections; thrombocytopenia results in which finding of the mouth
Definition
Gingival and mucousal membrane changes; ulceration, swelling, or bleeding
Term
Pernicious anemia and iron-deficiency anemia has which mouth finding
Definition
a smooth tongue
Term

Lymphadenopathy

(lymph node enlarge (>1cm) and are tender)

occurs w/

Definition
infection, foreign infiltrations, or systemic disease such as; leukemia, lymphoma, Hodgkin's lymphoma, and metastatic CA
Term
A compensatory mechanism in anemia to increase cardiac output
Definition
tachycardia
Term
Anemia, fluid volume overload, hypotension w/impending syncope, hypertension, and dysrhythmias may cause which finding of heart and chest
Definition
palpitations
Term
Orthostasis (hr >20bpm increase or blood <20mmHg decrease), a common manifestation of anemia, especially low blood volume; hypotension indicating infectious process, blood loss, or compromised cardiovascular compensatory mechanisms; hypertension occurring initially when pts are anemic as a compensatory mechanism for anemia will result in which finding of heart and chest
Definition
Arterial BP
Term
Leukemia resulting from increased bone marrow cellularity, causing increase pressure and bone erosion; multiple myeloma as a result of strectching of periosteum may result in which heart and chest finding
Definition
sternal tenderness
Term
Which finding of heart and chest will you find in cases of severe anemia?
Definition
Low Osaturation
Term
 Which diseases result in hepatomegaly?
Definition
Leukemia, cirrhosis, or fibrosis secondary to iron overload from sickle cell disease or thalassemia.
Term

Which diseases result in splenomegaly?

 

Definition
Anemia, thrombocytopenia, leukemia, lymphomas, leukopenia, mononucleosis, malaria, cirrhosis, trauma, portal HTN
Term
What may result in distended abdomen?
Definition
Lymphoma may manifest as abdominal adenopathy, masses, or bowel obstruction
Term
Cobalamin (Vitamin B12) deficiency or folate deficiency results in which nervous system finding
Definition

Parasthesias of feet and hands; ataxia

(numbness and extreme sensitivity of the central and peripheral nerves; impaired muscle movement)

Term

Severe H/A w/ or w/out visual disturbances may signal cranial hemorrhage due to throbocytopenia. Which nervous system finding will you see?

 

Definition
H/A, nuchal rigidity
Term
Multiple myeloma R/T enlarged tumors that stretch periosteum; bone invasion by leukemia cells; bone demineralization resulting from various malignancies; sickle cell disease may result in which musculoskeltal finding
Definition
bone pain
Term
Which musculoskeletal finding occurs w/ hemophilia and sickle cell anemia as bleeding occurs in hoint (hemarthria) causing inflammation?
Definition
Joint swelling
Term
Sickle cell disease from hemarthrosis causes joint swelling and ____.
Definition
arthralgia- joint pain
Term

 About 1mg of every 10-20mg of iron is ingested in the _______________.

 

Definition
duodenum, and upper jejunum
Term
Name some sources of iron
Definition

Oatmeal, peas, lentils, clams, beef, chicken, sunflower seeds, turkey, oysters, cashews, pumpkin seeds, bran cereals, and beets.

The best is green leafy vegetables to eat is raw spinach, kale, or chard

Term
Name the functions of the spleen.
Definition
hematopoietic (produce RBC during fetal development), filtration(remove old and defective RBCs from the circulation by the mononuclear phagocyte system), immunologic( contains a rich supply of lymphocytes, monocytes, and stored immunoglobulins), and storage(storage site for RBCs and platelets)
Term
Common causes of blood clotting dysfunction
Definition
liver disease
Term
What are the 6 clotting factors the liver makes?
Definition
I (fibrinogen, II (Prothrombin), IV, V, VI, and VII
Term
If there is a decrease in the clotting factors made by the liver, what will be abnormally prolonged?
Definition
Prothrombin time (PT)- therefore can be used to indicate liver function/ dysfunction
Term
Which value is decreased in cases of anemia, hemorrage, and states of hemodilution, such as those that occur when the fluid volume is excessive?
Definition
Hemoglobin (Hb)
Term
Which value is determined by spinning blood in a centrifuge, which causes RBCs and plasma to separate.
Definition
Hematocrit (Hct)
Term
A measurement of gas-carrying capacity of RBC
Definition
Hemoglobin
Term
What are Hb norms?
Definition

Male= 13.2-17.3

Female= 11.7-16

Term

Measure of packed cell volume of RBDs expressed as a percentage of the total blood volume

 

Definition
Hematocrit
Term
What are Hct norms?
Definition

Male= 39-50%

Female= 35-47%

Term
Measurement of total number of leukocytes
Definition
WBC
Term
What are WBC norms?
Definition
4-11,000
Term
Measurement of number of platelets available to maintain platelet clotting functions (not a measurement of quality of platelet function)
Definition
Platelet count
Term

What are platelet count norms?

 

Definition
150,000-400,000 (150-400)
Term
What are the neutrophil norms?
Definition
50-70%
Term
A total WBC count < 4000/uL associated with bone marrow depression, severe or chronic illness, and/or some types of leukemia
Definition
leukopenia
Term
Atest that assesses the intrinsic coagulation by measuring factors I,II,V,VIII,IX,X,XI,XII;is longer with use of heparin
Definition

Activated partial thromboplastin time 

(aPTT)

25-35 sec

Term
Standardized system of reporting PT based on reference calibration model and calculated by comparing the pts PT with a control value
Definition

International Normalized Ratio

(INR)

2-3 is desired level with coumadin

Term
Measurement of all proteins available for binding iron; transferrin represents the largest quantity of iron-binding proteins
Definition

Total Iron-binding capacity

(TIBC)

250-425 or 45-76

Term
Measurement of immature RBCs; reflection of bone marrow activity in producing RBCs
Definition

Reticulocyte count

0.5-1.5%

Term
The largest of proteins that bind iron; increased in majority of people with iron-deficiency anemia
Definition

Transferrin

190-380mg/dL

Term
Decreased in iron-deficiency anemia and increased in hemolytic and megaloplastic anemia
Definition

Transferrin saturation

15-50%

Term
An electrophoretic measurement is used to detect the presence of the Bence Jones protein, which is found in most cases of multiple myeloma. Negative is considered nml. Requires a random urine specimen
Definition
Bence Jones protein test
Term
An individual who lives at high altitudes may normally have an increased # of RBC bc
Definition
hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis
Term
Malignant disorders that arise from granulocytic cells in the bone marrow will have the primary effect of causing what?
Definition
decreased phagocytosis of bacteria
Term
An anticoagulant such as warfarin (Coumadin) that interferes w/ prothrombin production will alter the clotting mechanism during
Definition
activation of thrombin
Term
When reviewing lab results of an 83y/o ot w/ an infection, the nurse would expect to find what?
Definition
minimal leukocytosis
Term
Significant info obtained from the pts health hx that r/t the hematologic system includes
Definition
jaundice
Term
While assessing the lymph nodes, the nurse must
Definition
lightly palpate superficial lymph nodes w/ the pads of the fingers
Term
If a lymph nose is palpated, which of the following is a normal finding?
Definition
Firm, mobile nodules
Term
Nursing care for a pt immediately following a bone marrow biopsy and aspiration includes:
Definition

administering analgesics as necessary

Instruct pt on need to lie still w/ a sterile pressure drsg intact

Monitor V/S and assess the site for excess drainage or bleeding

Term
Functions as a filter, produces all the procoagulants that are essential to hemostasis and blood coagulation, and stores iron that is in excess of tissue needs, which can occur frequent blood transfusions or diseases that cause iron overload.
Definition
liver
Term
A key regulator of iron balance produced by the liver
Definition
Hepcidin
Term
Synthesis of hepcidin is stimulated by..
Definition
iron overload or inflammation
Term
What is the most important granulocyte?
Definition
Neutrophil
Term
Describe the formation process of a clot.
Definition
When blood vessel is injured, gets vascular response (local vasoconstriction occurs); Vascular spasm may last up to 20-30 min to allow time for the platelet response and plasma clotting factor to be activated; Once activated, Platelets stick to one another to form clumps and release platelet factor 3 and serotonin to facilitate coagulation. At the same time platelets release sdenosine diphosphate to increase adhesiveness and aggregation; In addition von Willebrand's factor forms adhesive bridgs btwn platelets and endothelial structure, causing platelet plug formation; Plasma proteins circulate in inactive forms until stimulated by either the intrinsic (blood vessel) or extrinsic (tissue) pathway; thrombin converts fibrinogen to fibrin which is essential to form a blood clot; Lastly, fibrolynic system is initiated when plasminogen is activated by plasmin that attacks either fibrin or fibrinogen by splitting the molecules into smaller elements.
Term

List the different types of anemias

 

Definition

- Iron-deficiency anemia

- Thalassemia

- Megaloplastic anemia

- Aplastic Anemia

-Anemia of chronic disease

- Acquired Hemolytic Anemia

-Pernicious Anemia

 

 

Term
s/s of anemia
Definition
  • Hb <10-12
  • palpitations
  • dyspnea
  • mild fatigue
  • pallor
  • jaundice
  • pruritis
  • sclera of the eyes & mucous membranes are jaundice
  • may develop systolic murmurs or bruits
  • Extreme cases may involve HF, cardiomegly, pulmonary and systemic congestion, ascites, & peripheral edema

 

Term

What is the difference btwn sickle cell anemia and thalassemia?

 

Definition
They are both autosomal recessive genetic disorders but thalassemia causes a decrease RBC production. It involves inadequate production of nml Hb. Hemolysis occurs w/ Thalassemia, but insufficient production of nml Hb is the main problem. It is due to absent or reduced globulin protein. Sickle Cell is the presence of an abnormal form of Hb in the RBC. Hemoglobin S causes the RBC to stiffen and elongate, taking on a sickle chape in response to low O2 levels. HbS results from the substitution of valine for glutamic acid on the beta globulin chain.
Term

Describe the role cobalamin plays in pernicious anemia.

 

Definition
Intrinsic Factor is secreted by the gastric mucosa, if it is not secreted cobalamin is not absorbed. In pernicious anemia, the gastric mucosa is not secreting intrinsic factor bc of ABXes being directed against the gastric parietal cells and/or IF itself. 
Term

Cobalamin is absorbed in the ___

 

Definition
distal ileum
Term
A disease of insideous onset that begins in the middle ages or later (usually after 40).
Definition
Pernicious Anemia
Term
In_____, pernicious anemia tends to begin early, and occurs w/ women more often than men, and is more severe.
Definition
African Americans
Term

What are some other causes of Cobalamin deficiency?

 

Definition
gastrectomy, chronic gastritis, Crohn's, ileitis, celiac disease, diverticuli, nutritional deficiency, chronic alcoholism, and hereditary enzymatic defects of Cobalamin utilization.
Term

What are some clinical manifestations of Cobalamin deficiency?

 

Definition
sore, red, beefy, and shiny tongue, anorexia, n/v, and abdominal pain, weakness, parasthesis of feet and hands, reduced vibratory and position senses, ataxia, muscle weakness, impaired thought process.
Term
What are s/s of G6PD?
Definition
RBCs are affected by oxidative stress more easily from triggers such as; medications (sulfonamides, sulfones, malaria-fighting drugs [such as quinine], or methylene blue [UTI tx], napthalene (an agent in mothballs), or fava beans.Pt may experience fatigue, pallor, jaundice possibly leading to kernicterus, anemia, elevations in pulse and respirations, neurologic status may be affected, note oxygen sat via pulse ox and blood gas, note tea-colored urine, possible hemolytic crisis and inspect for splenomegly.
Term
What is Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency? 
Definition
G6PD is an enzyme that is responsible for maintaining the integrity of RBCs by protecting them from oxidative substances. It is a X-linked recessive disorder that occurs when RBCs have insufficient G6PD, or the enzyme is abnormal and does not function normally. 
Term

G6PD is most common in who?

 

Definition
Males of African American descent.
Term

What is nurse mgmt of G6PD?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Definition
administer O2 and treat the symptoms
Term
s/s of lead poisoning
Definition
behavioral problems and learning difficulties, encephalopathy, seizures, and brain damage
Term
What is the treatment of high lead blood levels?
Definition
chelation therapy- removes lead from soft tissue and bone, allowing for its exvretion via the renal system; monitor I/O carefully, encourage oral hydration or provide IV hydration
Term
What is the nursing process for anemia?
Definition
correct the cause of anemia, drug therapy, blood products, volume replacement, oxygen therapy, dietary and lifestyle changes, saftey precautions
Term

The most common human enzyme defect is____

 

Definition
G6PD
Term
Age-related changes in hematologic system
Definition

red marrow and # of stem cells decrease, marrow space declines after 70, Hb levels decrease after middle age, not able to produce reticulocytes in response to hemorrhage or hypoxemia, nutritional intake of iron may be decreased, osmotic fragility of RBC is increased, May have a slight increase in MCV and a slight decrease in MCHC of RBCs, decrease in Tcell function and humoral antibody response.

*Platelets and WBC count are not affected, and Iron absorption is not impaired.

Term

4 Nursing interventions for thalassemia

 

Definition
Thalessemia minor requires no interventions. Thalassemia major is managed w/ blood transfusions or exchange transfusions in conjuction w/ oral deferasirox (Exjade) or IV or SQ deferoxamine (Desferal) (chelating agents that bind to iron) to reduce iron overloading (hemochromatosis) that occurs w/ chronic transfusion therapy. Give folic acid if evidence of hemolysis, Zinc supplementation may be needed as well as absorbic acid during chelation therapy (increase urine excretion of iron), iron supplements, splenectomy. Monitor cardiac, hepatic, pulmonary organ function. A hematopoietic Stem Cell Transplantation (HSCT) remains the only cure.
Term
What is polycythemia?
Definition
the production and presence of increased #s of RBCs
Term

What are the 2 types of polycythemia? Differentiate btwn the 2.

 

Definition

Primary polycythemia or polycythemia vera and secondary polycythemia.

Polycythemia vera is considered a chronic myeloproliferative disorder arising from chromasomal mutation (a single recurrent JAK2 mutation) in a single pluripotent stem cell. Therefore RBC, WBC, and platelets are involved, leading to increase in these blood cells.

Secondary polycythemia can be either hypoxia driven or hypoxia independent. It is a physiologic response in which the body is trying to compensate for a problem rather than a pathologic response.

Term
Name 3 types of throbocytopenia.
Definition

Immune thrombocytopenic Purpura

Thrombotic Thrombocytopenic Purpura

Heparin- Induced Thrombocytopenia

 

Term

What are appropriate nursing interventions for thrombocytopenia?

 

Definition
notify caregiver of black tarry stool; ask about restrictions in nml activities; do not blow nose forcefully, pat it with tissue; If you are weak, get supervision during activities; If nosebleed occurs, apply firm pressure to the nostrils and bridge of the nose; dont bend w/ head lower than waist; prevent constipation, Drink plenty of fluids; shave only w/ electric razor, do not pluck eyebrows or other hair; do not puncture skin, avoid tattoos and piercings; avoid using meds that can prolong clotting; use soft bristle toothbrush; no alcohol based mouthwashes; women keep track of amt of bleeding during menstration; ask MD before any invasive procedures
Term

What is difference btwn hemophilia and von Willabrand's disease?

 

Definition
Hemophilia is an X-linked recessive genetic disorder caused by defective or deficient coagulation factor and is displayed almost exclusively in men. Two forms are Hemophilia A (classic hemophilia, factor VIII deficiency) and Hemophillia B (Christmas disease, factor IX deficiency); von Willabrand disease is a related disorder involving deficiency of von Willabrand coagulation protein vWB is autosomal dominant (seen in both genders) and recessive (severe forms)
Term
most common form of Hemophillia
Definition
Hemophillia A; makes up approimately 80% of all cases
Term
What is the most common congenital bleeding diorder?
Definition
vWB disease; life threatening hemorrhage is rare in this disease
Term
Nursing Interventions for Hemophilia
Definition
stop bleeding as quickly as possible and apply pressure, administer specific coagulation factor, manage life- threatening complications by prevention or treatment of airway obstructionfrom hemorrhage into the neck and pharynx, recognize compartment syndrome, and early assessment and treatment of intracranial bleeding.
Term
What is neutropenia?
Definition

a reduction in neutrophils

(<1000)

Term
Nursing interventions for neutropenia
Definition
Prevent infection, good handwashing, use isolation precautions, assess for subtle signs of infections, low grade temp should be reported. Neutrophil count <500 and temp greater than 100.4 is medical emergency., screen visitors for communciable disease, eliminate undercooked food from diet, Administer ABX and hemopoietic growth factors, check ckin, oral mucosa, and perineal for s/s of infection, obtain v/s and assist w/ oral care and personal hygiene, use HEPA filtration if available.
Term
Nursing and collaborative care of neutropenia
Definition

1- determine cause of neutropenia

2- identifying the offending organisms if an infection has developed

3- instituting prophylactic, empiric, or therapeutic ABX therapy

4- administering hematopoietic growth factors

5- instituting environmental practices, such as strict handwashing, visitor restrictions, and private room if hospitalized, a positive pressure room and HEPA filter

Term
what are lymphomas?
Definition
neoplasms originating in the bone marrow and lymphatic structures resulting in the proliferation of lymphocytes
Term
The 5th most common type of CA in the US.
Definition
Lymphomas
Term
Name the two major types of lymphomas
Definition
Hodkin's and Non-Hodgkins lymphoma
Term
Compare Hodgkins and Non-Hodgkins
Definition
Hodgkins cellular origin is B lymphocytes and Non-Hodgkins cellular origin is B (90%) and T lymphocytes.(10%) Hodkins is localized to regional, but may be more widespread adn Non-Hodgkins is disseminated. B symptoms that include fever, night sweats, and wgt loss is common in Hodgkins and is seen in about 40% in Non-Hodkins. Extranodal involvement is rare in Hodgkins, but is common in Non-Hodgkins.
Term
What is the most commonly occurring hematologic CA and 5th leading cause of CA death
Definition
Non-Hodgkin's Lymphoma
Term
Name some precipitating factors that cause DIC.
Definition
hemorrhagic, cardiogenic, and anaphylactic shock, septicemia, Hymolytic processes (transfusion of mixed matched blood, acute hemolysis from infection or immunologic disorders), Malignancies, tissue damage, transplant rejections, post-op damage, fat and pulmonary emboli, snakebites, glomerulonephritis, acute anoxia, prosthetic devices, obstetric (retained dead fetus), liver disease, lupus
Term
What is DIC characterized by?
Definition
profuse bleeding that results from the depletion of platelets and clotting factors.
Term
Nursing Interventions for DIC
Definition
early detection of bleeding, astute accurate assessment, monitor s/s of acute bleeding, monitor coagulation studies, avoid injections, use electric razor, administer blood product, protect pt from trauma,instruct pt to avoid high impact activities, 
Term
name the two types of blood transfusion reactions
Definition
Acute and Delayed transfusion reactions
Term
The most common cause of hemolytic reactions is transfusion of _____
Definition
ABO incompatible blood
Term
Febrile reactions are most commonly caused by _____. 
Definition
leukocyte incompatibility
Term
_____ result from the recipient's sensitivity to plasma proteins of the donor's blood.
Definition
Allergic reactions
Term
Delayed hemolytic reactions include 
Definition
delayed hemolytic reactions, infections, and iron overload.
Term
Name some infectious agents transmitted by blood transfusions
Definition
hepatitis B & C, HIV, HSV-6, Epstein- Barr virus, human T-cell leukemia virus type 1 (HTLV-1), cytomeglovirus, and malaria
Term
In a severely anemic pt, the nurse would expect to find which s/s?
Definition
tachycardia and dyspnea
Term
When obtaining assessment data from a p[t w/ microcytic, hypochomic anemia, the nurse would question the pt about what?
Definition
dietary intake of iron
Term

Nursing interventions for a pt w/ severe anemia r/t peptic ulcer disease would include

 

Definition

monitoring stools for guaiac

instructions for high- iron diet

Term
The nursing mgmt of a pt in sickle cell crisis includes
Definition

monitoring of CBC

blood transfusions if required and chelation therapy

rest as needed and DVT prophylaxis

optimal pain mgmt and oxygen therapy

Term
A complication of the hyperviscosity of polycythemia is
Definition
thrombosis
Term
When providing care for a pt w/ thrombocytopenia, the nurse instructs the pt to
Definition
dab his or her nose instead of blowing
Term
The nurse would anticipate that a pt w/ von Willabrand disease undergoing sx would be treated w/ administration of vWF and 
Definition
factor VIII
Term
DIC is a disorder in which
Definition
a disease process stimulates coagulation processes w/ resultant thrombosis, as well as depletion of clotting factors, leading to diffuse clotting and hemorrhage.
Term
Priority nursing action when caring for a hospitalized pt w/ new onset temp of 102.2 and severe neutropenia include
Definition

administering the prescribed ABX stat

Drawing peripheral and central line blood cultures

Ongoing monitoring of pts v/s for septic shock

taking a full set of v/s and notify physician immediately

Term

Because myelodysplastic syndrome arises from the pluripotent hematopoietic stem cell in the bone marrow, lab results the nurse would expect to find are

 

Definition
a deficiency of all cellular blood components
Term
The most common type of leukemia in older adults is
Definition
chronic lymphocytic leukemia
Term
Multiple drugs are often used in combinations to treat leukemia and lymphoma bc
Definition
the drugs work by different mechanisms to maximize killing of malignant cells
Term
The nurse is aware that the major difference btwn Hodkins and Non-Hodgkins lymphoma is that
Definition
Non-Hodgkins lymphoma can manifest in multiple organs
Term

A pt w/ multiple myeloma becomes confused and lethargic. The nurse would expect that these clinical manifestations may be explained by diagnostic results that indicate

 

Definition
hypercalcemia
Term
When revieewing the pts hematologic lab values after a splenectomy, the nurse would expect to find
Definition
increased platelet count
Term
Complications of blood transfusions that can be decreased by the use of leukocyte depletion or reduction of RBC transfusion are
Definition
transmission of cytomegalovirus and fever
Term
What is the most common leukemia in children?
Definition
Acute lymophocytic leukemia
Term
immature lymphocytes proliferate in the bone marrow; most are of B-cell origin
Definition
Acute lymphocytic leukemia
Term
characterized by uncontrolled proliferation of myeloblasts, the precursors of granulocytes
Definition
Acute Myelogenous leukemia
Term
Is caused by excessive development of mature neoplastic granulocytes in the bone marrow
Definition
Chronic Myelogenous Leukemia
Term
The most common leukemia in adults.
Definition
Chronic lymphocytic leukemia
Term
characterized by the production and accumulation of functionally inactive but long-lived small, mature-appearing lymphocytes.
Definition
chronic lymphocytic leukemia
Term
Important nursing interventions of leukemia are:
Definition

- maximizing pt physical functioning

-providing hope that acute symptoms of treatment are usually temporary

- encouraging pts to discuss their quality-of-life issues

Term

Nursing interventions of multiple myeloma

 

Definition

- maintain adequate hydration

- monitor fluid and electrolytes

-be careful when moving and ambulating pt due to pathological fractures

-pain mgmt

-assessmentand prompt treatment of infection is important in the care of pts w/ multiple myeloma

-address pts psychosocial needs

- assist the family with coping mechanisms of death

-assess for peripheral neuropathy

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