Term
|
Definition
|
|
Term
|
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
|
Definition
| (the process of red blood cell production) is regulated by cellular oxygen requirements and general metabolic activity |
|
|
Term
|
Definition
| a deficiency in the number of erythrocytes(red blood cells), the quantity of hemoglobin, and/or the volume of packed RBCs (hematocrit). |
|
|
Term
|
Definition
| a continual process resulting in the dissolution of fibrin to maintain blood in its fluid form |
|
|
Term
|
Definition
| blood cell production that occurs within the bone marrow |
|
|
Term
|
Definition
| destruction of RBCs by monocytes and macrophages removes abnormal, defective, damaged, and old RBCs from circulation. |
|
|
Term
|
Definition
| an autosomal recessive disease characterized by increased intestinal iron absorption and, as a result, increased iron deposition |
|
|
Term
|
Definition
| an anemia caused by destruction of RBCs at a rate that proceeds production |
|
|
Term
|
Definition
| hereditary bleeding diorders caused by defective or deficient clotting factors |
|
|
Term
|
Definition
| a malignant condition characterized by proliferation of abnormal giant, multinucleated cells, called Reed-Strenberg cells, which are locatedin lymph nodes |
|
|
Term
|
Definition
| an abnormal decrease in the number of total white blood cells to <4000/ uL |
|
|
Term
|
Definition
| Its cell function is phagocytosis, expecially during the early phase of inflammation |
|
|
Term
|
Definition
| a microcytic hypochromic anemia caused by inadequate supplies of iron needed to synthesize hemolglobin; characterized by pallor, fatigue, weakness |
|
|
Term
|
Definition
| a broad term given to a group of malignant diseases characterized by diffuse replacement of bone marrow with proliferating leukocyte precursers |
|
|
Term
|
Definition
| malignant neoplasm originating in the bone marrow and lymphocytic structures resulting in proliferation of lymphocytes |
|
|
Term
|
Definition
| a group of disorders caused by impaired DNA synthesis and characterized by the presence of large red blood cells |
|
|
Term
|
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
|
Definition
| an abnormal reduction of neutrophil count to <1000/uL |
|
|
Term
|
Definition
| a heterogeneous group of malignant neoplasms involving lymphoid tissue |
|
|
Term
|
Definition
| marked decrease in the number of red blood cells, white blood cells, and platelets |
|
|
Term
|
Definition
| a progressive megaloblastic macrocytic anemia resulting from inadequate gastric secretion of intrinsic factor necessary for absorption of cobalamin |
|
|
Term
|
Definition
|
|
Term
|
Definition
| an abnormal condition with excessive levels of red blood cells |
|
|
Term
|
Definition
|
|
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
|
Definition
| a reduction of the platelet count |
|
|
Term
|
Definition
| an autosomal recessive genetic disorder of inadequate production of normal hemoglobin |
|
|
Term
|
Definition
| a condition marked by excessive platelets; a disorder that occurs with inflammation adn some malignant disorders |
|
|
Term
|
Definition
| a reduction of the platelet count |
|
|
Term
|
Definition
| Its cell function is phagocytosis (not as effective as neutrophil); allergic response; protection from parasitic infections |
|
|
Term
|
Definition
| Its cell function is the inflammatory response and allergic response; release of bradykinin, heparin, histamine, serotonin, limited phagocytosis |
|
|
Term
|
Definition
| Neutrophil, Eosinophil, Basophil |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Its cell function is cellular and humoral immune response |
|
|
Term
|
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
|
|
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
|
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
|
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
|
|
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
|
|
Term
| What is the primary function of erythrocytes (RBCs)? |
|
Definition
| transport of gases (both O2 and 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
|
|
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
|
|
Term
| An accumulation of bile pigment caused by rapid or excessive hemolysis or liver damage may show which skin finding |
|
Definition
|
|
Term
| Reduced Hb, excessive concentration of deoxyHb in blood may show what finding in skin |
|
Definition
|
|
Term
| Scratching from intense puritis may show what skin finding |
|
Definition
|
|
Term
| Hodgkins Lymphoma, cutaneous lymphomas, infiltrative lymphomas, and increased bilirubin may show which skin finding |
|
Definition
|
|
Term
| Sickle cell disease may show which skin finding |
|
Definition
|
|
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
|
|
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
|
|
Term
| Anemia, fluid volume overload, hypotension w/impending syncope, hypertension, and dysrhythmias may cause which finding of heart and chest |
|
Definition
|
|
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
|
|
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
|
|
Term
| Which finding of heart and chest will you find in cases of severe anemia? |
|
Definition
|
|
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
|
|
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
|
|
Term
| Which musculoskeletal finding occurs w/ hemophilia and sickle cell anemia as bleeding occurs in hoint (hemarthria) causing inflammation? |
|
Definition
|
|
Term
| Sickle cell disease from hemarthrosis causes joint swelling and ____. |
|
Definition
|
|
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
|
|
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
|
|
Term
| Which value is determined by spinning blood in a centrifuge, which causes RBCs and plasma to separate. |
|
Definition
|
|
Term
| A measurement of gas-carrying capacity of RBC |
|
Definition
|
|
Term
|
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
|
|
Term
|
Definition
Male= 39-50%
Female= 35-47% |
|
|
Term
| Measurement of total number of leukocytes |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Measurement of number of platelets available to maintain platelet clotting functions (not a measurement of quality of platelet function) |
|
Definition
|
|
Term
What are platelet count norms?
|
|
Definition
| 150,000-400,000 (150-400) |
|
|
Term
| What are the neutrophil norms? |
|
Definition
|
|
Term
| A total WBC count < 4000/uL associated with bone marrow depression, severe or chronic illness, and/or some types of leukemia |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| When reviewing lab results of an 83y/o ot w/ an infection, the nurse would expect to find what? |
|
Definition
|
|
Term
| Significant info obtained from the pts health hx that r/t the hematologic system includes |
|
Definition
|
|
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
|
|
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
|
|
Term
| A key regulator of iron balance produced by the liver |
|
Definition
|
|
Term
| Synthesis of hepcidin is stimulated by.. |
|
Definition
| iron overload or inflammation |
|
|
Term
| What is the most important granulocyte? |
|
Definition
|
|
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
|
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
|
|
Term
| A disease of insideous onset that begins in the middle ages or later (usually after 40). |
|
Definition
|
|
Term
| In_____, pernicious anemia tends to begin early, and occurs w/ women more often than men, and is more severe. |
|
Definition
|
|
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
|
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
|
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
|
|
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
|
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
|
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
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Term
| When obtaining assessment data from a p[t w/ microcytic, hypochomic anemia, the nurse would question the pt about what? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| When revieewing the pts hematologic lab values after a splenectomy, the nurse would expect to find |
|
Definition
|
|
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 |
|
|
