Hematology-Review and Rationale – Flashcards
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What are the components of blood?
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Plasma-consists of water, amino acids, proteins, carbohydrates, lipids, vitamins, hormones, electrolytes, and cellular wastes Blood cells Platelets
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What is erythropoiesis?
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RBC being formed within the bone marrow as erythroblasts, when eventually mature into erythrocytes
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What is culling?
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Destruction of RBC Lifes pan of 120 days
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How does culling occur?
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Phagocytic cells in the liver, spleen, bone marrow, and lymph nodes recognize ingest and destoy old blood cells The amino acids from the globulin and the iron from the heme are spared. Heme is converted to bilirubin
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Define hemoglbbin and hematocrit level?
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Hemoglobin measures the hemoglobin in circulation Hematocrit is the ration of RBC volume to volume of whole blood
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What is the normal bleeding time?
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1 to 4 minutes
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What is PT?
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Prothrombin time- evaluates extrinsic pathway Rapidity of blood clotting; normal range is 11 to 16 INR is often currently used instead of PT- therapeutic range often varies from 2 to 3 depending on condition.
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What is PTT?
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Evalutes intrinsic pathway Normal ranges is 60 to 70 seconds
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What is the normal WBC value?
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5,000-10,000/mm3 Neutrophlils - 70% Eosinophils 1-3% Basophils-.3% to .5% Lymphocytes- 20-30% Monocytes - 3 -8%
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What are the nursing actions fo administering blood products?
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KVO with normal saline Validate data on the blood or blood product with another nurse Obtain pre-tranfusion vital signs Stay with client first 15 minutes
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What are the nursing actions for suspected blood tranfusion reaction?
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Stop immediately KVO with normal saline Notify physician
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What is iron-deficiency anemia?
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Anemia that results when the supply of iron is inadequate for optimal formation of RBC
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What causes iron deficiency anemia?
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Blood loss from GI or GU system Normal iron excretionis less than 1mg/day through urine, sweat, bile, feces Women lose .5 to 15mg monthly during menstraution Iron is stored as ferritin
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What is the clinical assessment findings for anemia?
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Fatigue Weakness SOB Pallor Brittle spoon like nails Cheilosis (cracks in corner of mouth) Smooth, sore tongue Pica (craving to eat unusual substances)
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What is the therapeutic management for iron deficiency anemia?
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Administration of iron Vitamin supplement Increase of iron-rich foods
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What are the nursing actions for iron deficiency anemia?
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Administer with Vitamin C to increase absorption- (not grapefruit)- Take oral iron on empty stomach to increase absorption Parenteral iron IM with z-track method Caution client that bowel movment may appear greenish/black tarry Use seperate needles for drawing and injecting medication
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What is megaloblastic anemia?
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Vitamin B12 deficiency anemia Anemia characterized by enlarged RBC
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What are the causes?
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Inevitably occurs after total gastrectomy Lack of Vitamin B12 alters the structure and disrupts the function of the peripheral nerves Pernicious anemia is the body's inability to absorb Vitamin B12 bc lack of intrinsic factor (substance secreted by parietal cells)
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What are the clinical manifestations of megaloblastic anemia?
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Pallor and slight jaundice Beefy red tongue (glossitis) Impaired proprioception
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What is the therapeutic management for megaloblastic?
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Nutrition if not caused by lack intrinsic factor defiency Lifelong-B12 supplement
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What is folic acid deficiency anemia?
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Anemia caused by a deficiency of folic acid resulting in the interruption of DNA synthesis and normal maturation of RBC
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What causes folic acid deficiency anemia?
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Nutrition Medications that impede absorption
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What are the assesment findings for folic acid deficiency anemia?
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Pallor Progressive weakness Fatigue SOB GI symptoms are similar to B12; however, neurological symptoms are not present
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What is the client education for folic acid disorders?
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Discuss dietary sources of folic acid
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What is aplastic anemia?
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Aplastic anemia is a form of anemia resulting in decreased production of bone marrow elements, namely erythrocytes, leukocytes, and platelets
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What causes aplastic anemia?
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Congenital Acquired-radiation, chemical agents, toxins, etc There is a decrease or cessation of production of RBC, WBC, and platelets
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What is sickle cell disease?
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Hereditary chronic form of hemolytic anemia RBC take on sickle shape
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What conditions can cause a sickle cell crisis?
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Hypoxia Low environmental body temp Excessive exercise High altitudes
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What assessment findings are consistent with a sickle cell crisis?
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Priaprism (male) Pallor Jaundice Fatigue
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What is the therapeutic managment for sickle cell crisis?
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Bone marrow transplant Blood transfusions Management of pain
