Blood And Lymph 2118

Front 1

Hematopoetic System

Back 1

Bone marrow and lymph

Front 2

Origin of all blood cells

Back 2

stem cells/hemacytoblast

Front 3

Causes stem cells to differentiate into familial parenteral cells

Back 3

Regulatory Mechanism

Front 4

Functions of blood

Back 4

1 Transport of oxygen,nutrients,hormones and metab wastes
2 Protect against invasion of pathogens
3 Maintain coagulation
4 Regulates fluids,electrolytes, acids,bases, and TEMPERATURE

Front 5

Normal value Reticulocytes

Back 5

slides: 0.5-2.5%

Front 6

Increased RBC

Back 6

Polycythemia

Front 7

Normal Value WBC

Back 7

4000-11000/uL

Front 8

Immature RBC's

Back 8

Reticulocytes

Hint 8

Suggests hemolysis or acute blood loss

Front 9

Oxygen Carrying capacity

Back 9

Hgb

Front 10

Transport medium

Back 10

Plasma

Front 11

Hemostasis

Back 11

Pct

Front 12

Decreases first in acute blood loss

Back 12

Rbc

Hint 12

Hgb and Hct stabilize in 4 hours

Front 13

measures the average size of RBC

Back 13

Mean Cell Volume(MCV)

Hint 13

Hct + RBC

Front 14

Measures the amount or mass of Hgb

Back 14

Mean Cell Hgb

Hint 14

RBCs that are normochromic versus hypo hyperchromic

Front 15

Manual differential

Back 15

used to confirm microcytic cells,
confirm low or high platelet, count,
Identify abnormal RBCs,
Identify abnormal WBCs,

Front 16

Abnormal RBCs

Back 16

Anisocystosis-size,
Poikilocytosis-shape

Front 17

Abnormal WBCs

Back 17

Bands vs Segs,
Leukemic blast cells

Front 18

Immature Netrophils

Back 18

Bands : 3-5%

Front 19

Granulocytes

Back 19

Basophils: 0.4-1%,
Eosinophils: 1-3%,
Neutrophils: 50-70%,

Front 20

agranulocytes

Back 20

Lymphocytes:25-35%,
Monocytes: 4-6%

Front 21

Left Shift

Back 21

The immature bands increase or out number the segmented neutrophils

Front 22

RBC critical value

Back 22

Hgb < 7, Hct < 21

Front 23

Acute blood loss (Anemia)

Back 23

Normochrocomic, Nomocytic

Hint 23

MCV & MCH is normal

Front 24

Iron Deficient,Inherited Anemia's

Back 24

microcytic,hypochrcomic

Hint 24

MCV low,MCH loW

Front 25

Chronic Illness, sometimes thalasemia

Back 25

Microcytic,Normochomic

Hint 25

MCV low; MCH normal

Front 26

B12 and Folate deficiency anemia

Back 26

Macrocytic

Hint 26

MCV high; MCH andMCHC Variable

Front 27

Signs and Symptoms of anemia

Back 27

can be asymptomatic

Front 28

Laboratory for Microcytic Anemia

Back 28

Serum Feritin, Iron, Total Ir0n Binding Capacity(TIBC),Homoglobin electrophoresis,

Front 29

Laboratory for Macrocytic (Megaloblastic Anemia)

Back 29

B12 & folate

Hint 29

Shilling test

Front 30

Laboratory forHemolytic Anemia

Back 30

Reticulocyte, Direct coombs test

Front 31

Laboratory for Pancytopenia

Back 31

Bone Marrow Biopsy

Front 32

findings in Acute Hemorrhagic Anemia

Back 32

-fluid shift from interstitial to intravascular space
-FIRST cbc sign is LOW RBCs
-accurately reflected in h&h in about 4hours
-May manifest low iron early on

Front 33

Findings in chronic blood loss

Back 33

Typically normal RBCs
-Microcytic, Hypochromic
With decreased iron stores
-Increased TIBC
-Deacreased serum Iron
-Low ferritin
-MILD increase in Reticulocyte count

Front 34

S&S of Iron Deficiency Anemia

Back 34

-Mild to Moderate fatigue, weakness, activity intolerance, Dyspnea, Pica
-BRITTLE SPOON SHAPED NAILS, Cheilosis

Front 35

Treatment for Iron deficiency anemia

Back 35

Diet,
Iron Sucrose,
Dextran- IM,Oral or IV

Front 36

Causes of Iron Deficiency Anemia

Back 36

Diet-Vegetarian,
Decreased absorption,
Increased metabolic, requirements,
Blood loss,
Chronic Hemoglobinuria,

Front 37

Dietary sources for Heme Iron

Back 37

Beef, Chicken, Egg yolk, Clams, Oysters, Pork loin, Turkey and Veal

Front 38

Sources of non heme Iron

Back 38

Bran flakes, Brown Rice, whole grain breads, Dried beans, Dried fruits, Greens, Oatmeal

Front 39

Sources of folic acid

Back 39

Green Leafy Veg, Brocoli,Organ meats, Eggs, wheat grain, asparagus, Liver, Milk, Yeast, Kidney beans

Front 40

Sources of Vit B12

Back 40

Liver, Fresh shrimp and oysters, Eggs, Milk, Kidneys, Meats(muscle), Cheese

Front 41

What is deficient Megaloblastic Anemia?

Back 41

Folate and B12

Front 42

Paresthesia

Back 42

Only in B12 deficiency

Front 43

Labs for B12 Deficiency

Back 43

shillings test-24 hours urine collection

Front 44

treatment for B12 deficiency

Back 44

Diet and suplements,
Life long injection with Pernicious anemia

Front 45

Symptoms for Folic acid deficiency

Back 45

Glositis and cheilosis,
if with Neuro symptoms its B12

Front 46

Premature Lysis of RBC

Back 46

Hemolytic Anemia

Front 47

Hematopoetic Activity leads to

Back 47

increased reticulocytes

Front 48

initial manifestation of anemia

Back 48

tachypnea and tachycardia

Front 49

Care for iron deficiency anemia

Back 49

Iron rich food,
oral supplement

Front 50

care for vit b12 anemia

Back 50

Dietary intake,
oral supplement,
parenteral supplement for malabsorption

Front 51

Care for folic acid anemia

Back 51

Dietary intake,
oral supplement,
Suplements for pregnant women

Front 52

Care for sickle cell crises

Back 52

Rest,
Oxygen,
Narcotics,
Vigorious Hydration,
Tx precipitating factor

Front 53

Care for Vhest Syndrome

Back 53

Hydration,
Oxygen,
Transfusion,

Front 54

Care for Thalasemia

Back 54

Regular BT,
Folic acid supplement,
Splenectomy,
genetic counseling,

Front 55

Care for aplastic anemia

Back 55

Withdrawal causative agent,
BT,
Bone marrow transplant

Front 56

HYDROXYUREA

Back 56

A drug that promotes fetal, hemoglobin production

Front 57

Aplastic anemia med mnmgt

Back 57

Immunosupressive therapy with antithymocyte globulin, Corticosteroids, and cyclosporines

Front 58

Hypertension in polycethemia

Back 58

Caused by increased blood, viscosity,
may lead to complaints of h/a, dizziness and blurred vision with hearing dysruptions

Front 59

2 types of hodgkin's dse virus

Back 59

Epstein-Barr Virus,
Reed-steinberg(malignant cells)

Front 60

MHCH

Back 60

% of hgb in RBC
how much Iron is in Hgb

Front 61

Can indicate sepsis in BMT

Back 61

Left shift

Front 62

in anemia heart rate increases upto 110-120 inducates

Back 62

SHOCK

Front 63

Nsg diagnosis in anemia

Back 63

activity intolerance

Front 64

MCV and MCH normal

Back 64

Normochromic Normocytic
Acute blood loss

Front 65

MCV low MCH low

Back 65

Microcytic hypochromic,
Iron deficiency, Inherited anemia
Chronic blood loss

Front 66

MCV high MCH and MCHC variable

Back 66

Macrocytic,

B12 and folate deficiency, anemias

Front 67

Heart rate is increased up to about 110-120 in anemia

Back 67

SHOCK

Front 68

First CBC sign is lowered RBC

Back 68

Acute hemorrhagic Anemia

Front 69

Typically normal RBC count but Microcytic hypochromic

Back 69

Chronic hemorrhagic Anemia,

May show signs and symptoms, of decreased iron

Front 70

Decreased RBC, H&H, Iron and increased TIBC

Back 70

Iron Deficiency anemia,

Abnormal RBC shapes-teardrops

Front 71

Hydrops fatalis

Back 71

Alpha thalasemia trait

Front 72

Produces pacytopenia

Back 72

Aplastic anemia

Front 73

Diagnostic for aplastic anemia

Back 73

BMA and biopsy,
healthy marrow is replaced by fat

Front 74

Donate in advance Donate right before surgery Salvaged Underuterilized

Back 74

Autologous

Front 75

Use donate blood

Back 75

Homologous

Front 76

Use donate blood

Back 76

Homologous

Front 77

Blood donation between relatives

Back 77

Directed

Front 78

Can occur in PRBC

Back 78

Hyperkalemia and fluid overload

Front 79

watch out before plasma transfusion

Back 79

PT and PTT >15 normal value

Front 80

3 types of transfusion reaction

Back 80

1. Allergic
2. Hemolytic
3. Febrile non hemolytic

Front 81

Tends to be high antigenic with reactions
Most likely to cause allergic reactions

Back 81

Granulocytes

Front 82

Managent for hemolytic transfusion reaction

Back 82

STOP

Front 83

Antigen-antibody response to plasma and or WBC

Usual history of previous Transfusion reaction

Back 83

Febrile non hemolytic reaction

Front 84

Management of reactions

Back 84

Stop infusion,

keep vein open,

Institute emergency protocol,

Notify the physician,

Careful assessment,

send bag back to the bank

Front 85

What type of transfusion reaction would the patient who receive multiple transfusions over the course of his cancer treatment most likely experience?

Back 85

Febrile non hemolytic

Front 86

indicated for symptomatic anemia in non-myeloid cancer patient

Back 86

Epogen

Front 87

Indicated for myelosuppression r/t HCST, chemo, HIV

Goal is to reacch WBC count above 3500

Back 87

Neupogen- STIMS

Front 88

In bone marrow aspiration what would you do if bleeding occurs?

Back 88

Apply direct pressure

Front 89

any increase in temperature is significant

Back 89

BMT/SCT

Front 90

last blood cell to recover

Back 90

Platelet

Front 91

first S/S of Graft versus host Disease

Back 91

Widespread rash, eventually leads to peeling may start in hands and feets

Front 92

Leukemia common in kids and young adults

Back 92

ALL

Front 93

Leukemia common in older adults

Back 93

AML

Front 94

Leukemia only seen in adults

Back 94

CLL and CML

Front 95

also called erythrocytosis

Back 95

Polycythemia vera

Front 96

Manifestations of polycythemia vera

Back 96

Hypertension,

Plethora,

Hypermetabolism,

Hyperviscosity,

Front 97

Polycythemia vera management

Back 97

Recurrent phlebotomy of 300-500 ml

Front 98

Goal for leukemia treatment

Back 98

To prevent overwhelming infection and hemorrhage

Front 99

Nursing Diagnosis for patient with neutropenia

Back 99

Risk for infection

Front 100

Nurisng Diagnosis for patient with thrombocytopenia

Back 100

Risk for bleeding

Front 101

Treatment for Idiopathic thrombocytopenia

Back 101

1.GCSF

2.splenectomy

Front 102

similar to leukemia and lymphoma

plasma cells multiply uncontrollably and infiltrate the bone marrow, lymph nodes, spleen and other tissues

Back 102

Multiple Myeloma

Front 103

There is destruction of of bones of skull and hips can lead to swiss cheese

Back 103

Multiple myeloma

Front 104

over production of plasma cells

-high levels of cytokines and immunoglobulin

Back 104

Multiple Myeloma

Front 105

Treatment for multiple myeloma

Back 105

Fumilant or indolent,

chemo,

HSCT,

THALIDOMIDE,

localized RADIATION for BONE, LEsions

Front 106

S/S for Hodgkin's lymphoma

Back 106

REED STEINBERG CELL,
painless enlarged lymph node,

treated with raditaion and chemo therapy

Front 107

S/S for non hodgkin's lymphoma

Back 107

do not have reed steinberg cells,

increasedrisk among, immunosuppressed, autoimmune dse,

Treated with chemo, HSCT, Radiation + biotherapy

Front 108

Nursing Consideration before raditaion

Back 108

Sperm bank

Front 109

family members colorectal cancer

Back 109

increased surveillance

colonoscopy q 3 yrs

Front 110

in breast cancer 90% of lumps are

Back 110

benign not cancerous

Front 111

Chemo for Colon cancer

Back 111

5-FU

Leucovirin

Camptosar

Front 112

Has spread into surrounding breast tissue but not other organs or structures

Back 112

Invasive ductal Ca

Front 113

Diagnostic test for Breast Ca

Back 113

Sentinel Lymph node biopsy

hormone receptor status

DNA ploidy status

Cell proliferative indices

Her-2/neu genetic marker

Front 114

Not always present Breast Ca Diagnosis

Back 114

Her-2/neu genetic marker

Front 115

Breast Ca Diagnosis

ER or PR receptor

tamoxifen-blocks these receptors

Back 115

Hormone Receptor status

-if no receptors tamoxifen is not indicated

Front 116

adjunctive therapy

chemotherapy

Back 116

for non advanced Ca

Front 117

Adjunctive therapy for breast Ca

Back 117

Radiation therapy

High dose Brachy therapy

chemotherapy

Front 118

Given for Osteoprosis risk

Back 118

Biphosphonates

Front 119

Red Urine

Back 119

Adriamycin

Front 120

Chemo protectant or enhance cancer treatment

-Strong type of folic Acid

Back 120

Leucovorin

it can be given with 5-FU

always given with methotrexate

Front 121

secondary prevention

C
A
U
T
I
O
N

Back 121

Changes in bowel and bladder habbits,

A sore that does not heal,

Unusual bleeding or discharge,

Thickening lump on breast,

Idigestion-difficulty swallowing,

obvious changes in wart or mole,

Nagging cough or horseness of voice

Front 122

ways to obtain tissue sample for biopsy

Back 122

Endoscopy,

Needle core biopsy,

Laparoscopy,

Incisional Biopsy,

Fine needle biopsy,

Excisional biopsy

Front 123

Tertiary Care Cancer treatment

Back 123

Surgery,

Chemotherapy,

Radiation therapy,

Biologic therapy

Front 124

Protecting yourself from exposure to chemo drugs

Back 124

Mask-inhalation,

gown,hat,gloves-skin contact,

Minimize exposure through, ingestion

Front 125

3 types of CVAD

Back 125

Portha cath,

Hickmann or broviack,

Groshong

Front 126

Cvad does not give HIT

Back 126

Groshong

Front 127

adverse effect of chemo

Back 127

Thrombocytopenia,

hypersensitivity reaction,

alopecia,

Fatigue,

Anorexia,

Neutropenia,

Mucositis,

Anemia,

N&V,

Front 128

Extravasation

Back 128

D/C Infusion,

follow facility policy for re-extravasation,

Notify physician,

Carry out orders,

Document S/S,

Monitor closely

Front 129

May be curative, adjuvant or palliative

Back 129

Raditaion

Front 130

2 types of raditaion

Back 130

Brachytherapy,

Teletherapy

Front 131

-High dose to small area

-interstitial,oral, or intracavity

-out patient or inpatient

-complete in 5 days

requires direct tumor access

Back 131

Brachytherapy

Front 132

-external beam radiation

-usually 5x/week for 6 weeks

-Actual radiation is just only a minute

-variable dose based on goal of radiation

Back 132

Teletherapy

Front 133

Divers ever growing approach to cancer treatment(Biologic Response Modifier)(BRM)

Back 133

Biotherapy

Front 134

IL-2, Interferon, Vaccines

Back 134

Immunotherapy

Front 135

Most common targeted therapy

Back 135

Tamoxifen-blocks estrogen at receptor sites

Front 136

Is a life threathening emergency, rapid onset of metabolic derangemeents and acute renal failure

Back 136

Tumor Lysis Syndrome

Front 137

TLS Most frequent with

Back 137

bulky, high proliferative, chemo sensitive tumors

Front 138

TLS body is unable to excrete bi products leading to

Back 138

Hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia

Front 139

TLS prevention

Back 139

Hydrate and Bicarb

Front 140

Diagnosis for TLS

Back 140

LDH(NV:100-300)

Front 141

TLS manifestations

Back 141

Hypocalcemia,

Urinary symptoms,

Hyperkalemia

Front 142

TLS treatment includes

Back 142

Identification of risk patients

Front 143

Nurisng care for TLS

Back 143

Review Labs

Front 144

Most common life threatening condition associated with maliganancy

Back 144

Hypercalcemia

Front 145

Uneven synthesis of alpha and beta chain

Back 145

Thalassemia

Front 146

diagnosed through hemoglobin electrophoresis

Back 146

hemoglobinopathies

Front 147

thalassemia is is characterized by

Back 147

lack or decreased globin chain

Front 148

synthesis of a normal globin chain proceeds at

Back 148

a normal rate

Front 149

heinz bodies

Back 149

G6PD

Front 150

Chemo diet

Back 150

No grapefruit or citrus juice

Front 151

oral care protocol,

cryotherapy

palifermiin

Back 151

Mucocytis

Front 152

Hct/RBCs

Back 152

MCV

Front 153

Hgb + RBCs

Back 153

MCH

Front 154

Hgb + Hct x 100

Back 154

MHCH

Front 155

Normal Value RBC

Back 155

Book: w: 4-5x10'uL
m: 4-6x10'uL