Blood And Lymphatic System

Front 1

What is blood responsible for?

Back 1

O2 and nutrition distribution, waste removal, fighting infection, and clotting

Front 2

What is the consistency of blood?

Back 2

45% blood cells 55% plasma (antigens and antibodies)

Front 3

What is the normal volume of blood in the body?

Back 3

10-12 pints (1 pint=500ml)

Front 4

What is another name for RBCs?

Back 4

erythrocytes

Front 5

What do erythrocytes do?

Back 5

transport o2 and co2

Front 6

What is erythropoiesis?

Back 6

the process of RBC production in the red bone marrow

Front 7

What are normal Hgb and Hct levels?

Back 7

Hgb 12-18 Hct 37-52%

Front 8

What does Hgb provide?

Back 8

ENERGY

Front 9

What is another name for WBCs?

Back 9

Leukocytes

Front 10

What do leukocytes do?

Back 10

body defenses; destroy bacteria and viruses

Front 11

What is phagocytosis?

Back 11

the breakdown and removal of bacteria, cellular debris, and solid particles

Front 12

What is a differential WBC count?

Back 12

an exam in which the different kinds of WBCs are counted and reported as % of the total examined

Front 13

What is a shift to the left?

Back 13

presence of excess bands in the peripheral blood (i.e. shift to immature cells) and indicates severe infection

Front 14

What are the 6 types of leukocytes and how much of the blood do they make up?

Back 14

Neutrophils (55-70%), Eosinophils (1-4%), Basophils (0.5-1%), Monocytes (2-8%), Lymphocytes (20-40%), and plasma cells

Front 15

What are granulocytes?

Back 15

WBCs that contain granules in the cytoplasm, make up greatest number of WBCs

Front 16

What are the 3 types of granulocytes?

Back 16

Neutrophils, Eosinophils, Basophils

Front 17

What are the 2 types of agranulocytes?

Back 17

Lymphocytes, Monocytes

Front 18

What do neutrophils do?

Back 18

useful in ingesting bacteria

Front 19

What do eosinophils do?

Back 19

useful in allergic reaction and parasitic infection

Front 20

What do basophils do?

Back 20

secrete histamine and heparin

Front 21

What do monocytes do?

Back 21

travel to site of invading organism and transform into macrophages

Front 22

What do macrophages do?

Back 22

capable of ingesting large quantities of microorganisms and damaged cells by phagocytosis; secrete interluken-1, which is a chemical signal used to tell the body which WBCs are needed

Front 23

What is another name for platelets?

Back 23

Thrombocytes

Front 24

What do thrombocytes do?

Back 24

initiate blood clotting

Front 25

What happens if thrombocyte count is <20000?

Back 25

spontaneous bleeding can occur

Front 26

What is hemostasis?

Back 26

Body process that arrests the blow of blood and prevents hemorrhage

Front 27

What is the sequence of the clotting cascade?

Back 27

Injury, hemorrhage, grouping platelets, thromboplastin released, converts prothrombin into thrombin, links to fibrinogen, formation of fibrin, trap RBCs and platelets, forms clot

Front 28

How are blood types determined?

Back 28

by presence or absence of specific antigens on the outer surface of RBC and the antibodies found in plasma

Front 29

What is done before blood transfusion is administered?

Back 29

assess lab values, verify order, large bore IV (20 or 18 but can use 22 if needed), Hx of blood transfusion reaction?, verify blood using institution policy

Front 30

What are the timelines for hanging and transfusing blood

Back 30

hanging blood w/in 30 min, transfusion complete w/in 4 hrs

Front 31

What should be done during blood transfusion?

Back 31

Monitor VS, rate of infusion, and respiratory status

Front 32

What should be monitored after blood transfusion?

Back 32

VS!

Front 33

What is protocol for mixing drugs w/ blood products?

Back 33

NEVER mix drugs w/ blood products. NEVER use products containing calcium (i.e. lactated ringers) b/c causes clumping

Front 34

What are the 5 types of transfusion reactions?

Back 34

1. Febrile nonhemolytic (most common, presents w/ fever)
2. Allergic urticarial (develops w/ skin rash w/in 1 hr)
3. Delayed hemolytic (days to weeks after transfusion, Hgb drops due to incompatibility of RBC antigens)
4. Acute hemolytic (POTENTIALLY LIFE THREATENING; usually w/in 15 minutes)
5. Anaphylactic

Front 35

What are the treatments of transfusion reactions?

Back 35

Depends on type of reaction: stop blood transfusion, flush w/ new bad of saline, emergency meds, notify MD and blood bank, save bag and tubing, collect blood and urine samples

Front 36

What are the functions of the lymphatic system?

Back 36

Maintenance of fluid balance, production of lymphocytes, absorption and transportation of lipids from intestine to bloodstream

Front 37

What is lymph?

Back 37

specialized fluid formed in the tissue spaces, transported by way of lymphatic vessels and reenters circulatory system

Front 38

What are lymph nodes?

Back 38

act as filters, keeping particulate matter such as bacteria from entering bloodstream

Front 39

What do tonsils do?

Back 39

produce lymphocytes and antibodies that trap bacteria

Front 40

Why is the spleen useful?

Back 40

it is a reservoir of blood; forms lymphocytes, monocytes, and plasma; destroys RBCs; removes bacteria by phagocytosis; holds up to 1 pint of blood for emergencies

Front 41

What is the thymus for?

Back 41

immune system before and a few months after birth, atrophies at puberty

Front 42

What are the diagnostic tests used to id lymphatic system disorders?

Back 42

CBC, red cell indices, peripheral smear, Schilling test (measures b12 absorption, used for pernicious anemia), megaloblastic anemia profile, lymphangiography, bone marrow aspiration or biopsy

Front 43

What is anemia?

Back 43

low count of RBC, Hgb, Hct; causes delivery of insufficient amounts of 02 to tissues and cells

Front 44

What are the causes of anemia?

Back 44

Blood loss, impaired production of RBCs, increased destruction of RBCs, nutritional deficiencies

Front 45

What are the clinical manifestations of anemia?

Back 45

Disorientation, SOB, dyspnea, pallor, tachycardia, vertigo

Front 46

What is the medical management of anemia?

Back 46

Depends on cause; correction of disease process may correct or lessen anemic condition; often specific to particular anemia

Front 47

What is hypovalemic anemia?

Back 47

Anemia caused by abnormally low circulating blood volume due to blood loss; body can tolerate losing 500ml of blood due to spleen, but 1000ml of blood loss can cause severe complications

Front 48

What are the clinical manifestations of hypovalemic anemia?

Back 48

Weakness, stupor, irritability, pallor, hypotension, tachycardia, hypothermia, Hgb < 10, Hct < 10%

Front 49

What is the medical management of hypovolemic anemia?

Back 49

control bleeding, treat shock (O2, elevate lower extremities, keep warm, Trendelenberg), replace fluid (blood transfusion, plasma, dextran, lactated ringers), monitor VS

Front 50

What is pernicious anemia?

Back 50

absence of intrinsic factor produced by gastric mucosa; intrinsic factor is essential for absorption of vitamin b12; deficiency of b12 affects growth and maturity of all body cells and is related to nerve myelination, may cause progressive demyelination and degeneration of nerves and white matter; Schilling's test shows malabsorption of b12

Front 51

What are the clinical manifestations of pernicious anemia?

Back 51

FEVER, JAUNDICE, SORE BURNING TONGUE (smooth and erythematous), extreme weakness, dyspnea, hypoxia, weight loss, pallor, GI complaints, dysphagia, neurological symptoms (tingling in hands and feet, disorientation, personality changes, behavior problems, partial or total paralysis)

Front 52

What is the medical management of pernicious anemia?

Back 52

Vitamin B12 (1000u, daily for 1 week, weekly for 1 month, monthly for life), folic acid supplement, iron replacement, RBC transfusion, diet (high protein, vitamins, and minerals)

Front 53

What is aplastic anemia?

Back 53

decrease in bone marrow function that results in decreased number or RBC/WBC and platelets; only primary if congenital; can be secondary to viral invasion, meds, chemicals, and radiation or chemo

Front 54

What are the clinical manifestations of aplastic anemia?

Back 54

pancytopenic (low amounts of many types of blood cells), repeated infections w/ high fevers, fatigue, weakness, malaise, dyspnea, palpitations, bleeding tendencies

Front 55

What is the medical management of aplastic anemia?

Back 55

id and remove cause, platelet transfusion for severe thrombocytopenia, splenectomy for hypersplenism when is the cause of destruction of platelets, steroids, androgens, bone marrow transplant

Front 56

What is iron deficiency anemia?

Back 56

occurs when RBCs contain decreased levels of Hgb; most common cause of anemia; due to excessive iron loss caused by chronic bleeding (intestinal, uterine, gastric)

Front 57

What are the clinical manifestations of iron deficiency anemia?

Back 57

pallor, fatigue, weakness, SOB, angina, s/s of HF, glossitis, pagophagia (eating lots of ice), HA, paresthesia (numbness & tingling)

Front 58

What is the medical managements of iron deficiency anemia?

Back 58

Ferrou sulfate 900mg po or injected (z-track) daily, ascorbic acid (vitamin C), diet high in iron

Front 59

What is sickle cell anemia?

Back 59

severe, chronic, incurable condition in which RBCs are an abnormal crescent shape; usually african americans; 1 in 500 have disease 1 in 10 are carriers

Front 60

What are the clinical manifestations of sickle cell anemia?

Back 60

precipitating factors (dehydration & change in O2 tension in body), loss of appetite, irritability, weakness, abdominal enlargement, joint and back PAIN, edema of extremities, enlarged heart, jaundice, chronic leg ulcers, tachypnea, dyspnea, arrhythmias

Front 61

What is the medical management of sickle cell anemia?

Back 61

ALLEVIATE SYMPTOMS, O2, fluids, rest, analgesics, bone marrow transplant

Front 62

What is polycythemia?

Back 62

Overproduction of RBCs; characterized by erythrocytosis (abnormal increase in # of circulating RBCs) also increased production of granulocytes and platelets

Front 63

What are the s/s of polycythemia?

Back 63

HA, dizziness, tinnitus, blurred vision, fatigue, weakness, pruritis, exertional dyspnea, angina, increased BP and pulse

Front 64

What is the treatment of polycythemia?

Back 64

Phlebotomy, meds, dietary changes

Front 65

What is agranulocytosis?

Back 65

severe reduction in number of granulocytes; characterized by WBC count of <200; caused by meds (PTU), chemo, radiation, neoplastic disease, viral and bacterial infections (POTENTIALLY FATAL)

Front 66

What are the clinical manifestations of agranulocytosis?

Back 66

symptoms of infection, ulcerations of mucous membranes, bronchial pneumonia, UTI

Front 67

What is the medical management of agranulocytosis?

Back 67

REMOVE CAUSE of bone marrow depression, prevent or treat infections, strict asepsis

Front 68

What is leukemia?

Back 68

malignant disorder of hematopoietic system; characterized by WBCs that are not functional; WBCs invade and destroy bone marrow, metastasize in liver, spleen, and lymph nodes; cause unknown

Front 69

What are the 4 classifications of leukemia?

Back 69

Acute lymphocytic leukemia ("ALL", usually occurs in kids younger than 15), Acute myelocytic leukemia ("AML", most common leukemia among adults, age of onset is usually 15-39), Chronic lymphocyctic leukemia ("CLL", most cases over age 60), Chronic myelocytic leukemia ("CML", most cases involve adults)

Front 70

What are the clinical manifestations of leukemia?

Back 70

PAIN, anemia, elevated WBCs before treatment, may develop thrombocytopenia or leukopenia, enlarged lymph nodes, splenomegaly

Front 71

What is the medical management of leukemia?

Back 71

CONTROL SYMPTOMS OR REMISSION, chemo radiation, bone marrow transplant, meds; pts often fail to cope due to chronic pain

Front 72

What is thrombocytopenia?

Back 72

condition in which number of platelets is reduced to <100000; may be caused by decreased production or decreased survival

Front 73

What are the clinical manifestations of thrombocytopenia?

Back 73

petechiae, ecchymosis, platelets <100000, bleeding from mucous membranes

Front 74

What is the medical management of thrombocytopenia?

Back 74

if platelets count continues to drop monitor changes in LOC (risk for brain hemorrhage), corticosteroid therapy, splenectomy, gamma globulin, immunosuppressive drugs, platelet transfusions, avoid trauma

Front 75

What is hemophilia?

Back 75

hereditary coagulation disorder seen mostly in men; characterized by disturbance of clotting factor; Hemophilia A most makes up 85% of cases; has x-linked hereditary trait

Front 76

What are the clinical manifestations of hemophilia?

Back 76

internal and external bleeding, excessive blood loss from small cuts and dental procedures, petechiae, ecchymosis

Front 77

What is the medical management of hemophilia?

Back 77

minimize bleeding (avoid trauma), relieve pain (no ASA, may apply ice for vasoconstriction and pain), transfusions (clotting factor concentrate, cryoprecipitate)

Front 78

What is von Willebrand's disease?

Back 78

inherited bleeding disorder characterized by abnormally slow coagulation of blood; similar to hemophilia but not limited to men

Front 79

What are the clinical manifestations of von Willebrand's disease?

Back 79

spontaneous episodes of GI bleeding, epistaxis, gingival bleeding

Front 80

What is the medical management of von Willebrand's disease?

Back 80

cryoprecipitate, desmopressin (DDAVP), minimize bleeding (avoid trauma), relieve pain (NO ASPIRIN), fibrinogen, fresh plasma

Front 81

What is disseminated intravascular coagulation?

Back 81

overstimulation of clotting and anti-clotting processes in response to disease or injury; alternating of clotting and hemorrhaging occurs; characterized by microclots w/ decrease in clotting factors

Front 82

What are the clinical manifestations of disseminated intravascular coagulation?

Back 82

bleeding, dyspnea, diaphoresis, cold mottled digits, pupura on the chest and abdomen, petechiae

Front 83

What is the medical management of disseminated intravascular coagulation?

Back 83

Treat underlying cause; cryoprecipitate, heparin, protect from bleeding and trauma, ADMINISTRATION OF PLATELETS AND PACK RED BLOOD CELLS

Front 84

What is multiple myeloma?

Back 84

malignant neoplastic immunodeficiency disease of bone marrow; characterized by bone marrow tumors

Front 85

What are the clinical manifestations of multiple myeloma?

Back 85

bone pain & pathological fractures (due to loss of Ca+ in the bones), infection, anemia, bleeding, hypercalcemia (bones break and release Ca+), renal failure

Front 86

What is the medical management of multiple myeloma?

Back 86

maintaining fluid intake of 3-4L/day to dilute Ca+; symptomatic (not curable), radiation, chemo, corticosteroids, IV fluids

Front 87

What is lymphangitis?

Back 87

inflammation of one or more lymphatic vessels; usually occurs from acute streptococcal or staphylococcal infection in an extremity

Front 88

What are the clinical manifestations of lymphangitis?

Back 88

fine red streaks from aa, edema, chills, fever, local pain, HA

Front 89

What is the medical managements of lymphangitis?

Back 89

penicillin, moist heat, elevate extremity

Front 90

What is lymphedema?

Back 90

accumulation of lymph in the soft tissue; may be primary or secondary disorder

Front 91

What are the clinical manifestations of lymphedema?

Back 91

massive edema and tightness of affected extremity, pain

Front 92

What is the medical management of lymphedema?

Back 92

diuretics, antibiotics, compression pump, elastic stocking or sleeve, restricted sodium diet, avoid constrictive clothing, meticulous skin care

Front 93

What is Non-Hodgkins lymphoma?

Back 93

neoplastic disorder of the lymphoid tissue; tumors usually start in lymph nodes and spread to lymphoid tissue in spleen, liver, GI tract, and bone marrow; most cases involve adults; possible causes include viral infection and exposure to chemical agents

Front 94

What are the clinical manifestations of Non-Hodgkin's lymphoma?

Back 94

fever, anemia, pruritis, fatigue, malaise, painless enlarged cervical lymph nodes, weight loss, anorexia

Front 95

What is the medical management of Non-Hodgkin's lymphoma?

Back 95

Radiation, chemo, bone marrow trasplant

Front 96

What is Hodgkin's lymphoma?

Back 96

inflammation of infectious process that develops into neoplasm; affects males and arises as painless swelling in lymph node and confirmed when biopsy reveals Reed-Sternberg cells

Front 97

What are the clinical manifestations of Hodgkin's lymphoma?

Back 97

Painless enlargement of lymph nodes, anorexia, weight loss, pruritis, low-grade fever, night sweats, anemia, leukocytosis

Front 98

What is the medical management of Hodgkin's lymphoma?

Back 98

Stage 1 or 2 (localized) - radiation, stage 3 or 4 (generalized) - chemo or combination of chemo and radiation