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50 Cards in this Set
- Front
- Back
Bone Marrow
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The soft tissue the fills spaces in the interior of the long bones and spongy bones
Manufactures blood cells |
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Red marrow
Yellow marrow |
Red marrow
Manufactures blood cells and hemoglobin Yellow marrow Consist of fat cells and connective tissue ¡ Does not manufacture blood cells ¡ Can manufacture under intense stimulation |
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Blood
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Consist of cells suspended in a fluid called plasma
All blood cells are produced from stem cells in the bone marrow |
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Erythrocytes (RBC)
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Flexible, anuclear, biconcave disks covered by a thin membrane through which O2 and CO2 pass freely
The flexibility of erythrocytes allows them to change shape as they travel through capillaries Their major function is to transport O2 and remove CO2 from the tissues |
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Erythropoiesis
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Production of erythrocytes
Regulated by erythropoietin A hormone released by the kidneys Erythrocytes require Iron Folate B vitamins B12, B6 |
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Hemoglobin
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An iron containing pigment attached to erythrocytes
Gives blood its red color Carries oxygen to the cells of the body Normal range 12-17.4 g/dL |
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Leukocytes (WBC)
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Perform various protective functions
Circulate in blood and migrate into body tissues to search for and destroy potentially harmful substances Divided into two categories Granulocytes Agranulocytes |
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Platelets
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When a blood vessel is injured, platelets migrate to the injury site
Release a glycoprotein IIb/IIa, which causes the platelets to adhere and form a clot |
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Lymphatic System
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Circulates interstitial fluid and carries it to the veins
Filters and destroys pathogens and removes potentially harmful substances Includes Thymus gland Spleen Lymphatic vessels Lymph nodes and lymph |
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Thymus Gland
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Lymphoid tissue in the upper chest that contains undifferentiated stem cells released from bone marrow
The stem cells migrate to the thymus gland and develop into T lymphocytes |
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Spleen
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Largest lymphatic structure
The reservoir of blood and contains phagocytes that engulf damaged erythrocytes and foreign substances |
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Lymph Nodes
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Along the lymphatic network
Axilla Groin Neck Large vessels of thorax and abdomen Contain T and B lymphocytes |
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Lymph
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Fluid
Flows through the lymphatic system by contraction of skeletal muscles As lymph pass through the nodes, macrophages attach and engulf foreign substances |
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Assessment
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The nurse collects data by taking a health history, examining the client and monitoring the results of the laboratory test
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Physical Examination
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Inspection of the skin
VS Palpation of lymph nodes |
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Anemia
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A deficiency of either erythrocytes or hemoglobin
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Most anemias result from
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– Blood loss
– Inadequate or abnormal erythrocyte production – Destruction of formed RBC |
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Hypovolemic Anemia
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Caused by a loss of blood volume which results in fewer blood cells
– Trauma (acute) – Gastric Bleeding When blood is lost, bone marrow produces more erythrocytes – Cells are smaller and have less heme • Inadequate oxygen supply and accumulated CO2 |
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Assessment Findings
Hypovolemic Anemia |
Acute blood loss
– S/S of hypovolemic shock |
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Management Hypovolemic Anemia
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Replacement of blood by transfusions
If it is a chronic blood loss – Need to treat the underlying cause |
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Iron deficiency anemia
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Develops when iron is insufficient to produce hemoglobin
– Heme cannot be recycled because of blood loss – Dietary intake of iron is insufficient – Absorption of iron from food is inadequate – The need for iron exceeds reserves |
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Iron deficiency anemia
Assessment findings |
Reduced energy
Feel cold all the time Fatigue Dyspnea with minor physical exertion Fast HR |
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Management
Iron deficiency anemia |
Determining the cause and correcting it
Nutritional intake of iron Oral iron supplements – Take on empty stomach – No not take with an antacid – Take with orange juice – Dilute if liquid iron • Drink with a straw |
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Pernicious anemia
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Develops when a client lacks intrinsic factor
– Intrinsic factor is necessary for absorption of vitamin B12 |
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Intrinsic factor
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Production decreases with age and gastric mucosal atrophy
Surgical removal of the stomach or small bowel Without adequate B12, erythrocytes remain in an immature form |
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Assessment Findings
Intrinsic factor |
Stomatitis
Glossitis Digestion disturbances Diarrhea |
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Intrinsic factor
Management |
Vitamin B12 IM for life
– Usually 100 g IM daily for 2 weeks – Then 100 g monthly |
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Folic Acid deficiency anemia
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Causes anemia characterized by immature erythrocytes
Related to an insufficient dietary intake of foods rich in folic acid |
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Folic Acid deficiency anemia
Assessment Findings |
Severe fatigue
Sore and beefy-red tongue Dyspnea Nausea Anorexia H/A weakness |
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Folic Acid deficiency anemia
Management |
Oral folic acid supplements
Food high in folate |
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Sickle cell anemia
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Name because erythrocytes become sickle or crescent shaped when oxygen supply in the blood is inadequate
Common genetic disorder – Primarily in African Americans • Affects 1 in 600 African Americans in the US |
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Sickle Cell Crisis
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Develops rapidly under hypoxic conditions
During a crisis the sickle shaped cells lodge in small blood vessels, where they block the blood flow and oxygen to the affected tissue The vascular occlusion causes severe pain Stroke is a common complication |
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Chronic hemolytic anemia
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Results from defective HbS molecule which shortens the lifespan of affected erythrocytes and causes them to be destroyed prematurely
The spleen becomes obstructed and infarcted with excess dead erythrocytes The bone marrow enlarges to compensate for decreased erythrocytes |
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Assessment Findings
Sickle Cell Crisis |
One of the unique manifestations of sickle cell disease is Acute chest syndrome
– A type of pneumonia triggered by decreased hemoglobin and infiltrates in the lungs • Coughing • Wheezing • Tachypnea • Chest pain |
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Medical Management
Sickle Cell Crisis |
Treatment is supportive rather than curative
Regular blood transfusions Hydroxyurea/ Inhaled nitric oxide Bone marrow transplantation Narcotic analgesia Oxygen Hydration |
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Hemolytic anemia
S/S Management |
Chronic premature destruction of erythrocytes
S/S – Jaundice – Enlarged spleen Management – Remove the cause |
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Erythrocytosis
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Polycythemia Vera
– An increase in circulating erythrocytes Rapid proliferation of blood cells produced by the bone marrow Insidious onset and prolonged course Shorter life span Blood becomes more viscous |
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Erythrocytosis
Assessment Findings |
Face and lips are reddish-purple
Fatigue Weakness H/A Excessive bleeding after an injury |
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Erythrocytosis
Management |
Phlebotomy
Anticoagulants Antineoplastic drugs |
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Erythrocytosis
Patient Teaching |
Drinking 3 liters of fluid per day
Avoid crossing legs Physically active |
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Pancytopenia
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Numbers of all marrow-produced blood cells are reduced
Aplastic anemia – Inadequate stem cell production in bone marrow – Possible autoimmune – Death rate is high |
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Pancytopenia
Assessment Findings |
Infections
Coagulation abnormalities Small skin hemorrhages Enlarged spleen |
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Pancytopenia
Management |
Transfusions
Antibiotics Corticosteroids Bone marrow transplantation |
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Thrombocytopenia
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Decreased number of platelets or thrombocytes
Occurs when platelet manufacture by the bone marrow is decreased or platelet destruction by the spleen is increased |
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Thrombocytopenia
Assessment Findings |
**Purpura**
Bleeding in other parts of the body Internal hemorrhage |
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Management
Thrombocytopenia |
Corticosteroids
Platelet transfusion Splenectomy |
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Thrombocytopenia
Nursing interventions |
– Minimizing bleeding
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Hemophilia
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A disorder involving an absence or reduction of a clotting factor
3 Types – Hemophilia A, B and C Inherited from mother to son Severity depends on the type inherited Short life expectancy |
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Hemophilia
Assessment Findings |
Persistent oozing
Spontaneous severe bleeding Bleeding in the joints |
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Hemophilia
Management |
Transfusions
Factor VIII concentrate FFP’s Nurse needs to assess joints Minimize bleeding episodes |