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22 Cards in this Set
- Front
- Back
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Pts with infection, white blood cell abnormalities, or transfusion reactions may present with _____
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febrile symptoms
p1392 |
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Treatment of pts with disorders of the hematoietic system, in most cases, is _____
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Supportive
p1392 |
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Pts may require IV fluids to support _____ and ____, and should receive high flow O2 to prevent hypoxia from ____ and _____
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*end-organ perfusion
*prevent shock, *poor perfusion *diminished oxygen-carrying capacity of the blood p1392 |
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Alterations in the hematopietic systems may present as life-threatening bleeds or overwhelming infections with ____ shock
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Septic
p1393 |
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True or False
Spend time obtaining a complete set of vitals during the primary assessment |
False
Check the ABC's and quickly determine your priority for transport P1393 |
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____ pts will have increased heart and respiratory rates as
the body attempts to compensate for less oxygen reaching the tissues |
Anemic pts
p1393 |
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Complaints of fatigue, lethargy, malaise, apprehension, or confusion may indicate
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inadequate oxygen delivery to the tissues
p1393 |
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lymph node enlargements, sore throat, or pain on swallowing may indicate
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Infection
p1393 |
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Bleeding abnormalities may be disguised as
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gastrointestinal upset
p1393 |
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Signs and symptoms general statement
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Ask about overt bleeding w/vomiting and diarrhea, but do not overlook complaints of nausea or anorexia, vomiting of "coffee ground" material, of having black tarry or cranberry, sticky, odoriferous stool
p1393 |
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Atraumatic bleeding of the gums almost always points to
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underlying hematologic abnormality
p1393 |
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Medications that may indicate an alteration in the hematologic system
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pain relievers
antibiotics anticoagulants hormones meds for heart disease, arthritis, and seizures p1393 |
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Hematology
Physical Exam: Nervous System |
*Assess LOC
*is pt fatigued, weak all over, or have focal weakness *Is he dizzy or have true vertigo *examine eyes for abnormalities (sickle cell is notorious for causing eye problems) p1394 |
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Hematology
Physical Exam: Skin |
*Jaundice(liver disease or hemolysis of RBC)
*Florid(reddish skin)(polycthemia) *Pallor skin(anemia) *observe for petechia(red dots on skin, purpura(purple blotches on skin), bursing, and pruritus(itching) p1394 * |
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Hematology
Physical Exam: Lymphatic |
*palpate lymph nodes on neck, clavicle, axilla, and groin and note enlargement
*Splenomegaly(enlarged spleen) is often present, but can be hard to examine in the field p1394 |
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Hematology
Physical Exam: Gastrointestinal |
*Epistaxis(nosebleed) is often common
*Blood acts like a cathartic(laxative), report of loose bowel movements may appear bright red or like coffee grounds *bleeding of the gums is common *Gingivitis increases the risk of sepsis *Thrush(yeast infection in the mouth) in adults is almost always associated w/AIDS *Liver disease can slow blood clotting p1395-96 |
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Name the 2 major organs associated with the hematopoeitic system
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Liver and spleen
p1396 |
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By the time children w/sickle cell are 5, they are virtually without a ____
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Spleen (asplenic)
p1396 |
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Hematology
Physical Exam: Musculoskeletal |
*hematopoietic problems are autoimmune in nature(trouble determining which tissues are self and nonself)
*tend to affect more than one joint-swollen, discolored, painful p1396 |
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Hematology
Physical Exam: Cardiorespiratory |
*dyspnea, tachycardia, chest pain, high-output heart failure
*Pulmonary edema can occur *expectorating blood when coughing *breath sounds- crackles or ronchi indicative of heart failure or infection p1396 |
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Hematology
Physical Exam: Genitourinary |
*hemturia(blood in urine)
*blood in scrotal sac for men, heavy menstrual bleedin(menorrhagia) or frank vaginal bleeding in women *Recurrent UTI's or STD's *Sickle cell anemia can cause priapism *Sickle cell disease is the most common cause of priapism in the ER p1396 |
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Hematology
General Managment |
*High-flow high-concentration of O2
*Assess circulatory system *Consider fluid replacement(crystalloids cannot carry O2, to much can dilute blood) * be alert for dysrhythmias *give pt aspirin *ventilate to compensate for acidosis *provide comfort measures including analgesia p1397 |
