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67 Cards in this Set
- Front
- Back
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What is th extrinsic pathway
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it is activated by the release of thromboplastin from the tissue. Resulting prothrombin to thrombin which changes fribrinogen to fibrin
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how much iron is normally stored in the body
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3 g
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how much iron is normally absorbed by the body
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0.5 - 1 mg
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what is the intrinsic pathway
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activated when the collagen that lines blood vessels is exposed. Clotting factors activated as with the extrinsic pathway with fibrin ultimately formed.
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what is plasminogen
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after the fibrin clot is no longer needed, plasminogen is required to break it down as plasmin. and the degraded products are released into the vascular system.
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What cells have their activity in the spleen
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Macrophages derived from monocytes
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where does hemotopoiesis occur
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in the bone marrow, (but can in the spleen in fetal life and in later adulthood when the bone marrow can't)
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what are 2 sourses of iron loss for the elderly,
how do you test for it |
GI bleeding
nutritional deficiency by the occult blood of the stool |
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which diagnosis is most appropriate for iron deficiency anemia?
deficient fluid volume impaired gas exchange ineffective airway clearance ineffective breathing pattern |
impaired gas exchange
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A finding that most strongly supports a diagnosis of acute leukemia is the presence of a large number of immature:
monocytes basophils thrombocytes leukocytes |
leukemia is manifested by abnormal overproduction of immature leukocytes in the bone marrow.
increase in monocytes = viral infection increase in basophils = allergic reaction increase in thrombocytes=polycythemia |
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Bone Marrow Aspiration - why is it done, where
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done to evaluate hematopoiesis (size, shape of RBC, WBC and platelets)
from posterior illiac crest |
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Major risk factor of bone marrow aspiration
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infection
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main nursing consideration
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Pain control
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Is anemia a disease,
what are the major causes (6) |
no, it is a underlying disorder sign.
dietary deficiency(chronic) hereditary disorder (thalessmia Major) bone marrow damage (radiation) malignancy overactive spleen bleeding |
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What is hypoproliferative anemia
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decrease or defective production of RBCs
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what are diagnositc labs, procedures for anemia
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CBC (for RBC, WBCs Platelets
hgb hct cellular morphology sedimentation rate |
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what are diagnositc labs, procedures for anemia
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CBC (for RBC, WBCs Platelets
hgb hct cellular morphology sedimentation rate |
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What are coagulation panels prior to bone marrow aspiration
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PT (measures intrinsic pathway) and INR
PTT (extrinsic) platelet count fibrinogen d-dimer fibrin degradation products |
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What are coagulation panels prior to bone marrow aspiration
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PT (measures intrinsic pathway) and INR
PTT (extrinsic) platelet count fibrinogen d-dimer fibrin degradation products |
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a nurse is administering B12 to a client w/pernicious anemia, what admin route should the nurse use
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Parental route, IM or SQ
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what are potential complications of anemia
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heart failure, angina, paresthesia, confusion
megaloblastic anemia to neurologic |
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s/s of anemia
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weakness, fatigue, general malaise, pallor of skin and mucous membranes
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megaloblastic anemia, or hemolytic s/s
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jaundice (tongue beefy red and sore) angular cheilosis
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s/s iron def anemia
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tongue smooth and red, angular cheilosis
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assessment of anemia pt includes
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heath history/family history
nutritional assessment cardiac status assess GI neurologic examination labs |
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a nurse is administering B12 to a client w/pernicious anemia, what admin route should the nurse use
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Parental route, IM or SQ
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what are potential complications of anemia
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heart failure, angina, paresthesia, confusion
megaloblastic anemia to neurologic |
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s/s of anemia
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weakness, fatigue, general malaise, pallor of skin and mucous membranes
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megaloblastic anemia, or hemolytic s/s
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jaundice (tongue beefy red and sore) angular cheilosis
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s/s iron def anemia
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tongue smooth and red, angular cheilosis
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What are major nursing diagnosis of anemia
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Fatigue
alt nutrition alt tissue perfusion |
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assessment of anemia pt includes
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heath history/family history
nutritional assessment cardiac status assess GI neurologic examination labs |
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s/s iron def anemia
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tongue smooth and red, angular cheilosis
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top nursing interventions for anemia
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assist pt to prioritize activities and establish balance between activity and rest
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nutrition of anemia
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iron, b12, folic acid, protein, decrease milk w/iron (decrease absorption)
increase vit C |
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Major goals of anemia nursing care
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decrease fatigue, attain adequate nutrition, attain adequate tissue perfusion
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What is aplastic anemia
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T-cells attack bone marrow resulting in aplasia - decrease hematoporeisis. so in addition to anemia, neurtropenia and thrombocytopenia are seen
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what is the cause of aplastic anemia
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benzenes, chemicals - airplane glue, DDT
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how do you diagnose aplastic anemia
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bone marrow aspiration shows marrow replaced w/fat cells
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what is the treatment for aplastic anemia
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bone marrow transplant < 60, then immunosuppressive therapy
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what are 3 phases of chemotherapy
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1. induction - (high dose), to destroy leukemic cells (irradication of WBC )
2. consolidation - after complete remission all resolves. increase WBC w/neupogen 3. maintenance - low dose 3-4 weeks |
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in regards to bleeding disorders what is the primary mechanism of hemostasis
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the blood vessels constrict
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in regards to bleeding disorders what is the secondary mechanism of hemostasis
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reinforcement of platelet plug - intrinsic or extrinsic pathway
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What is pernicious anemia and its cause
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from deficiency of intrinsic factor necessary for intestinal absorption. Different than just B12 def from eating.
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s/s of pernicious anemia
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severe pallor, fatigue, wt loss, smooth beefy red tongue, parathesias of hands and feet. diturbances w/gait and blanace.
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what is managment of pernicious anemia
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B12 injections, lifelong, or surgery of ileum
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what are s/s of bleeding disorders
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vascular - local bleeding
platelets - petechial, ecchymosis w/ trauma coagulation - see blood in feces, urine, emesis, GI drainage pain, decrease BP, oliguria, decrease CO |
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what are s/s of hypovolemia
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decrease BP, tachycardia, pallor, clammy skin, oliguria
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what are vascular disorders characterized by
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rupture of small vessels (defective or injured)
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what is the etiology of vascular disorders
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Vit C deficiency, or adrenocortical excess
drug reaction allergic disorders collagen vascular disease, bacterial infections |
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what is sickle cell anemia
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sickel cell gene from 2 recessive parents cause hemoglobin molecule to be defective, causing RBC to lose O2, lose shape, which can now adhere to small vessels
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what are 3 types of platelet defects
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hemophilia
vonwillebrands disease hypoprothombinemia |
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what is vonwillebrands treatment
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replace deficient protein
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what is hypoprothrombimia's treatment
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Vit K
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the hematolymphatic system consists of
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blood, bone marrow, spleen, liver, lymphatics, thymus
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what are diagnostic studies for vascular disorders
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platelet counts and coagulation studies
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what are s/s of vascular disorders
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petechia, ecchymosis, splinter hemorrhage under nails
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what is the mgmt of vascular disorders
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protection, safety issues
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what is serum
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same as plasma, less fibrinogen and some clotting factors.
We give "plasma" not serum |
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where is the site of bone marrow, what happens there
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the bone marrow is the site of hematopoiesis
the myeloid stem cells and lymphoid stem cells come from the bone marrow of the sternum, pelvis, ribs and vertebral (flat bone) |
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where is erythropietin from - for what?
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from kidneys to the bone marrow (hormone). to differentiate the myeloid cell into RBCs
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blood consists of (2) ____ at ____%, and ____ at ___ %
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cellular components 40-45% and
Plasma 55% |
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cellular components of blood includes (3)
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RBC
WBC Platelets |
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WBCs in blood are made up of 2 groupings:
What cells fall under these groupings |
Granulocytes: eos, basos, neutros
Agranulocytes: T cells, B cells |
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the main stem cell is called?
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pluripotential stem cells
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the pluripotential stem cell divides into 2 cells -
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myeloid and lymphoid
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the lymphoid stem cell makes?
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agranulocytes: T cells and B cells (plasma)
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