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110 Cards in this Set

  • Front
  • Back
hemoglobin norm is
12-16g/dl
hemocrit norm is
38-47percent
rbc norm is
4.2-6
wbc norm is
5,000 to 10,0000
neutrophils make up what percent of the differential.
40-70
basophils make up what percent of the diff
1 percent
lymphocytes make up what percent of the diff
20-40
monocytes make up what percent of the diff
4-8
esoninophils make up what percent of the diff
2-4
platelents counts are
150k-400k
shift to the left in diff means
infarction, infection, stress, bacteria
shift to the right in diff means
virus, anemia
hi neutrophil and hi bands mean/
shift to left
hi lymph and hi mono mean
shift to right
what does the MCV determine?
size of RBC
macro rbc's are seen with what anemias
periucous, and folic acid anemias
micro- no iron are seen with what anemia
sickle cell.
MCH measures what>?
weight" amt of hemoglobin
what is the best place to do a marrow aspiration
illiac crest.
what to monitor pt for after a marrow aspiration
soreness and tenderness.. there is no bleeding
what is the shillings test used for?
measures the absorption of vit-b12. (pernicious anemia)
if tablet shows up in urine when doing a shillings test, what does this indicate?
does not have pernicious anemaia because they are able to absorb it.
pernicious anemia is the absence of what/
vit-b12
what are some foods with vit-b12
organ meats, liver, muscle meats. eggs
what leads to the pheripheal neuropathy found with pernicious anemia
decreased myelin, decreased potential of cells
sources of iron are
green leafy veggies, potatoes, liver, eggs, raisins approcots
sources of folic acid are
green veggies, fish whole grain
sources of vit-b6 are
meat potatoes
sources of amino acids are
eggs nuts.
sources of vitamin c are
strawberries, green leafty veggies
folic acid helps with?
red blood cell maturation
iron does what for the body
synthesis of hemoglobin
amino acids do what?
synthesis of nuclear protein
vit c helps with what kind of absorbtion
iron
iron aborbtion is increased with what vitamine
C
an immobilized pt wihh receive what medication and what dose?
heprin. 5000u/12hr
reverse heprin with what?
protamine sulfate
when reversing heprin give how much protamine sulfate?
1ml/100u hep
serrum ferritin test shows what 0-12
iron deficiency, anemia, measures stored iron.
what is a reticulocyte
immature rbc. 1% of all rbc
increased number in reticulocytes means what?
anemia
large amount of protein in urin is what?
bence jones protein
multiple myeloma is cancer of what?
plasma cell
what exposure to chemicals can cause hematological cancers
benzine
jaundice is prevelant in sicke cell anemia how do you assess for it
conjuntiva. sclera.
vit c deficit can lead to what problem with the lips
cheilitis, dry cracking inflamation
iron deficit can cause a smooth tongue texture also called
glottis
bone pain in leukemia is do to
the rapid production of abnormal cells
with accute blood loss when is it evident through cbc's
12hrs
when doing a bone marrow aspiration how to you postiion the pt.
on the side.
what is the benefit of packed rbc's
1/2 the volume when fluid overload is an issue.
what gauge needle is used for blood transfusions
18-16-14
blood transfusions must be complete in
2-3hrs
when blood is on the floor, must start administration within how long
30mins
what volume loss is it mostly noticable that the pt is in trouble
30
with a 40% volume loss you see what
bp below normal at rest, rapid pulse, cold clammy skin
with a 30% volume loss you see what?
tachycardia
postural hypotension
with a 50% volume loss you see
shock and potential death
type 0 blood has what antigen
none
type a has what antigens
A
when giving blood check vitas pulse resp and temp how often?
every 5 minutes for 15 minutes.
what to give if pt has fluid v overload while giving blood
lasix
when giving blood start out at what rate.
1ml/ min for 15 minutes.
how is febril non hemolitic reaction caused
sensitive to wbc, platelets or plasma antigen.
signs of febril non hemolitic reaction are
chills, fever of 101 within one hr of giving, HA, N&V
what to do if you suspect febril nonhemolitic reaction
stop blood, keep ns going, give tylenol, monitor vs, call dr
how is allergic urticaria reaction caused
allergic to what donor took before donation. chocolate, penicillin, pollen.
signs of allergic urticaria are
skin rash, hives
what to do if you suspect allergic urticaria
stop blood, keep vein open with ns,notify blood bank or dr. give antihistamine and/or corticosteroid turn blood back on and monitor.
signs of delayed hemolytic reaction include
extreme fatigue 6 weeks to 6 months, gradual decline in cbc.persistent low grade fever.
nursing interventions for someone with delayed hemolytic reaction are.
give ferrous sulfate,
improve nutrition
ferous sulfate can result in what
constipation and dark stools.
nutrition for a person with delayed hemolytic reaction is
eggs, spinach , oj, increase iron and vit c
how long does it take ferous sulfate to restore cbc's to norm
6 months
anaphylactic blood reaction happens most often in individuals with
multiple transfusions
what to ask apt with multiple transfusions
how did you handle it?
signs of anaphylactic blood reaction
flushing, bronchospasms, chest pain, loss of airway
what to do if you suspect an anaphylactic reaction
stop blood, keep ns running, Code, cpr, maintain airway, give epinephrine
what to do if the person had an anaphylactic reaction to a prior infusion
ask blood bank for blood from donor lacking IgA, use filter, frozen washed cells.
what is the causes for an acute hemolytic reaction
ABO compatibility problem, or improper storage of blood.
signs of acute hemolytic reaction
flank pain,
decreased bp, N&V,anxiety, restlessness.
most fatal reaction from a blood infusion is
acute hemolytic reaction
what to do do if you suspect acute hemolytic reaction
stop blood, keep vein open, change tubes, hang D5W, give o2, give epinephrine and nitro, insert foley, monitor I and O. may need clotting factors infused. notify lab immediatley..
what drugs do you administer when you suspect an acute hemolytic reaction
epinephrine and vasopressors.
circulatory overload is due to
fluid being administered faster than the circulation can accommodate.
monitor what with circulatory overload
breath sounds., distended neck veins, rales, Ha, dyspnea
nursing interventions for a pt with circulatory overload.
place in high fowlers with feed dependent, give diuretic,give o2, may need phlebotomy.
if you suspect sepsis while giving blood you should do what?
stope blood, give tylenol, dc tubing, lines, bags, send to blood bank to culture. give antibiotic, vassopres, corticosteriods.
corticosteroids given with allergic urticaria and with sepsis include
prednisone, decadron, solu-medrol.
neutrophils life span is
12 hrs
anemia is characterized by an imbalance of how many mls or more per day.
3ml
iron deficiencey anemia usually occurs in who
children or elderly
with iron dificency anemia, rebs are
microcytic
what med is given with an iron def anemia.
ferrous sulfate,
dextran
goods to encourage with iron deficiency anemia are
red meats, eggs, green leafy vegs, carrots, oj, raisins
NI's with iron deficiency anemia are
increase fiber-rt ferrous sal
give before meals,
dextram im must be given how
IM, Z-track, air lock.5ml
with iv iron, watch for this
anaphlactic reactions
megablastic anemias include
pernicious anemia and folic acid anemia
pernicious anemia results because there is a lack in
intrinsic factor
B-12
pernicious anemia is evident by what test
shillings test.
peripheral neuropathy ret decreased production of myelin is evident with what anemia
perniciouis anemia.
what med is given with pernicious anemia.
cyanocobalamine IM. 100-200mcg/month
how to give cyanocobalamine
100-200mcg/month to replenish then 1 injection each day for a week.
with folic acid deficiency give what med
folite PO.
folic acid deficiency is promonent in who
alcoholics
hemolytic anemias are
an inadequate number of circulating red blood cells (anemia) caused by premature destruction of red blood cells.
one type of hemolytic anemia is
sickle cell anemia.
excellerated erythropoiesis is found in
sickle cell anemia
treatment for sicke cell is
hydration, avoid stress, pain med. give folic acid, genetic counceling