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49 Cards in this Set

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complete blood count CBC
RBC, WBC, PLTS, blood types,
RBC
4.5-5.9 x10^12/L
delivers oxygen and removes waste
polycythemia
overproduction of RBC
erythropoietin
stimulates production of RBCs by bone marrow
hemoglobin
12-17
contains iron and protein.
gives blood its red color.
measures the severity of anemia and polycythemia
monitor the response to treatment.
hematocrit
36-51%
-evaluate the degree of blood loss, anemia, polycythemia & dehydration.
-determines the proportion of RBC in plasma
-expressed in percentage: HCT of 30% is 30ml of RBC in 100ml of whole blood.
sickle cell anemia
RBC destruction
-misshapen Hgb and RBC
-supportive interventions: prevent infection, relieve pain, provide fluid and o2.
Thalassemia
RBC destruction
-mutated Hgb
-iron overload and excessive hematopoisis
-requires transfusions or removal of excess iron from blood.
-splenectomy/bone marrow transplant.
nursing interventions with Plts
critical values: <50,000, >1,000,000.
report to MD stat.
-low counts, teach pt measures to prevent bleeding.
thrombocytopenia: assessment
-monitor pt's ksin for bruising, indicates bleeding under teh skin
-protect from bruising.
-electric razor
-soft tooth brush
-avoid use of aspirin because it worsens the ability to clot.
WBC
-monitor bone marrow response to cancer treatment
-attack and destroy bacteria, virus, or foreign org.
-detects anemia, infection, and leukemia
lab values for bone marrow disorder
up/down RBC
up/down HGB
up/down HCT
up/down PLTS
lab values for hemoconcentration
up RBC
up HGB
up HCT
lab values for dehydration
up RBC, HGB, HCT
lab values for diarrhea/vomiting
up RBC, HGB, HCT
lab values malignant tumors
down RBC, HGB, HCT,
up PLTS
lab values for hemorrhage
down RBC, HGB, HCT
up PLTS
lab values for anemia
down everything
platelet either way
hemodilution--lab values
everythign down. doesn't affect PLTS
chemo/rt--lab values
everythign down.
pt with low RBC, Hgb, adn Hct
Intervention
-assess vital signs
-monitor frequently for safety
-give blood transfusion
-assist with ADLs
-encourage food intake e.g. increase red meat
-iron and B12
PTT reflects?
effect of heparin anticoagulant therapy, dose is adjusted based on test results.
-PTT reflects serum heparin at the moment the sample is taken (heparin activity varies from moment to moment)
antidote to heparin
protamine sulfate
PT ??
monitor oral anticoagulant therapy--coumadin/warfarin (range monitored through INR)
-SNAIDS, aspirin, and other anti-platelet agents can affect PT level.
antidote to coumadin
vitamin K
INR??
needs to be monitored for clients on coumadin for:
-deep veing thrombosis DVT
-pulmonary embolism PE
-myocardial infarction MI
-mitral valve replacement MVR
what decreases INR level
vitamin K
FFP
albumin
maintains osmotic pressure within cell walls.
helps investigate symptoms of disease: swelling of the ankles (pedal edema) or abdomen (ascites).
prealbumin
evaluate nutritional status to determine whether a diet contains enough protein.
BUN
-protein metabolism--urea nitrogen
-exretion primarily by kidneys
-used to evaluate renal function
elevated BUN
kidney damage
acute/chronic renal failure
dehydration
creatinine
waste product of creatinine phosphate
-muscle tissue energy metabolism--creatinine
-excretion primarily by kidneys
-sensitive to kidney dysfunction/muscle mass
-evaluates renal dysfunction
increased Cr+
renal damage/failure, nephrotoxic drugs, etc.
uric acid
-end product of protein metabolism
-excreted by kidney as waste product
-monitor pt with renal failure
GOUT and treatment of
disease associated with consistently high serum uric acid levels (more common in men)


treatment: allopurinol prevents elevation
cardiac enzymes
found in all tissues, heart, brain, and skeletal muscle.
-cardiac enzyme studies measure the levels of the ensymes Troponin (Tnl, TnT) and creatine phosphokinase (CPK, CK) in the blood.
-Levels rise, peak & normalize
-diagnose MI
troponin-basic
protein that helps to regulate cardiac contractility
-three types
-troponin I specific to cardiac muscle injury.
-gives faster diagnosis that other enzymes
troponin: onset, peak, duration
TnI:
onset: 2-6 hours
peaks: 16hrs
dure: 5-9 days

TnT:
onset: 3-4hrs
peaks: 12-48 hrs
dure: 10-14 days
interventions: MI
-baseline VS, monitor CPK & troponin level
-cardiac monitor monitors cardiac rhythms for arrhythmias
-02 therapy
-aspirin and nitrates
-intravenous access
-thrombolytic therapy
-close monitoring of pt as needed.
parathyroid hormone PTH regulates what?
calcium and phosphorus ions in the blood...they have inverse relationship.
hydrogen ions
calcium, phosphorus, magnesium
calcium
-maintains proper heart function, nerve transmission and blood clotting
50% bound to albumin, 50% ionized or free.
2 regulators of calcium
parathyroid hormone
calcitonin
increase in PTH = increase in Ca
cause of hypocalcemia
-hypoparathyroidism
-excess phosphorous
-vit D deficiency
-low albumin
-prolonged IV fluid therapy
-diuretics
-malnutrition
S&S of hypocalcemia
-neuromuscular excitability
-muscle twitching
-numbness
-tingling
-trousseau's & Chvostek's signs
-seizures
-irregular heart beat
-DIARRHEA
interventions for hypocalcemia
-place pt on seizure precautions
-IV calcium as ordered
-oral calcium supplements, taken w/ vit D
-foods
-calcium should never be given IM.
causes of hypercalcemia
-hyperparathyroidism
-metastatic bone cancer
-bone loss
-high ca intake antacids
-vit D intoxication
-dehydration
-immobilization
S & S of hypercalcemia
-neuromuscular weakness
-lack of coordination
-lethargy
-confusion
-convulsions
-coma
-impaired memory
-irregular puse/heartbeat
-CONSTIPATION
interventions for hypercalcemia
-assess pt for s/s of hypercalcemia
-assess pt level of consciousness
-seizure precautions
-assess if pt is on digoxin therapy
-intravenous fluids
-IV bisphosphonates
-check pt EDG for changes.