Med-Surg Nursing Exam 4

Front 1

Define Hematopoiesis

Back 1

Hematopoiesis is the complex process of the formation and maturation of blood cless

Front 2

Type of anemia resulting from red blood cell destruction

Back 2

Hemolytic anemia

Front 3

Define Anemia

Back 3

Lower than normal hemoglobin and fewer than normal circulation erythrocytes. A sign of an underlying disorder

Front 4

What is Hypoproliferative anemia

Back 4

Defect in production of RBC's

Front 5

Hypoproliferative Anemia Patho

Back 5

Due to iron, V B12 or folate deficiency. Decreased erythropoietin production, cancer.

Front 6

What is Hemolytic anemia

Back 6

Excess destruction of RBC's

Front 7

Hemolytic anemia patho

Back 7

Due to altered erythropoiesis, or other causes such as hypersplenism, drug-induced or auto-immune processes, mechanical heart valve.

Front 8

S/S of anemia

Back 8

Fatigue, weakness, malaise, pallor, jaundice, cardiac or respiratory problems, tongue changes, nail changes, angular cheilosis, and pica.

Front 9

Medical Management of anemia

Back 9

Correct/control underlying cause. Transfusion. Treatment to specific type: dietary, vitamin supplement, etc.

Front 10

Potential anemia problems

Back 10

heart failure, angina, paresthesias, and confusion.

Front 11

Anemia nursing interventions

Back 11

Balance activity, exercise, and rest. Maintain adequate nutrition, pt education, monitor VS, monitor for potential complications.

Front 12

Define Leukemia

Back 12

Hematopoietic malignancy with unrelated proliferation of leukocytes

Front 13

What increase absorption of iron

Back 13

Vitamin C

Front 14

Acute Myeloid Leukemia (AML)

Back 14

Defect in stem cell that differentiate into all myeloid cells: monocytes, granulocytes, erythrocytes, and platelets. Most common nonlymphocytic leukemia. Peak incident at age 60.

Front 15

S/S of Acute Myeloid Leukemia (AML)

Back 15

fever and infection, weakness and fatigue, bleeding tendencies, pain from enlarges liver or spleen, hyperplasia of gums, bone pain

Front 16

When there is low hemoglobin the heart ______

Back 16

Pumps faster

Front 17

Medical management of Acute Myeloid Leukemia (AML)

Back 17

Chemotherapy-induction therapy, BMT or PBSCT

Front 18

Chronic Myeloid Leukemia (CML)

Back 18

Mutation in myeloid stem cell with uncontrolled proliferation of cells-Philadelphia chromosome. Uncommon in people under 20. Mean age 55-60. Life expectancy 3-5 years.

Front 19

Three stages of Chronic Myeloid Leukemia (CML)

Back 19

Chronic phase, transformational phase, blast crisis

Front 20

Signs and symptoms of Chronic Myeloid Leukemia (CML)

Back 20

Initially may be asymptomatic, malaise, anorexia, weight loss, confusion or SOB due to leukostasis, enlarged tender spleen, or enlarged liver.

Front 21

Medical management of Chronic Myeloid Leukemia (CML)

Back 21

imatinib mestylate (Gleevec) blocks signals in leukemic cells that express BCR-ABL protein; chemotherapy, BMT or PBSCT

Front 22

Acute Lymphocytic Leukemia

Back 22

Uncontrolled proliferation of immature cells from lymphoid stem cell. Most common in young children, boys more often than girls. 8-% 5-year event-free survival, but drops with increased age.

Front 23

S/S of Acute Lymphocytic Leukemia

Back 23

Leukemic cell infiltration is more common with this leukemia, with symptoms of meningeal involvement and liver, spleen, and bone marrow pain

Front 24

Medical management of Acute Lymphocytic Leukemia

Back 24

Chemotherapy, imatinib mestylate (if Philadelphia chromosome positive), BMT or PBSCT, monoclonal antibody therapy.

Front 25

Chronic Lymphocytic Leukemia

Back 25

Malignant B lymphocytes, most of which are mature, may escape apoptosis, resulting in excessive accumulation of cells. Most common form of Leukemia. Most common in older adults, effects men more often. Survival 2-14 years depending upon stage

Front 26

S/S of Chronic Lymphocytic Leukemia

Back 26

Lymphadenopathy, hepatomegaly, splenomegaly; in later stages anemias and thromocytopenia; autoimmune complications with RES destroying RBC's and platelets may occur, B symptoms include fever, sweats, weight loss.

Front 27

Medical management of Chronic Lymphocytic Leukemia

Back 27

early stage may require no treatment, chemotherapy, monoclonal antibody therapy

Front 28

Potential Leukemia Problems

Back 28

Infection, bleeding, renal dysfunction, tumor lysis syndrome, nutritional depletion, mucositis, depression

Front 29

Leukemia nursing interventions

Back 29

reduce risk for infection and bleeding. Frequent, gentle oral hygiene.

Front 30

Improving Nutrition for Leukemia

Back 30

Oral care before and after meals, analgesics before meals, appropriate treatment of nausea, small, frequent feedings, soft foods, low-microbial diet, nutritional supplements.

Front 31

Disseminated intravascular coagulation (DIC)

Back 31

A condition in which blood clots from throughout the body's small blood vessels. These blood clots can reduce or block flow through the blood vessels, which can damage the body's organs. Severity is variable; may be life-threatening.

Front 32

Disseminated intravascular coagulation (DIC) triggers

Back 32

Sepsis, trauma, shock, cancer, abrupto placentae, toxins, and allergic reactions

Front 33

Medical management of Disseminated intravascular coagulation (DIC)

Back 33

treat underlying cause, correct tissue ischemia, replace fluids and electrolytes, maintain blood pressure, replace coagulation factors, use heparin.

Front 34

Potential Disseminated intravascular coagulation (DIC) complications

Back 34

Renal failure, Gangrene, pulmonary embolism, hemorrhage, acute respiratory distress symdrome, stroke

Front 35

Disseminated intravascular coagulation (DIC) Nursing interventions

Back 35

Assessment and interventions should target potential site of organ damage. Monitor and assess carefully. Avoid trauma and prodecures which increase risk of bleeding, including activities which would increase intracranial pressure.

Front 36

Hematologic System Structures

Back 36

blood, bone marrow, spleen, lymph system)

Front 37

Bone marrow aspiration and Biopsy

Back 37

Out pt procedure, lies on back or side, gets local anesthetic agents, feels pressure, a few seconds of sharp pain during aspiration, <1 hr procedure

Front 38

Post-bone marrow aspiration care

Back 38

pressure dressing on site, monitor VS, monitor for bleeding, lie on aspirated side for 30-60 mins

Front 39

Iron Deficiency Anemia

Back 39

without transferrin (carries iron) iron cannot be out in circulatory system. Ferritin (stores iron in liver & heart) iron should not be excreted (in urine or stool).

Front 40

Iron Deficiency Anemia risk factors

Back 40

Inadequate dietary intake, malabsorption, GI surgery, loss of blood, premenopausal women, hemorrhage, chronic renal failure