Nursing 211: Hematology

Front 1

The study of blood and blood forming tissues is:

This includes:

Back 1

Hematology

bone marrow, blood, spleen, and lymph system.

Front 2

A basic knowledge of hematology is useful to:

Back 2

evaluate pts ability to transport oxygen and CO2, coagulate blood, and combat infections

Front 3

Bone cell production is called:

Soft material that fills the central core of bones:

Back 3

Hematopoiesis

Bone Marrow

Front 4

Which type of marrow actively produces blood cells:

Where is this found?

Back 4

Red marrow.

Flat and irregular bones such as: (ends of them) pelvic bones, vertebrae, sacrum, sternum, ribs, flat cranial bones, and scapulae.

Front 5

All 3 types of blood cells, develop from:

Back 5

A common hematopoieitic stem cell with in the bone marrow.

Front 6

Blood is a connective tissue that performs 3 what functions:

Back 6

Transportation, regulation, and protection.
* Transportation of O2, nutrients, hormones, and waste products around the body
* Regulates F&E and acid base balance
* Protective role in its ability to coagulate and combat infections.

Front 7

How much of the blood is plasma?

What is plasma mostly composed of?

Serum refers to:

Back 7

55 %

Water

Plasma minus clotting factors

Front 8

About ___% of the blood is composed of formed elements, or blood cells.

Back 8

45 %

Front 9

2 primary functions of erythrocytes?

Erythrocytes are primarily composed of:

Back 9

1)transports gases (O2 & CO2)
2)assists in maintaining
acid-base balance

Hemoglobin

Front 10

The process of RBC production:
It's regulated by:

Back 10

Erythropoiesis
cellular oxygen requirements and general metabolic activity.

Front 11

Erythropoiesis is stimulated by ___ and controlled by ___.

Back 11

hypoxia & erythropoietin

Front 12

A hormone synthesized and released by the kidney that stimulates the bone marrow to increase erythrocyte production
Nutrients essential for this:

Back 12

Erythropoietin.

protein, uiron, flate, B12, B2, B6.)

Front 13

The lymph system assists with carrying fluid from ___ to ____.

Lymph allows ___ & ___ & certain ___ from the GI tract to be returned to the circ system.

What function of the lymph system helps prevent edema?

Back 13

interstitial spaces to the blood.

Fats & proteins & hormones

lymph system returns interstitial fluid to the blood

Front 14

When does lymphedema develop?

Examples of when?

Back 14

When there's too much interstitial fluid or when something interferes with the reabsorption of lymph.

Aftter mastectomy or lumpectomy with dissection of axillary nodes.

Front 15

Lymph capillaries differ from blood capillaries in that:

Lymphatic capillaries unite to form lymphatic vessels that carry all lymph fluid to either:

Back 15

Lymph ones are slightly larger and do not contain valves.

the right lymphatic duct or the thoracic duct. From here they go into the subclavian veins in the neck.

Front 16

Primary function of lymph nodes:

Superificial nodes can be:
Deep only seen by:

Back 16

Filter bacteria and foreign particles carried by lymph.

Palpated
X-ray

Front 17

The elderly is at a larger risk for problems with:

Back 17

clotting, O2 transport, fighting infection, especialy during periods of increased demand. This results in diminished ability of an older adult to compensate for an acute or chronic illness.

Front 18

T or F
Hgb levels begin to decrease in both men and women after middle age.

Platelets are affected by aging process?

A patient previously treated with chemotherapy agents, particularly alkylating agents, is at a higher risk for developing a secondary malignancy of leukemia or lymphoma.

Back 18

True

False

True

Front 19

Where are clotting factors producted?

Alcohol damgaes ___ & ___.

Back 19

Liver.

Platelet function & the liver

Front 20

___, ___, & ___ are necessary for production of RBC's.

Back 20

Iron, cobalamin, Folic acid

Front 21

A primary lymph node may be a sign of:

Nodes that are enlarged and tender are usually associate with:

Back 21

Hodgkin's disease or non-Hodgkin's lymphoma.

an acute infection

Front 22

Some possible causes of arthalgia:

Back 22

autoimmune d/o, gout secondary to increased uric acid production, expanding bone marrow - leukemia,

Front 23

IF a lymph node is paplable it should be:

Abnormal:

Tender lymph nodes usually:
Hard or Fixed ones suggest:

Back 23

small (.5-1 cm), mobile, firm, and nontender.

tender, hard, fixed, or enlarged.

result of inflammation
malignancy

Front 24

What is a reticulocyte?

Destruction of RBC's is called?

Whats the normal life span of a RBC?

Back 24

Immature RBC.

Hemolysis

120 days

Front 25

Reticulocytes can develop into mature RBC's with ____ hours of release into circulation.

Hemolysis occurs in the bone marrow, liver, and spleen resulting in:

Back 25

48

Increased bilirubin.

Front 26

Where do leukocytes originate from?

Back 26

stem cells within the bone marrow

Front 27

Name the granulocytes:

Name the agranulocytes:

Back 27

neutrophils, eosinophils, basophils

lymphocytes & monocytes (also referred to as mononuclear)

Front 28

What's the primary function of granulocytes?

Back 28

Phagocytosis

Front 29

Primary phagocytic cells involved in acute inflammatory responses:

Back 29

Neutrophil

Front 30

Mature neutrophil called:

Immautre neturophil called:

Neturophils account for __% of WBCS

Back 30

Seg

band

50-70%

Front 31

Primary function of eosinophil?

Also defend against:

Esophinophils account for only ____% of all WBCs

Back 31

Engulf antigen-antibody complexes formed during an allergic response.

Parasitic infections

2-4%

Front 32

Basophils make up less than __% of WBC's.

These cells have cytoplasmic granules that contain ___, ___, and ___ and play a part seen in ____ & ____ reactions.

Back 32

2

heparin, serotonin, and histamine.
Allergic and inflammatory

Front 33

Lymphocytes constiute __% to __% of WBC's.

Lymphocytes originate from stem cells in the bone marrow and form the basis of the ___ & ____ immune responses.

2 subtypes of these are:

Where do T cells originate from and where do they go to?

Back 33

20-40%

Cellular and humoral

B & T cells

bone marrow, thymus

Front 34

Monocytes account for approximately __ - __% of WBCS

These are:

Back 34

4-8%

Potent phagocytic cells

Front 35

Second type of WBC to arrive at the scene of an injury?

These are only present a short time before they migrate to the ___ and become ____.

Back 35

Monocytes

Tissues, macrophages

Front 36

Where do platelets originate from?

Life span of platelets?

Back 36

stem cells within the bone marrow.

5-9 days

Front 37

What 3 factors contribute to hemostasis?

Back 37

vascular response, platelet response, & plasma clotting factors.

Front 38

What is the most powerful enzyme in the coagulation process?

That does it do?

Back 38

Thrombin

Converts fibrinogen to fibrin

Front 39

Two ways anticoagulation may be achieved:

Back 39

antithrombins and fibrinolysis

Front 40

Antithrombins antagonize ___.

Example:

Back 40

Thrombin

Endogenous heparin

Front 41

Fibrinolysis results in dissolution of ____.

Back 41

Fibrin

Front 42

4 functions of the spleen:

Back 42

hematopoietic function
filter function
immune function
storage function

Front 43

What does the spleen store?

When does the spleen produce RBC's?

The spleen contains a rich supply of __ & __ to assist with immune function.

Back 43

*Approximately 30% of platelet mass
*during fetal development.
*monocytes & lymphocytes

Front 44

What is necessary for development of RBC's.

Back 44

Iron, Cobalamin, and folic acid

Front 45

Foods rich in iron:

Back 45

liver, meat, eggs, whole-grain and enriched breads and cereals, potatoes, leafy green vegetables, dried fruits, legumes, and citrus fruits.

Front 46

An increasing abd girth can be realated to:

Back 46

an enlarged spleen, and enlarged liver, or abd bleeding.

Front 47

A marked decrease in RBCs, WBCs, and platelets:

With this care should be dircted toward the mgmt of:

Back 47

pancytopenia

anemia, infection, hemorrhage

Front 48

Hgb is low with:

Back 48

anemai, hemorrhage, and states of hemodilution

Front 49

Hgb is high with:

Back 49

polycythemia or states of hemoconcentraction (dehydration)

Front 50

The hematocrit represent the:

Back 50

percentage of RBC compared with the total blood volume.

Front 51

Elevations of WBC over 11,000/ul are assocaited with:

A count less than 4000/jl (leukopenia) is associated with

Back 51

infection, inflammation, tissue injury or death, and malignancies (leukemia, lymphoma)

bone marrow depression or some types of leukemia

Front 52

What happens when infections are severe?

Back 52

More granulocytes are released from the bone marrow as a compensatory mechansim. Causing bands to be released.

Front 53

A neutrophil count of less than 1000 cells/ul

A neturophil count of less than 500 cell/ul

Neutropenia can result from:

Back 53

Neutropenia.

Severe nuetropenia

leukemia or bone marrow depression

Front 54

Normal Platelet Count

Back 54

150,000 to 400,000 ul

Front 55

Normal Hgb

Back 55

Women 12-16 g/dl
Men 13.5-18 g/dl

Front 56

Normal Hct

Back 56

Women 38-47%
Men 40-54%

Front 57

Nomal RBC

Back 57

Women 1-5 X 10^6/ul
Men 4.5-6 X 10^6/ul

Front 58

MCV =

Back 58

HCT X 10
---------
RBC X 10^6

Determination of relative size of RBC

82-98 fl

Front 59

MCH =

Back 59

Hgb X 10
--------
RBC X 10^6

Measurement of avg wt of hgb/RBC

27-33 pg

Front 60

MCHC =

Back 60

Hgb
--- X 100
Hct

32-36% (.32-.36)

Front 61

Normal WBC

Back 61

4000-11,000/ul

Front 62

WBC differential:

Back 62

Neutrophils 50-70%
Eosiniphils 2-4%
Basophils 0-2%
Lyphocytes 20-40%
Monocytes 4-8%

Front 63

Normal Platelets

Back 63

150,000 to 400,000/ul

Front 64

Increased sed rate is comon with:

Back 64

acute and chronic inflammatory reactions when cell destruction is increased. Also in people with malignancy, myocardial infarction, and end-stage renal disease.

Front 65

What test is used to evaluate the person's Rh status?

Back 65

Coombs

Front 66

Normal PT

Back 66

12-15 seconds

Front 67

Normal INR

Back 67

2-3*

Front 68

Normal APTT

Back 68

30-45 seconds
* longer with use of heparin

Front 69

Universal donor

Back 69

O

Front 70

Normal ESR

Back 70

Women 1-20 mm in 1 hr
Men 1-15 mm in 1 hr

Front 71

Reticulocyte count:

Back 71

0.5-1.5% of RBC count

Front 72

Normal Bilirubin level

Back 72

Total: 0.2-1.3mg/dl
Direct: 0.1-0.3 mg/dl
Indirect: 0.1-1 mg/dl

Front 73

The prefered method of checking deep lymph nodes?

Back 73

CT

Front 74

The benefit gained from bone marrow examination is:

Preferred site of aspiration and biopsy.

Back 74

a full evaluation of hematopoiesis.

posterior iliac crests

Front 75

The hazard is greatest in aspiration procedures involving the:

Back 75

sternum.

Front 76

Nsg responsbility with CT scan

Back 76

ask about allergy to iodine if contrast is used

Front 77

Nsg responsibility with MRI

Back 77

Ask about metals and surgical Hx with staples plates and other metals. Instruct client must lay still in small chamber.

Front 78

Nsg responsibility with Bone marrow biopsy:

Back 78

Explain procedure to client, obtain signed consent form, analgesics. pressure dressing after procdure. Assess for bleeding

Front 79

Nsg responsibility with Lymph node biopsy:

Back 79

Explain procedure, obtain signed consent, sterile technique in dressing changes, assess for healing. Look for bleeding and edema.

Front 80

An individual who lives at a high altitude may normally have an increased RBC count because:

Back 80

Hypoxia caused by decreased atmospheric oxygen stimulates erythropoiesis.

Front 81

Disorders such as myeloblastic leukemia that arise from myeloblast cells in the bone marrow will have the primary efect of causing:

Back 81

decreased phagocytosis of bacteria

Front 82

An anticoagulant such as coumadin that interferes with wht production of prothrombin will alter the clotting mechanism during:

Back 82

activation of thrombin

Front 83

When reviewing lab results of an 83 yo pt with an infection, the nurse would expect to find:

Back 83

minimal leukocytosis

Front 84

Mild anemia:

Moderate anemia:

Severe anemia:

Back 84

10-14

6-10

Under 6