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61 Cards in this Set
- Front
- Back
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anemia pathophys
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impaired production of RBC
increased hemolysis massive/chronic blood loss |
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anemia etiology
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diet - lack of iron, folic acid, B12
hemolysis do not synthesize hemoglobin chronic dieases |
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anemia S&S
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pallor, tachycardia, tachypnea, irritability, fatigue, SOB, beefy red tongue, fissures, glossitis, spoon shaped fingernals
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anemia diagnostic tests
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CBC - # RBC/WBC
hemoglobin/Hct serum folate gastric acid levels |
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anemia interventions
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elimnate cause
increase intake of nutrient/supplement blood transfusion |
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aplastic anemia pathophys
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bone marrow becomes fatty, cannot produce RBC = pancytopenia (lack of all blood cells)
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aplastic anemia etiology
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congenital
exposure to toxic substance chemo cardiopulmonary bypass |
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aplastic anemia S&S
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weakness, fatigue, pallor, SOB, headaches, ecchymosis, petechiae (reduced platelet count), oozing blood to frank bleeding, infection (less WBC)
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aplastic anemia diagnostic tests
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CBC
bone marrow biopsy |
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aplastic anemia treatment
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supportive measure to prevent infection and bleeding
bone marrow transplant steroids colony stimulating factors |
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sickle cell anemia pathophys
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inherited - RBC mutation that causes sickle shape if hypoxic
will break and clump |
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sickle cell anemia etiology
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autosomal recessive hereditary
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sickle cell S&S
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crisis - tissue infarction - necrosis
decreased o2 causes crisis - pneumonia, cold, infection priapism, swelling of joints, renal failure, hand-foot syndrome |
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sickle cell anemia diagnostic tests
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blood smear
sickledex |
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sickle cell anemia treatment
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no cure -educate to prevent crisis
hospital for 5-7 days during crisis; oxygen, antibiotics, blood transfusions |
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sickle cell anemia interventions
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warm compresses - not cold, oral fluids, avoid restrictive clothing; avoid strenous exercise, cold temps, alcohol
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polycythemia pathophys
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too many RBC = thick blood
Hmg > 18 mg/dL, RBC > 6 million, Hmt > 55% |
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primary polycythemia
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unknown cause
bone marrow too packed - cells spill into tissues - thrombosis and occlusion occurs |
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secondary polycythemia
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long term hypoxia
COPD, CHF, high altitudes, smoking body overproduces RBC |
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polycythemia S&S
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hypertension, visual changes, headache, vertigo, dizzy, tinnitus
panmyelosis (all bone marrow components increased) nosebleeds, bleeding gums, retinal hemorhage, exertional dypsnea, chest pains dark flushed complexion abdominal pain/fullness = enlarge liver and spleen |
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polycythemia treatment
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decrease hyperviscosity = therapeutic phlebotomy; must be repeated
chemo to suppress creation of RBC |
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polycythemia interventions
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small meals
ROM monitor for hypovolemia/bleeding drink 3L water daily, avoid tight clothes, do not elevate feed |
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DIC pathophys
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accelerated clotting=>all clotting supplies and platelet used up =>bleed everywhere
clotting leads to organ/limb necrosis |
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DIC etiology
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major trauma
overwhelming infection severe burn abdominal surgery |
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DIC S&S
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abnormal bleeding - petechiae, ecchymosis, bleeding from venipuncture sites
shock - N/V, dsypnea, oliguria, convulsions, abdominal pain |
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DIC diagnostic tests
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increase PT time and PTT time, decreased platelet count, increased evidence of fibrin degradation
BUN/creatinine elevated |
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DIC interventions
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early recognition
administer blood, fresh frozen plasma, platelets heparin |
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DIC care
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prevent further bleeding
avoid trauma that might cause do not dislodge clots, ICU |
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Idiopathic Thrombocytopenic Purpura pathophys
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increased platelet destruction by immune system; increased risk of bleeding
may be drug induced |
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ITP S&S
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thrombocytopenia: petechiae, ecchymoses, bleeding frm mouth/nose/GI
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ITP diagnostic tests
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platelet less than 20,000
prolonged bleeding time bone marrow aspirations - short life span of platelets |
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ITP treatment
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steroids
chemo splenectomy treat bleeding with blood, platelet, and vitamin K transfusions |
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ITP interventions
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bleeding precautions
avoid trauma, restrict activity |
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Hemophilia pathophys
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A = deficient factor VII
B = defieicent factor IX platelet plug will form but not a clot |
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Hemophilia etiology
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x-linked recessive trait; female carriers
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Hemophilia S&S
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hemarthrosis
spontaneous bleeding |
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Hemophilia diagnostic tests
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prolonged PTT, missing factor
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Hemophilia interventions
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stop bleeding by administering missing factor
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Leukemia pathophys
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immature WBC generate explosively, body cannot fight infection
WBC collect in body organs/tissue and cause inflammation, pain, infection |
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leukemia classifications
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acute lymphocytic: children younger than 15
acute myelogenous: over 20 chronic lymphocytic:B and T lymphocytes chronic myelogenous: philadelphia chromosone |
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leukemia etiology
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viruses
down syndrome radiation |
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leukemia S&S
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low grade fever, pallor, wekaness, lassitude, SOB, malaise, fatigue, tachycardia, palpitations, abdominal pain, sternal pain/rib tenderness
confusion, headache, personality changes |
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leukemia diagnostic tests
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CBC
bone marrow aspiration is positive confirmation lumbar puncture (CNS involvement?) |
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leukemia interventions
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chemo: induction, intensification, consolidation, maintenance; goal is remission; radiation to decrease size of liver or spleen
bone marrow transplant |
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multiple myeloma pathophys
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cancer of bone marrow - cells infiltrate bone marrow and produce tumors that devour bone tissue
swiss cheese pattern later infiltrate major organs |
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multiple myeloma etiology
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chronic allergies
hypersensitivity |
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multiple myeloma S&S
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skeletal pain
constant severe back pain low grade fever, malaise peripheral neuropathy spinal cord compression - loose control of bladder, bowels patholgical fractures hypercalcemia (anorexia, N/V, mental status changes) b/c calcium leaves bones |
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multiple myeloma diagnostic tests
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CBC - anemia
urine studies - m-type globulins bone marrow biopsy increased calcium in blood x-ray |
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multiple myeloma interventions
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steroids
chemo bisphosphone agents to control serum Ca+ (below 10) external beam irradiation |
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Hodgkins disease pathophys
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reed-sternburg cells; cancer of lymph system
one more more painlessly enlarge lymph nodes in cervical, axillary, inguinal areas |
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Hodgkin's disease etiology
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unknown
mono impaired immune system |
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Hodgkins S&S
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painless swelling in lymph nodes
alcohol induced pain pain at disease site low grade fever, night sweats, fatigue, weight loss, malaise |
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Hodgkin's diagnostic tets
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lymph nod biopsy
bone marrow biopsy CT - has it spread to liver/spleen |
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Hodgkin's staging
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I: single lymph node or site
II: two or more nodes on same side of diaphragm III: nodes on both sides of diaphragm, may have organs too IV: widely dessimated |
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Hodgkin's interventions
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radiation/chemo
symptom management |
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Non-Hodgkin's lymphoma pathophys, etiology
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absence of Reed-sternberg cells
arise from B and T cells unclear - viruses? |
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Non-Hodgkin's lymphoma S&S
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enlarged, painless, rubbery nodes in cervical and supraclavicular area, enlarge tonsils/adenoids, dyspnea/cough
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non-Hodgkins diagnostic tests
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biopsy
bone scans x-ray CBC |
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non-Hodgkin's interventions
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chemo, radiation
stem cell transplant |
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splenectomy pre-surgery
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CBC
coagulation profile blood transfusion to correct anemia vitamin K for clotting resp. assessment coughing/deep breathing |
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splenectomy post-op
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watch for bleeding
control pain respiratory problems related to location - pneumonia/infection pancreatitis/fistula overwhelming post-op infection from strep (fever, malaise) |
