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61 Cards in this Set

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