• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/42

Click to flip

42 Cards in this Set

  • Front
  • Back
What should be assessed in a hematologic assessment?
skin for petechi, bruising, pallor
Enlarged organs: spleen, liver, kidneys
Labs: **
What is anemia?
low number of RBC and Hgb: the heme portion of RBC can't carry oxygen
What are the effects of anemia on the circulatory system?
hemodilution
dec peripheral resistance
inc cardiac circulation and turbulence - murmur can lead to failure
Cyanosis
Growth retardation
What causes iron deficient anemia?
dec iron intake
inc demand of iron (growth spurt)
dec in RBC or Hgb (<10)
blood loss
malabsorption
What are iron sources for iron deficient anemia?
fortified cereal
leafy green veges
red meat
no cows milk for 1yr (post yr <24oz/day)
if BF, mom eat iron
beans
grains
dried fruits
Vit C for absorption
What are the nursing considerations for iron supplementation?
no milk
stools will be tarry black
stain teeth (use straw)
diarrhea/vomiting
What is the patho of sickle cell disease SSD?
in infancy: Hbg F converts to Hgb A
In SSD, Hgb S replaces Hgb A
The Hgb S can't pass through the vessles blocking them and die 15-20 days
Why doesn't SSD show up in an infant?
bec the Hgb A isn't being converted until >1yr
In what cultures does SSD occur in?
AA
mediterranean
indian
middle eastern
What are the main problems in SSD?
obstruction: hypoxia, infarction
Destruction: of RBC
WHat is the genetic component of SSD?
25% no disease
25% have disease
50% carriers
What systems are affected in SSD?
pg 917
What is the diagnosis of SSD?
DNA prenatal
Sickledex: performed at birth with PKU (NOT DX)
if +, electrophoresis confirms (fingerprint of protein)
What are the precipitating factors of sickle cell crisis?
dehydration
infection
change in weather
stress (physical and emo)
RR with asthma
Trauma

BASICALLY ANYTHING THAT ALT BODY"S NEED FOR OXYGEN
What are the Cx of SSD?
Crisis:
Vaso-occlusive Crisis
Acute Chest Syndrome
Splenic Sequestration Hemolysis

Infection: penicillin for 2mo post testing
Stroke
What is important to understand about vaso-occlusive Crisis?
fever and pain
often in joints (swollen)
What is important to know about acute chest syndrome?
impaired gas exchange/hypoxia
s.s of pneumonia
What is important to understand about splenic sequestration Hemolysis?
pooling of blood in spleen
pain
inc abd girth
weak
L abd pain
HR inc
What is the tx for SSD?
Hydration: 150cc/kg/day
Pain management
iron checks or iron chelation
PCN until age 5
Hydroxurea (Rx inc Hgb F)
Transfusion
Ox to treat acidosis
avoid cold
immunizations (yes)
stem cell transplant
What is the prognosis of SSD?
no cure (except bone marrow transplant)
supportive care (prevent crisis)
bacterial infections may reoccur due to immunocomprimise (causing death)
What is Thalassemia Anemia?
Autosomal recessive Hgb synthesis disorder
RBC structurally impaired
hemolasized quickly - inc bilirubin and jaundice
inc iron
hypoxic
spleen and liver engorged with blood
How is thalassemia anemia dx?
by 1yo
6wk dx with electrophoresis
found in Mediterranian
What is the management of thalassemia?
transfusion, H&H, iron levels - chelation therapy
Desferol qPM SQ via I-Med (chelation)
Spleenectomy
Bone marrow transplant
What is the prognosis of thalassemia?
retarded growth
delayed or absent secondary characteristics
expect to live well into adulthood with proper clinical management
What is aplastic anemia?
blood disorder in which the bone marrow fails to produce RBCs WBC and platelets
What are the types of aplastic anemia?
Aquired:
Rx
Infection: HPV, Hep
Chemo in utero
radiation
immune disorder
household cleaners
lymphomias

Congenital
What are the s/s of aplastic anemia?
epistaxis
gum oozing
ecchymoses
petechiae
purpura
tachycardia
tachypnea
blood in urine and stool
fatigue
bleeding
What is the management of aplastic anemia?
avoid hemorrhage
assist with bone marrow transplant
prevent infection from bleeding
What are the types of clotting disorders?
Idiopathic Thrombocytopenia Purpura
DIC
Hemophilia
Von Willebrand Disease
What is hemophilia?
group of disorders with deficiency of clotting factors causing prolonged bleeding with trauma or spontaneously
What is the genetic component of hemophilia?
x linked recessive
females carrier
males affected
can be spontaneous mutation
What are the s/s of hemophilia?
bleeding
might not occur until 6mo
Hemarthrosis
Ecchymosis
Epistaxis
Bleeding post minor procedures can cause large SQ or IM hemorrhages to occur
What is the dx for hemophilia?
Dx during pregnancy
genetic testing for family
Labs
What is the nursing management for hemophilia?
prevent bleeds
emergency for bleed in neck, chest, mouth (airway)
Replacement of deficient factor (DDAVP)
exercise/PT (dec spontaneous bleed)
avoid obesity
no contact sports
What is the management of a bleed?
pressure
ice
elevation
splint
rest
What is Von Willebrand Disease VWD?
congenital bleeding disorder with deficiency of vWF causing prolonged bleeding time (no platelet plug) from membranes
What are the interventions for vWD?
no ASA or NSAIDS (inhibit platelet fx)
manage bleeding with prompt infusion therapy
normal life expectancy
What is Idiopathic Thrombocytopenic Purpura?
autoimmune hemorrhagic disorder with <20,000 platelets found in 2-10yo

theres destruction of platelets
What are the manifestations of ITP?
Follows viral respiratory infection (unvaccinated MMR or polio)
self limiting
petechiae
prolonged bleeding
purpura
bruising
appears well: WBC normal
Epistaxis
Black stools
hematemisis
Menorrhagia
What are nursing interventions for ITP?
prevent bleeding
no asa or NSAIDS
Steroids and IV immunoglobulin if <20,000
Teach S/S of bleeding
WHat does recurrent epistaxis mean?
Vascular abnormality
leukemia
ITP
clotting deficiencies
What are interventions with epistaxis?
be calm
lean forward
pressure for 10 mins