Rn/year Test 4 Patricia And Amy

Front 1

This is a deficiency in the number of erythrocytes, the quantity of hemoglobin, and the volume of hematocrit.

Back 1

Anemia

Front 2

Name the 3 classifications of anemia?

Back 2

Blood loss
↓ RBC production
↑ destruction of RBCs

Front 3

A clinical manifestations of anemia is the body's response to tissue _____

Back 3

hypoxia

Front 4

anemia is not a specific process, it is a manifestation of a pathological process. T or F

Back 4

true

Front 5

Name some skin changes with anemia

Back 5

Pallor- due to ↓ blood flow to skin
Jaundice- Due to hemolysis of RBCs and ↑ concentration of bilirubin
Pruritis-↑ serum and skin bile salt concentrations

Front 6

T or F. Old people have a slight ↓ in hemoglobin

Back 6

True

Front 7

T or F. Anemia may go unrecognized in the older adult because manifestations of anemia may be mistaken with normal aging changes.

Back 7

True

Front 8

Normal life span of an RBC is how many days?

Back 8

120

Front 9

There are 3 alterations of Decrased RBC production, name them.

Back 9

↓ hemoglobin deficiency
Defective DNA synthesis in RBCs
Diminished availability of RBC precursors

Front 10

Anemias of decreased hemoglobin synthesis. Name three of them.

Back 10

Iron-deficiency anemia
thalassemia
Sideroblastic anemia

Front 11

One of the most common chronic hematologic disorders is which type of anemia?

Back 11

Iron-deficiency anemia

Front 12

Name the etiologies ( underlying causes) of iron deficiency anemia?

Back 12

Poor dietary intake-not enough iron intake
malabsorption-When the bowels are removed, or diseased and the iron can no be absorbed
blood loss- GI bleeds, Menstrual bleeds, Dialysis
hemolysis

Front 13

S/s of Iron defiency anemia

Back 13

Palor is the most common finding
glossitis- inflammation and burning of tongue
Cheilitis

Front 14

Treatement of iron deficiency anemia is to

Back 14

Treat the underlying disease causing the deficiency of iron
teach dietary intake

Front 15

This anemia is a decreased hemoglobin deficiency, it is an autosomal recessive genetic disorder involving inadequate production of normal hemoglobin. It is due to the absent or reduced globulin protein

Back 15

Thalassemia

Front 16

This decreased hemoglobin deficiency occurs in people near the Mediterranean sea and equatorial regions of Asia, middle east and Africa

Back 16

Thalassemia

Front 17

S/S of thalassemia

Back 17

Pallor, splenomegaly, hepatomegaly

Front 18

This medication is a chelating agent that binds to iron to reduce the iron overloading that occurs with chronic transfusion therapy.

Back 18

Desferal

Front 19

This hemolgobing deficient anemia acts like iron deficiency anemia, it has a ringed look in the microscopoe.

Back 19

Sideroblastic anemia

Front 20

This anemia is when they have the iron but it is not being incorporated the right way. Pts will end up with transfusions with vit B6. This is a hereditary.

Back 20

Sideroblastic anemia

Front 21

This anemia is a group of disorders caused by impaired DNA synthesis anc charactgerized by the presence of large RBCs

Back 21

Megaloblastic anemias

Front 22

Large RBCs are called

Back 22

megaloblasts

Front 23

Two common forms of megaloblastic anemia is

Back 23

Cobalamin defiency
folic acid deficiency

Front 24

Cobalamin is what vitamin
Folic acid is what vitamin

Back 24

b12
b6

Front 25

The protein made by the stomach that is needed to absorb cobalamin

Back 25

IF

Front 26

The most common cause of cobalamin deficiency is

Back 26

pernicious anemia

Front 27

A disease in which the gastric mucosa is not secreting IF needed to absorb cobalamin

Back 27

Pernicous anemia

Front 28

Other cuases of cobalamin deficicency:

Back 28

gastrectomy
Chrohns disease
ileitis
chronic alcoholism
nutritional defiency

Front 29

T or F. Cobalamin deficiency anemia can be reversed as long as they get the b12 needed

Back 29

true

Front 30

S/S of cobalamin deficienncy

Back 30

sore tongue, anorexia, nausea, vomiting, ab pain, weakness, paresthesias of hands and feet, ataxia, confusion

Front 31

Folic acid deficiency is caued by

Back 31

poor nutrition of B6
malabsorption syndromes (small bowel problems)
Drugs that impede folic acid
alcohol abuse and anorexia
hemodialysis

Front 32

Good nutrition of B6

Back 32

leafy green veges, liver, citrus fruits, yeast

Front 33

We need to draw serum folate levels to determine the deficiency

Back 33

Treatment of folic acid deficiency is replacement therapy

Front 34

Diminished availability of RBC precursors

Back 34

anemias of chronic disease
aplastic anemia
myeloproliferative disease and myelodysplasia

Front 35

Anemia of chronic diseases are immune driven like chronic inflammatory disease, autoimmune disease, infectious disease, malignant disease

Back 35

info

Front 36

an conditioin that causes increased RBC destruction by by self attacking itself, accompanied by the failure to augment erythropoiesis will contribute to anemia.

Back 36

autoimmune disease

Front 37

Example of anemia of chronic disease is renal disease, because why?

Back 37

Kidneys make the hormone erythropoietin which is responsible for erythropoiesis

Front 38

This anemia of a erythrocyte precursor is a diease in which the pt. has peripheral blood pancytopenia (decrease of all blood cell types and hypocellular bone marrow)

Back 38

aplastic anemia

Front 39

Two causes of aplastic anemia

Back 39

Aplastic anemias
congenital- caused by chromosomal alterations
aquired aplastic anemia- results from exposure to ionizing radiation, chemical agents, viral or bacterial infections and medications

Front 40

70% of acquired aplastic anemias are idopathic

Back 40

info

Front 41

This is when the bone marrow doesn't make the required amount of cells.

Back 41

hypocellular bone marrow

Front 42

Manifestations of aplastic anemia

Back 42

dsypnea, fatigue

Front 43

Neutropenia caused by aplatic anemia means that neutrophils are low, so we are susceptible to

Back 43

infections

Front 44

Aplastic anemia causes thrombocytopenia which means we are susceptible to

Back 44

hemmorhage

Front 45

This disease is characterized by chane in the quantity and quality of bone marrow elements. This shows cytopenia (decreased number of blood cells) in combo with hypercellular bone marrow exhibiting dysplastic changes (production of abnormal cells)

Back 45

Myeloproliferative disase myelodysplasia

Front 46

anemia from blood loss is an acute sudden like trauma or blood vessel rupture.

Back 46

info

Front 47

Quick change in volume will lead a person into shock. Should initially replace volume then correct the RBC loss

Back 47

info

Front 48

Chronic gastritis, menstrual flow and hemorrhoids can cause anemia from blood loss. however, the slower chronic loss of blood the person can adapt to the lower hemoglobin levels

Back 48

INFO

Front 49

Anemia from blood loss the prognosis leads to location and amount of blood loss.

Back 49

info

Front 50

The s/s of anemia from blood losss is ?

Back 50

pallor, dyspnea, lethargy, BP is low, Tachycardia, bleeding in tissue

Front 51

The nursing managment of acute and chroni blood loss.

Back 51

volume exander, O2, iron supplement

Front 52

This refers to a decrease in leukocytes total WBC count

Back 52

leukopenia

Front 53

A decrease in neutrophils

Back 53

Neutropenia

Front 54

A decrease in granulocytes

Back 54

granulocytopenia

Front 55

Something that originates in the bone marrow

Back 55

myeloid

Front 56

Elements of bone marrow are not formed correctly

Back 56

myelodysplasia

Front 57

Malignant disorder affecting the blood and blood-forming tissues of the bone marrow, lymph system, and spleen.

Back 57

Leukemias

Front 58

Malignant condition characterized by proliferation of abnormal giant, multinucleated cells, called Reed-Sternberg cells, which are located in the lymph nodes.

Back 58

hodgkins disease

Front 59

a heterogenous group of malignant neoplasm (abnormal growth-tumor) in primarily B or T-cells.

Back 59

Non-hodgkins disease

Front 60

a condition where neoplastic plasma cells infiltrate the bone marrow and destroy bone.

Back 60

multiple myeloma

Front 61

Leukemia occurs in all age groups. can result from genetics and environmental factors

Back 61

info

Front 62

Leukemia is very specific to which WBC?

Back 62

lymphocytes

Front 63

Immature cells are know as what?

Back 63

blast cells

Front 64

Very large immature lymphocytes are called.

Back 64

lymphoblasts

Front 65

very large bone marrow cell

Back 65

myeloblast

Front 66

Classifications of leukemia is based on what?

Back 66

acute and chronic

Front 67

This Classification of leukemia is characterized by the clonal prliferation of immature hematopoietic cells. It develops follwoing malignant transformation of a single type of immature hematopoietic cell, following cellular replication of that malignant clone. It is abrupt rapid and survival is thort

Back 67

acute

Front 68

This classification of leukemia involves more mature forms of the WBC and the diease is onset and more gradual

Back 68

chronic

Front 69

as leukemia progresses, fewer normal blood cells are produced. Because the abnormal WBCs accumulate due to they do not go through the normal cell cycle to death. (Apoptosis)

Back 69

info

Front 70

Leukemic cells infiltrate the organs leading to:

Back 70

splenomegally
hepatomegaly
lympadenopathy
bone pain
meningeal irritation
oral lesions

Front 71

Solid masses resulting from collections of leukemic cells are called

Back 71

chloramas

Front 72

The clinical manifestations of leukemia are varied. essentially the relat to problems caused by bone marrow _____ and the formationn of leukemic ____.

Back 72

failure, infiltrates

Front 73

Bone marrow failure results in?

Back 73

bone marrow overcrowding by abnormal cells and inadequate production of normal marrow elemtns

Front 74

In leukemia, inadequate marrow elements cause

Back 74

anemia, thrombocytopenia, ↓ number and fucntions of WBCs

Front 75

This type of leukemia is the uncontrolled proliferation of myeloblasts. There is hyperplasia of the bone marrow.

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 75

A

Front 76

The leukemia is when the normal hematopoietic cells in the marrow are replaced with leukemic myeloblasts that causes infiltration of organs and tissues causing serios infectoins and abnormal bleeding

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 76

a.

Front 77

This type of leukemia affects 85% of adults.

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 77

a.

Front 78

the signs and symptoms of this leukemia are fatigue and weakness, h/a, mouth sores, anemia, bleeding, fever, infection

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 78

a

Front 79

This leukemia is most common type in children

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 79

b

Front 80

This leukemi is when immature lymphoctyes proliferate in the bone marrow

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 80

b

Front 81

s/s of thhis leukemia appear abruptly with bleeding and fever, or insidious with progressive weakness, bone and/joint pain, and bleeding tendencies
a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 81

b

Front 82

This leukemia is caused by excessive development of mature neoplastic granulocytes in the bone marrow, which then move into the peripheral blood and infiltrate the liver and spleen

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 82

c.

Front 83

this leukemia has no symptoms early in the disease. Featigue weakness, fever, sternal tenderness, weight loss, joint pain, increased sweating

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 83

c.

Front 84

This type of leukemia usually happens b/t the ages of 25 to 60 with the peak at 45

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 84

c

Front 85

Most common type of leukemia in adults

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 85

d.

Front 86

This leukemia is characterized by the production an accumulation of functionally inactive but long lived, small, mature-appearing lymphocytes

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 86

d

Front 87

this leukemias s/s are chronic fatigue, anorexia, plsenomegaly, lympadenopathy, hepatomegaly, night sweats

a. acute meyelogenous leukemia b. Acute lymphocytic leukemia c. chronic myelogenous leukemia
d. chronic lymphocytic leukemia

Back 87

d

Front 88

This leukemia has a hairy appearance under the microscopole

Back 88

hairy cell leukemia

Front 89

These type of leukemic cells are lymphoid, myeloid or mixed. the prognosis is ppor

Back 89

unclassified

Front 90

This treatment therapy is the attempt to induce or bring about a remission

a. induction
b. consolidation
c. maintenance

Back 90

a.

Front 91

This treament therapy of leukemia is to eliminate remaining leukemic cells

a. induction
b. consolidation
c. maintenance

Back 91

b.

Front 92

This leukemic therapy is to lower the dose of the induction therapy. to keep the treatment steady.

a. induction
b. consolidation
c. maintenance

Back 92

c

Front 93

these are malignant neoplasms originating in the blone marrow and lymphatic structures resulting in the prliferation of lymphocytes.

Back 93

lymphomas

Front 94

Name the stages of hodgkins and nonhodgkins

Back 94

stage 1 on lymph node affected
stage 2- 2 or more lymph nodes affected on teh same side of diagphram
stage 3- involvement of lymh nodes affected on both sides of the diagphram
stage 4- tissue and organ involvement with or without lymph nodes affected

Front 95

This is a condition in which neoplastic plasma cells infiltrate the bone marrow and destroy bone

Back 95

multiple myeloma

Front 96

The cause of mulitple myeloma is unkown. The median age is 60. Normal bone marrow has 5% plasma cells. with mulitple myeloma there are 30-90% in bone marrow

Back 96

info

Front 97

Plasma cells are activated B-cells. In multiple myeloma, the malignant plasma cells infiltrates the bone marrow and produces abnormal and excessive amounts of immunoglobulins and causes bone destruction

Back 97

info

Front 98

A condition caused by the destruction of hemolysis of RBCs at a rate that exceeds production.

Back 98

Hemolytic anemia

Front 99

Intrinsic hemolytic anemias are which kind?

Back 99

sickle cell, G6PD, RBC membrane abnormalities

Front 100

Extrinsich hemolytic are aqcuired. The RBCs are normal but damage is caused by external factors such as trapping cells within sinuses of hte liver or spleen, antibody mediated destruction, toxins or mechanical injury

Back 100

info

Front 101

This is a group inherited
autosomal recessive disorder characterized by the presence of an abnormal form of hemoglobin in the erythrocyte.

Back 101

SCD

Front 102

The anormal hemoglobin in SCD is what?

Back 102

S

Front 103

T or F. The typical pt is anemic but asymptomatic except during sickling episodes.

Back 103

true

Front 104

The primary symptom with SCD is

Back 104

pain

Front 105

Sickling episodes are most commonly trigered by low o2 tension in the blood. High stress, altitude, dehydration, decreased plasma, can cause sickling of cells

Back 105

info

Front 106

Symptoms of SCD are?

Back 106

pain and swelling, mallor, fatigue

Front 107

repeated episodes of sickling there is a gradual involvment of all body systems. Especially spleen lungs kidneys and brain.

Back 107

info

Front 108

Scd is usually fatal by middle age from renal and pulmonary functions.

Back 108

info

Front 109

In SCD, pneumonia is the most common infectoin

Back 109

info

Front 110

Nursing measures are to alleviate symptoms of disease complications. Minimize end target-organ damage. there is no specific treatment for SCD

Back 110

info

Front 111

There is no specific treatment for SCD Pt teaching is to avoid high altitudes, maintain fluid intake, treat infections and pain control

Back 111

info

Front 112

In SCD we give O2 for hypoxia, to control sickling, pain management, acute chest syndrome, antibiotics, o2 therapy, fluid therapy.

Back 112

info

Front 113

sickle cell disease things to do. give folic acid supplements, blood transfusions on crisis,

Back 113

info

Front 114

This is an antisickling agent

Back 114

hydroxyuria

Front 115

Erythropoieten is given to paitents with sickle cell disease if un responsive to hydroxyurea.

Back 115

info

Front 116

This is an autosomal recessive disease that has increased intestinal iron absorption causing liver elargement. Iron in the liver causes the liver to enlarge. Causes cirrhosis of the liver. Can invect the islet cells of the pancreas and become diabetic

Back 116

hemocrhomatosis

Front 117

The normal iron content in the body is 2-6 grams

Back 117

info

Front 118

Treatment of hemocrhomatosis is to remove the iron

Back 118

info

Front 119

This is known as the kissing disease. You don't want to get hit in the spleen because it may rupture. treatment is prophylactic antibiotics

Back 119

mononucleosis

Front 120

This is a reduction of platelets below 150k

Back 120

thrombocytopenia

Front 121

if platelet counts are below 20k. massive hemorrhaging

Back 121

info

Front 122

This is the most common acquired thrombocytopenia it is a syndrom of abnormal destruction of circulating paltelets.

Back 122

immune thrombocytopenia purpura

Front 123

ITP is an anutoimmune disease

Back 123

info

Front 124

This syndrom is when platelets are coated with antibodies. When these platelets reach the spleen the anibody-coated plateelts are recognized as foreing and are destroyed my macrophages.

Back 124

ITP

Front 125

This is a sex- linked recessive genetic disorder caused by defective or deficiennt coagulation factor 8

Back 125

Hymophila A

Front 126

Hemophila b - is known as the Xmas disease the factor deficienncy is

Back 126

9

Front 127

In hemophilia A desmopressin is used.

Back 127

info

Front 128

This is a serious bleeding and thrombotic disorder. It results from abnormally initiated and accelerated clotting. It is characterized by profuse bleeding that results from the depletion of platelets and clotting factors.

Back 128

DIC

Front 129

Anemias of decreased erythrocyte production:
Decreased hemoglobin synthesis: name 3

Back 129

Iron deficiency anemia
Thalassemia
Sideroblastic anemia

Front 130

Anemias of Decreased erythrocyte production:
Defective DNA Synthesis:

Back 130

Cobalamin deficiency
folic acid deficiency

Front 131

Anemias of Decreased Erythrocyte production:
Decreased number of erythrocyte precursors:

Back 131

Aplastic anemia
Anemia of myeloproliferative disease/myelodisplasia
Chornic diseases and disorders

Front 132

Hemolytic anemia or anemias of erythrocyte destruction:

Back 132

SCD
immune hemolytic
G6PD
Membrane abnromalities
Trauma, antibiotdcs meds, toxins