MED I EXAM II- BLOOD/LYMPH DISORDERS

What blood type is considered the universal donor?

O

Universal recipient is __

AB

What is the purpose of the Rh factor

To determine if a pt has the Rh antigen on the RBC causing them to be positive

**If they lack the Rh antigen= (-)

What test is ordered on Rh(-) pregnant women to screen for circulating Rh antibodies?

INDIRECT COOMBS Test

A pregnant woman has had an Indirect Coombs test and the results show that she has Rh antibodies in her blood.

What shot is given to prevent the body from attacking the fetus?

RhoGAM

This test is given before blood transfusions to detect Rh Antibodies

DIRECT COOMBS TEST

If a person presents to the ER with a Gun Shot Wound and is hemorrhaging. The blood type is unknown. What test is given to determine blood type

Type and Screen test

A more detailed test to determine blood type for clients who have a greater potential for blood transfusions is known as ___

Type and Crossmatch test

This common analysis of blood contains the number of RBCs, WBCs, and platelets.

Complete Blood Count (CBC)

__ indicates the body's ability to carry oxygen in the RBC's

Hemoglobin

The __identifies the % of RBCs in the blood

Hematocrit

Too many red blood cells in the body is ___

POLYCTHEMIA

What is the normal count of WBC's

5,000-10,000

When an infection is present, you can expect to see an increase in ___

{Known as LEUKOCYTOSIS}

WBCs

__ develop into B cells and t cells

LYMPHOCYTES

What is the lifespan of a RBC?

A platelet?

o 120 days

0 8-12 days

The PT (clotting time) should be less than _ seconds

12

What is used to determine the success of Coumadin?

PT/INR

Coumadin, a anticoagulant, should be given ___

In the evening when labs are returned

Heparin should be monitored by the __

PTT or aPTT

Antidote for Coumadin

Antidote for Heparin

Vitamin K

Protamine Sulfate

The __ time is used to determine platelet disorders

BLEEDING

What is the normal bleeding time in adults?

3-8 minutes

The ___ measures speed at which RBC's settle to the bottom of a tube of unclothed blood

Erythrocyte sedimentation rate (ESR)

What is the ESR useful in diagnosing?

Infections, inflammation processes, and autoimmune conditons

What culture is done to determine the presence of bacteria in the blood?

Blood culture test

A ___ is done to evaluate the number, size, and shape of RBC's, WBC'c, and platelets

bone marrow aspiration and biopsy

A biopsy or excision of a lymph node to determine the stage or to diagnose a tumor is called ___

Lymph node biopsy

When blood or blood products from donors are used, the procedure is called an ___

ALLOGENEIC TRANSFUSION

T or F

Two licensed personnel must identify the client to receive blood and the unit of blood

TRUE

Other than the pt's name, what are two other ways to identify the client to receive blood?

o Blood band #

o SSN

A muslim pt is due to receive a blood transfusion and refuse because of religious reasons. What is the nurses next step?

o Respect the pt's beliefs and notify the physician

__ blood donations are self-donated and is the safest blood for the client

AUTOLOGUS

__ blood donations are from donors the client selects, such as family members

DIRECT

When is whole blood used?

During times of acute massive hemorrhaging

Take and record the pt's __ vital signs before blood transfusions

BASELINE

If a reaction occurs during the blood transfusion, what is the next step?

Immediately stop the transfusion, flush with Normal Saline, and notify the dr.

Why is monitoring the pt for the first 15 minutes of a transfusion critical?

To observe for any dangerous reactions

Do not keep blood to infused out of a monitored refrigerator for more than __ minutes

30

How long can whole blood be refrigerated for?

up to 35 days

Why are packed RBC's mainly given?

For pts w/ anemia

Packed RBC's can be refrigerated for up to __ days

42

Fresh frozen plasma transfusions are given for some __ disorders

bleeding

Which immunoglobulin is given to a pt who has been recently exposed to an infectious disease?

IgG

What is the only solution that can be infused with blood?

Normal Saline

The entire transfusion has to be completed within _ hours

4

The goal of hemopoietic stem cells is to provide the client with new __ cells

HEALTHY

What are the sources for a pt to receive bone marrow cells from?

o Self (autologus)

o A twin (Syngeneic)

o Any other person (Allogeneic)

A cancer pt who is on chemotherapy needs a stem cell transplant? Why does the dr reduce the amount of chemo the pt receives?

o To ensure therapy kills any cancer cells to promote sites for new noncancerous cells to grow

What does the use of one's own stem cells eliminate?

o Eliminates the client from Graft versus Host Disease (GVHD)

**The stem cells begin to attack the pt's liver, skin, and GI tract with GVHD

What Tx is there for POLYCYTHEMIA (too many RBC's)

Phlebotomy

[blood needs to be removed from the body]

What common anemia do pregnant women suffer from?

Iron Deficiency Anemia

** Dr orders the pregnant woman to take iron supplements

Pts' who take liquid iron supplements orally must drink through a __ to prevent staining of the teeth

STRAW

What should you inform the pt about when taking iron?

Stools will be black and tarry and might cause constipation

This anemia results in immature RBC's in the blood?

HEMOLYTIC ANEMIA

___ anemia occurs after a rapid and often sudden loss of blood.

Acute Hemorrhagic

With acute hemorrhagic anemia, the pt is losing blood therefore there's a decrease in blood __ which can send the pt into hypovolemic shock

Volume

The best Tx for acute hemorrhagic anemia is to replace volume by infusing ___

o Normal Saline

o Plasma or

o Fresh whole blood

*Remember you will need to do an emergency Type and Screen test to determine blood type*

__ anemia is caused by the absence of a gastric substance known as intrinsic factor produced in the stomach

Pernicious

The body needs the intrinsic factor to absorb vitamin _ from food

B12

Why does the body need Vitamin B12

It is essential in the absorption of Iron

How would you administer Vitamin B12 to the pt?

o Give B12 by injection

**The stomach won't absorb Vitamin B12 if given PO

This anemia occurs when the bone marrow is underdeveloped which results in a decrease in RBC's, WBC's, and platelets {pancytopenia}

APLASTIC ANEMIA

Aplastic anemia can develop as a result of present viral illnesses such as __

HIV/ AIDS

Hepatitis

What is the most successful treatment of Aplastic Anemia?

Stem Cell Transplant

**Has a high mortality rate if untreated

Name some S/Sx of Anemia

o Intolerance to Cold

o Hypotension

o Rapid pulse

o SOB

o Decreased RBC's, hemoglobin, hematocrit

___ disease is a genetic disease in which a person's RBC's are deformed which then decreases the cells ability to carry oxygen which leads to being in a hypoxic state

SICKLE CELL

When an individual has a normal hemoglobin gene and a sickle cell gene, they are known to have the _____

sickle cell trait

If a pt is in sickle cell crisis, they will be on ___, IV fluids will be infusing, and have a prescription for pain meds because of pain in the extremities and abdomen

OXYGEN

__ is damage and deficient chains of Hemoglobin

THALASSEMIA

What can treat Thalassemia

Infusion therapy of packed RBC's

__ is a decrease in neutrophils, which are the first line of defense against bacteria

NEUTROPENIA

Too many immature lymphocytes in the blood and bone marrow are known as

o ACUTE LYMPHOID LEUKEMIA

Too many immature granulocytes (basophils, eosinophils, neutrophils) in blood and bone marrow is known as

0 ACUTE MYELOID LEUKEMIA

Mature lymphocytes that have now become diseased in the blood and bone marrow is known as

o Chronic lymphoid leukemia

Mature granulocytes that have now become disease in the blood and bone marrow is known as

o Chronic myeloid leukemia

The overproduction of platelets greater than 600,000 is called ___

Thrombocythemia

What can be given to treat Thrombocythemia

low-dose aspirin therapy

When a person's platelet count falls below 50,000, they are diagnosed with __

THROMBOCYTOPENIA

What type of thrombocytopenia tends to occur in young women and children

Idiopathic Thrombocytopenia Purpura (ITP)

What are S/Sx of ITP

o Petechiae (small hemorrhagic spots under the skin

o Bruises

o Abnormal bleeding

ITP is treated with ___

corticosteroids

__ is when the platelet's ability to clot has completed been depleted resulting in clots with hemorrhaging

DIC (Disseminated Intravascular Coagulation)

__ is a sex-linked genetic disorder, mostly in men, which causes a person's blood to slowly clot together which can result in bleeding to death

HEMOPHILIA

Biggest risk with men diagnosed with hemophilia is __

INTERNAL BLEEDING

___ involves the development of abnormal, cancerous B cells called Reed-Sternberg cells that spread throughout the lymphatic system

HODGKIN'S LYMPHOMA

**High cure rate if treated

How is Hodgkin's lymphoma diagnosed

By a biopsy showing Reed-Sternberg cells

How can Hodgkin's lymphoma be treated

o Chemotherapy

o Radiation therapy

o Combination therapy

In this disease, WBC's grow, divide, and overcome lymph nodes but do not have Reed-Sternberg cells

NON-HODGKIN'S LYMPHOMA

What are some S/Sx of Hodgkin's and Non-Hodgkin's Lymphoma

o Painless, enlarged lymph nodes

o Fever

o Night sweats

o Fatigue

o Unexplained weight loss

Cancer of the bone marrow is known as __

MULTIPLE MYELOMA