Immune/Hematology Studyguide/Flashcards

Iron Deficiency Anemia

Most common worldwide; due to diet, malabsorption, or blood loss.

Iron Deficiency Anemia Symptoms

Pallor, glossitis, headache, paresthesias, fatigue.

Iron Deficiency Anemia Labs

↓ Hgb, Hct, iron; ↑ TIBC.

Iron Deficiency Anemia Treatment

Iron supplements (ferrous sulfate), dietary changes, blood transfusion for severe cases.

Iron Deficiency Anemia Education

Take iron with vitamin C, avoid dairy, stools may be black.

Megaloblastic Anemia

Impaired DNA synthesis → large, fragile RBCs.

B12 Deficiency Causes

Pernicious anemia, GI surgery, alcohol.

Megaloblastic Anemia Symptoms

Smooth beefy red tongue, anorexia, neuro changes (weakness, confusion).

Megaloblastic Anemia Labs

↓ B12, ↓ Folate (if folic acid deficiency).

Megaloblastic Anemia Treatment

B12 IM injections for life, folic acid PO.

Megaloblastic Anemia Education

B12 foods (meat, eggs); Folic acid foods (green leafy veggies, liver, citrus fruits).

Sickle Cell Anemia

Inherited disorder → sickled RBCs → hypoxia, vaso-occlusion.

Sickle Cell Crisis Triggers

Infection, dehydration, high altitudes.

Sickle Cell Anemia Symptoms

Severe pain, jaundice, fever, swelling.

Sickle Cell Anemia Labs

Sickled cells, ↑ bilirubin.

Sickle Cell Anemia Treatment

O2, fluids, opioids (PCA pumps), hydroxyurea, stem cell transplant (rare).

Sickle Cell Anemia Education

Hydration, avoid high altitudes, infection prevention (vaccines).

Thrombocytopenia

↓ Platelets <150,000 (d/t drugs, chemo, HIT).

Thrombocytopenia Symptoms

Bleeding, petechiae, weakness, dizziness, possible cerebral hemorrhage.

Thrombocytopenia Labs

Platelet count ↓; Hgb/Hct ↓ if bleeding.

Thrombocytopenia Treatment

Stop causative agent, platelet transfusions, hormone therapy for heavy menstrual bleeding.

Thrombocytopenia Education

Bleeding precautions; avoid NSAIDs and aspirin.

Polycythemia

Overproduction of RBCs, WBCs, platelets → ↑ blood viscosity.

Polycythemia Symptoms

Headache, dizziness, pruritus, angina.

Polycythemia Treatment

Phlebotomy, hydroxyurea.

Polycythemia Education

Hydration, avoid iron supplements, prevent clotting.

Hodgkin's Lymphoma

Malignant proliferation of Reed-Sternberg cells in lymph nodes.

Hodgkin's Lymphoma Symptoms

Painless lymphadenopathy, B symptoms (fever, night sweats, wt loss).

Hodgkin's Lymphoma Diagnosis

Biopsy of node, PET/CT scan.

Hodgkin's Lymphoma Treatment

Combo chemo (ABVD), radiation.

Hodgkin's Lymphoma Education

Screen for secondary cancers, fertility preservation.

Acute Blood Loss

Sudden hemorrhage (trauma, surgery).

Acute Blood Loss Symptoms

Pain, hypotension, tachycardia, pallor.

Acute Blood Loss Treatment

Stop bleeding, IV fluids, blood transfusions.

Chemotherapy Side Effects

N/V, alopecia, bone marrow suppression, cardiotoxicity (doxorubicin), neuropathy (vincristine).

Chemotherapy Nursing Care

Infection prevention, bleeding precautions, monitor labs, extravasation prevention.

Chemotherapy Patient Education

Soft toothbrush, electric razor, hydration, fertility discussion.

Role of AP, LPN, RN

AP: VS, hygiene, basic care; LPN: Administer meds (except IV push chemo), wound care, reinforce teaching; RN: Care plans, IV chemo, blood transfusions, critical assessments, education.

Bone Marrow Biopsy Post-Op Care

Monitor for bleeding, infection, assess pain.

Hospice Focus

Quality of life, comfort, family support.

Warning Signs of Cancer

Change in bowel/bladder habits, a sore that does not heal, unusual bleeding/discharge, thickening/lump, indigestion/difficulty swallowing, obvious change in wart/mole, nagging cough/hoarseness.

Health Promotion & Cancer Prevention

No smoking, healthy diet (low fat, high fruits/veggies), regular screenings (mammograms, colonoscopy), HPV vaccines, sun protection.

Multiple Myeloma

Cancer of plasma cells in bone marrow → bone destruction.

Change in bowel/bladder habits

Warning sign of cancer.

A sore that does not heal

Warning sign of cancer.

Unusual bleeding/discharge

Warning sign of cancer.

Thickening/lump

Warning sign of cancer.

Indigestion/difficulty swallowing

Warning sign of cancer.

Obvious change in wart/mole

Warning sign of cancer.

Nagging cough/hoarseness

Warning sign of cancer.

No smoking

Health promotion and cancer prevention strategy.

Healthy diet

Low fat, high fruits/veggies for cancer prevention.

Regular screenings

Mammograms, colonoscopy for cancer prevention.

HPV vaccines

Health promotion and cancer prevention strategy.

Sun protection

Health promotion and cancer prevention strategy.

S/S of Multiple Myeloma

Skeletal pain, fractures, hypercalcemia, renal issues.

Tx for Multiple Myeloma

Chemo, corticosteroids, bisphosphonates.

Nursing for Multiple Myeloma

Fall prevention, hydration, pain control.

Lupus (SLE)

Autoimmune inflammation affecting multiple organs.

S/S of Lupus

Butterfly rash, arthritis, nephritis, fatigue.

Tx for Lupus

Hydroxychloroquine, corticosteroids, immunosuppressants.

Education for Lupus

Avoid sun exposure, infection prevention.

Lyme Disease

Cause: Borrelia burgdorferi via tick bite.

S/S of Lyme Disease

Bull's-eye rash, joint pain, neuro sx.

Tx for Lyme Disease

Doxycycline.

Anaphylaxis

Severe allergic reaction.

S/S of Anaphylaxis

Hypotension, bronchospasm, angioedema.

Tx for Anaphylaxis

Epinephrine IM immediately, O2, fluids, antihistamines.

HIV

Retrovirus attacks CD4 T cells.

Dx for HIV

ELISA, Western blot.

Tx for HIV

Antiretroviral therapy (ART).

Education for HIV

Adherence critical, infection prevention, regular labs.

Hydroxychloroquine

Retinal toxicity risk (eye exams).

Mitotic inhibitors (Vincristine)

Neurotoxicity (monitor for neuropathy).

Antineoplastics (Doxorubicin)

Cardiotoxicity, red sweat/urine.

Hydroxyurea

For sickle cell; monitor CBC.

Oprelvekin

Increases platelets.

Ferrous sulfate

Take with Vitamin C; dark stools.

Methotrexate

Hepatotoxicity, bone marrow suppression.

Rifampin

Red/orange urine; hepatotoxic.

Vancomycin

Ototoxicity; nephrotoxicity; red man syndrome.

Tetracycline

No dairy, photosensitivity.

Gentamicin

Nephrotoxic and ototoxic.

Piperacillin/tazobactam

Monitor for allergic reactions.

Cephalosporins

Cross allergy with penicillin.

Acyclovir

Hydration to prevent nephrotoxicity.

Terbinafine (Lamisil)

Hepatotoxicity, GI upset.

Fluconazole

Liver function monitoring.

Warfarin

Monitor INR; Vitamin K antidote.

Clopidogrel

Bleeding risk.

Heparin

Monitor aPTT; protamine sulfate antidote.

Epoetin alfa

Stimulates RBCs; monitor BP, Hgb.

Iron

Constipation; take on empty stomach with Vit C.

Hallmark symptom of iron deficiency anemia

Pallor.

Best way to take oral iron supplements

Empty stomach, with Vitamin C, avoid dairy.

What causes B12 deficiency anemia?

Lack of intrinsic factor, GI surgery, alcohol abuse.

Key neurological symptom of B12 deficiency

Weakness and impaired thinking.

What triggers a sickle cell crisis?

Infection, dehydration, low oxygen.

Medication used to prevent sickle cell crises

Hydroxyurea.

Critical platelet level that risks spontaneous bleeding

Less than 20,000.