Week-by-Week Review: Hematology, GI, Immunology, Bariatrics & HIV/Autoimmune Nursing Flashcards

Flashcards cover lab values, transfusion basics, infection/immunity, hematologic disorders, GI diseases (Crohn's/UC/GERD), nutrition and bariatrics, wound care, transplant immunology, HIV/AIDS, and RA/OA concepts from Weeks 4–7 notes.

What is the normal WBC range?

4500-11000 cells/µL.

What is the normal RBC range?

4.5-5.5 million/µL.

What is the normal CD4 count range?

600-1200 cells/µL.

What are the normal hematocrit ranges by sex?

Female 36-48%; Male 39-54%.

What are the normal hemoglobin ranges by sex?

Female 12-16 g/dL; Male 13-18 g/dL.

What is the normal platelet count?

150,000-450,000/µL.

What blood glucose range is listed in the notes?

110-150.

What are the types of blood products?

Whole blood, Packed red blood cells, Platelets, Plasma, Cryoprecipitate.

What characterizes packed red blood cells?

Blood from which most plasma has been removed, yielding about 60% hematocrit.

What are the key steps to administer blood?

Obtain consent/type and screen or crossmatch; establish IV access (18/20 gauge); use Y tubing with 0.9% saline; verify product; obtain vitals before; stay with patient 15 minutes to monitor for reactions and recheck vitals; transfuse within 30 minutes of getting it and complete within 4 hours.

What are signs of a hemolytic transfusion reaction?

Fever, chills, chest pain, lower back pain, and dark urine.

What is the role of white blood cells?

Fight infection.

What does leukocytosis mean?

Too many white blood cells.

What are neutropenic precautions?

Hand hygiene; private room; no fresh flowers or fruit; no sick visitors; no live vaccines.

What is the function of red blood cells (RBCs)?

Carry oxygen and carbon dioxide; contain iron as part of hemoglobin.

What is erythrocytosis?

Too many red blood cells.

What is erythrocytopenia?

Not enough red blood cells.

What is the function of platelets?

Blood cells responsible for repairing vessel injury and forming clots.

What is thrombocytopenia?

Low platelet count.

What is thrombocytosis?

High platelet count.

Name common anemia types listed in the notes.

Aplastic, pernicious, iron-deficiency, hemolytic, sickle cell, and blood loss anemia.

What is sickle cell disease (pathophysiology)?

Autosomal recessive disorder with sickling of RBCs due to abnormal hemoglobin, causing increased blood viscosity, obstructed flow, and tissue hypoxia.

What are sickle cell disease risk factors?

Family history and African American heritage.

What are sickle cell crisis types and features?

Vaso-occlusive crisis: severe pain; Splenic sequestration: splenomegaly and hypovolemic shock; Aplastic crisis: severe anemia due to viral infection; Acute chest syndrome: cough, fever, dyspnea; Hyperhemolytic crisis: rapid Hgb drop.

What is the treatment for sickle cell crises?

Opioids, IV fluids, blood transfusion if needed, and supplemental O2.

How is iron deficiency anemia treated?

Ferrous sulfate or iron dextran; risk higher in pregnancy and children with insufficient iron intake.

What is aplastic anemia treatment?

Erythropoiesis-stimulating agents, immunosuppressants, and bone marrow transplant.

How is hemolytic anemia treated?

Immunosuppressants and splenectomy.

What causes pernicious anemia and its treatment?

Caused by lack of intrinsic factor leading to impaired B12 absorption; treated with B12 supplements.

What is Crohn’s disease pathophysiology?

Inflammatory bowel disease that can affect any part of the GI tract (mouth to anus), often distal; autoimmune component.

What are Crohn’s disease complications?

Peritonitis, fistulas, sepsis, abscess.

What are Crohn’s disease signs and symptoms?

Steatorrhea, right lower quadrant pain, fever, fatigue, weight loss; 5-6 BMs/day.

What are Crohn’s disease management strategies?

Monitor bowel movements and weight; pain assessment; labs and imaging as indicated (CT/MRI).

What is ulcerative colitis pathophysiology?

Inflammatory bowel disease affecting the colon and rectum.

What are UC risk factors?

High-fat diet, family history, stress, autoimmune disorders.

What are UC complications?

Peritonitis.

What are UC symptoms and presentation?

Rectal bleeding, diarrhea (bloody stool), weight loss, fever, dehydration, abdominal pain; bowel movements up to 10-20/day.

What is UC management?

Monitor vital signs, bowel movements, and daily weights; supportive care and treatment as indicated.

What are common IBD treatments listed?

Aminosalicylates, corticosteroids, immunosuppressants, anti-diarrheals, ileostomy, fecal transplant.

What diagnostic tests are used for IBD?

Colonoscopy with biopsy and stool sample; possible colectomy or ileostomy.

Dietary guidance for IBD (Crohn’s/UC) from notes?

Low-fat; avoid caffeine, alcohol, lactose; small, frequent meals; high-calorie, low-fiber (per notes).

What is GERD and its pathophysiology?

Gastroesophageal reflux disease; stomach acid backflows into the esophagus.

GERD risk factors?

Obesity, smoking, hiatal hernia, pregnancy, alcohol use.

GERD signs and symptoms?

Dyspepsia, pyrosis (heartburn), chest pain, regurgitation, bad breath, dry mouth.

GERD treatments and interventions?

PPIs and H2 blockers; elevate head of bed.

GERD diagnostics and surgical option mentioned?

Endoscopy and pH monitoring; Nissen (Laparoscopic) fundoplication as a surgical option.

Dietary guidance for GERD?

Eat whole grains and fiber; small, frequent meals; avoid smoking; sit up after meals; avoid late meals; limit fatty foods and alcohol.

Foods to avoid with GERD?

Coffee, alcohol, soft drinks, fast food, garlic, onion, citrus, tomato, dairy, spice, chocolate.

Foods to eat for GERD?

Leafy greens, avocado, banana, coconut, brown rice, berries, apples.

What is Total Parenteral Nutrition (TPN)?

Nutrition via central line (long-term use); monitor glucose every 4-6 hours; discard bag after 24 hours; use 10-20% dextrose until next bag.

What is Enteral Nutrition?

Delivered to the GI tract via NG, PEG, G-tube, or J-tube.

What are the steps for safe enteral feeding?

Elevate bed 30-45°, aspirate residual, flush tubing before/after feeding and meds, change tubing every 24 hours; residual less than 200 mL before administering.

What is refeeding syndrome and its hallmark?

A complication of parenteral nutrition due to electrolyte shifts; hypophosphatemia is a hallmark sign.

How is BMI defined?

BMI = weight (kg) / height (m)^2.

What BMI ranges define underweight, normal, overweight, and obesity?

Under 18 (underweight); 18-24 (normal); 25-29 (overweight); 30-39 (obese); 40+ (morbidly obese).

What is metabolic syndrome?

Factors increasing stroke risk; associated with hypertension, high blood glucose, and obesity.

What are bariatric surgery criteria mentioned?

BMI 40 or BMI 35 with comorbidities.

What is a gastric sleeve procedure?

Removal of about 75% of the stomach; potential for stretching back out without ongoing therapy.

What is a gastric bypass procedure?

Small stomach pouch connected to the small intestine; about 90% of food bypasses the stomach, duodenum, and part of the jejunum.

What is dumping syndrome?

Rapid gastric emptying after gastric bypass; symptoms include vomiting, sweating, and weakness.

Post-op bariatric patient education highlights?

No sugary foods; drink fluids before/after meals; 30 mL of sugar-free fluids every 2 hours post-op; high-protein liquid diet before discharge; eat slowly and stop when full; use a pillow to brace incision while coughing.

What are the five signs of inflammation?

Redness, swelling, pain, warmth (heat), and loss of function.

What is the typical duration for acute, subacute, and chronic inflammation?

Acute: 2-3 weeks; Subacute: 2-6 weeks; Chronic: weeks to years.

What does CRP indicate and its normal value?

High CRP indicates bacterial or inflammatory disorder; normal CRP is <1 mg/dL.

Braden scale purpose and risk ranges (summary)?

Assesses pressure ulcer risk; scores <9 indicate severe risk; higher scores indicate lower risk; ranges include mild, moderate, high risk categories.

Wound healing types?

Primary (new sutures, fine scar); Secondary (untreated wound heals with clot/granulation, larger scar); Tertiary (infected wound treated first, then closed).

What is acquired immunity, active vs passive?

Active acquired: develops naturally from disease or vaccination; Passive acquired: receiving antibodies (e.g., IVIG or maternal IgG).

What are the immunoglobulins and their primary roles (IgA, IgM, IgE, IgD)?

IgA: mucous membranes and colostrum/breast milk; IgM: primary antibody in blood/lymph; IgE: allergy mediator; IgD: activates B cells and others; all circulate in blood.

Latex allergy reaction timing and dietary restrictions?

Contact dermatitis may occur 4-6 hours after exposure; avoid foods linked to latex allergy (banana, avocado, tomato, guava, hazelnut, potatoes, peaches, grapes, apricot).

Hyperacute transplant rejection—timing and mechanism?

Within 24 hours; rapid destruction by existing antibodies.

Acute transplant rejection—timing and mechanism?

Within 6 months; cell-mediated with possible humoral antibody response; infiltration by T and B cells causing damage.

Chronic transplant rejection—timing and outcome?

Months to years; irreversible fibrosis and scarring; unclear etiology.

HIV basics: CD4 threshold and transmission routes?

CD4 count <500 (in notes); transmitted via vaginal secretions, semen, breast milk, blood/needlestick.

Who has the lowest risk of HIV after a needlestick exposure?

Healthcare workers (relative risk is low in this context).

What is PrEP?

Pre-exposure prophylaxis to reduce risk of HIV acquisition.

What is PEP?

Post-exposure prophylaxis taken after potential HIV exposure.

Acute HIV symptoms?

Fever, swollen lymph nodes, sore throat, headache, malaise, nausea, myalgia, diarrhea, rash.

Chronic HIV symptoms?

Night sweats, severe fatigue, candidiasis, persistent headaches and diarrhea.

AIDS is diagnosed when CD4 count falls below what threshold?

CD4 count < 200.

Nursing interventions for HIV/AIDS?

Manage symptoms, prevent transmission, monitor ART therapy and medication adherence.

Opportunistic infections associated with AIDS mentioned in notes?

Kaposi's sarcoma, Epstein-Barr virus infection, shingles (herpes zoster).

Rheumatoid arthritis (RA) characteristics?

Bilateral joint inflammation, morning stiffness; autoimmune; deformities such as swan neck and boutonnière.

RA treatments listed?

Methotrexate, NSAIDs, opioids, systemic corticosteroids, DMARDs.

RA extraarticular manifestations?

Anemia, weight loss, heart/lung inflammation, anorexia, neuropathy, vasculitis, enlarged spleen.

RA diagnostic labs?

Positive rheumatoid factor; elevated CRP and ESR.

RA management approaches?

Ice/heat, non-weight-bearing exercise, acupuncture, braces/splints.

Osteoarthritis (OA) hallmark features?

Unilateral inflammation with Bouchard’s and Heberden’s nodes; wear-and-tear; pain with activity, relief with rest.

OA treatment?

NSAIDs/analgesics.

OA risk factors and disease course?

Risk factors: smoking, old age, obesity; slow progression; abnormal X-rays.

How do you calculate BMI correctly?

BMI = weight (kg) / height (m)^2.

What BMI range is cited for bariatric surgery in the notes?

35-40.

What is a gastric bypass procedure?

A small stomach pouch is connected to the small intestine; about 90% of food bypasses the stomach, duodenum, and part of the jejunum.

What is dumping syndrome?

Rapid gastric emptying after gastric bypass; symptoms include vomiting, sweating, weakness.

Key postoperative bariatric patient education points?

No sugary foods; fluids before/after meals; 30 mL sugar-free fluids every 2 hours; high-protein liquid diet before discharge; eat slowly and stop when full; use a pillow to support incision when coughing.