Test 1 Pathopharm (Hematololgy, Fluid and Electrolyte)

Pharmacology

The study of drugs and their interactions with living systems

Therapeutics

The use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy

Effectiveness

The most important property a drug can have, ensuring it produces the desired effect

Safety

Ensuring the drug does not produce harmful effects

Selectivity

The property where a drug elicits only the response for which it is given

Pharmacokinetics

What the body does to the drug, including absorption, distribution, metabolism, and excretion

Drug Administration

The process of giving a drug, considering dosage, route, and timing

Absorption

The movement of a drug from its site of administration into the blood

Drug-receptor interaction

The binding of the drug to its receptor, influencing pharmacodynamic processes

Patient adherence

The extent to which a patient's behavior coincides with medical advice

Barriers to Absorption

Factors hindering the entry of drugs into the bloodstream.

Intravenous (IV)

Administration route providing instantaneous and precise control over drug levels.

Oral (PO)

Enteral route with slow and variable absorption, ideal for self-medication.

Blood-Brain Barrier

Barrier restricting the passage of drugs into the central nervous system.

Metabolism

Enzymatic alteration of drug structure, mainly occurring in the liver.

Excretion

Removal of drugs from the body through various routes.

Therapeutic Range

Range of drug concentrations effective for treatment without adverse effects.

Half-life

Time taken for the drug concentration in the bloodstream to reduce by half.

Drug-Receptor Interactions

Mechanism of action where drugs bind to receptors to elicit a response.

Drug-Drug Interactions

Interactions between drugs leading to intensified or reduced effects.

Drug-Food Interactions

Influence of food on drug metabolism and effects.

Drug-Herb Interactions

Interactions between conventional drugs and herbal preparations.

Rounding

Process of approximating numerical values in drug calculations.

Dimensional Analysis

A method used for converting units in calculations by aligning labels, performing the necessary calculations, and ensuring the answer is in the desired unit.

Morphine Dosage Calculation

Calculating the amount of morphine to administer based on the patient's weight, drug concentration, and prescribed dosage.

Vasotec Dilution Calculation

Determining the volume of diluted Vasotec to administer based on the initial concentration and prescribed dosage.

Tylenol Dosage Calculation

Calculating the appropriate dosage of Tylenol for a child based on the recommended dosage per kilogram of body weight.

Lasix Dosage Calculation

Calculating the appropriate dose of Lasix for a child based on the recommended dosage per kilogram of body weight.

Keflin IV Dosage Calculation

Determining the milligrams of Keflin to administer to a child based on the recommended dosage per kilogram of body weight and the volume to be administered.

IV Drip Rate Calculation

Calculating the rate of intravenous fluid administration in drops per minute based on the volume to be infused and the time frame.

Individual Variation in Drug Responses

Factors influencing how patients respond differently to drugs, including body weight, age, organ function, and pathophysiology.

Drug Tolerance

Decreased responsiveness to a drug due to repeated administration, categorized into pharmacodynamic, metabolic, and tachyphylaxis tolerance.

Adverse Drug Reactions

Unintended and harmful responses to medications, including side effects, toxicity, allergic reactions, idiosyncratic effects, and paradoxical effects.

Parasympathetic vs

Understanding the difference between the parasympathetic and sympathetic nervous systems is crucial in medicine as they have opposing effects on various bodily functions.

Hematology Lecture Objectives

Knowing the function and normal lab values of blood cells, understanding anemia, differentiating types of anemia, listing treatments, and understanding medications for low blood counts are key objectives.

Blood Plasma

Composed of 90% water, blood plasma contains nutrients, electrolytes, gases, hormones, plasma proteins, and waste products.

Erythrocytes

Red blood cells transport oxygen from lungs to tissues and carry carbon dioxide back, with a normal count of 4-6 million per cubic millimeter of blood.

Leukocytes

White blood cells defend against infection, with a normal level of 5,000 to 10,000 cells/mm3, including granulocytes and agranulocytes.

Platelets

Small cell fragments essential for clotting, with a normal count ranging from 150,000 to 400,000 per cubic mm of blood.

Anemia

Anemia is a deficiency in the quantity or quality of erythrocytes, hemoglobin, or hematocrit, classified by causes like decreased production, blood loss, or increased destruction.

Iron-Deficiency Anemia

Most common worldwide, caused by inadequate dietary intake, malabsorption, blood loss, and pregnancy, leading to general manifestations like pallor and glossitis.

Iron-Deficiency Anemia

A condition characterized by a lack of sufficient iron in the body, leading to decreased red blood cell production.

Ferrous Sulfate

The preferred form of iron for absorption in an acidic environment, commonly used in iron supplements.

Megaloblastic Anemias

Disorders caused by impaired DNA synthesis, resulting in large, defective red blood cells.

Cobalamin Deficiency

A condition caused by inadequate levels of vitamin B12, often due to pernicious anemia or malabsorption issues.

Folic Acid Deficiency

A condition resulting from insufficient levels of folic acid, essential for DNA synthesis and red blood cell maturation.

Aplastic Anemia

A disorder characterized by a decrease in all blood cell types due to hypocellular bone marrow, ranging from chronic to critical.

Aplastic Anemia

A condition characterized by bone marrow failure resulting in low red blood cells, white blood cells, and platelets.

Neutropenia

A decrease in neutrophils, leading to increased susceptibility to infections.

Thrombocytopenia

Low platelet count, predisposing to bleeding.

Hematopoiesis

The process of producing red blood cells, white blood cells, and platelets.

Epoetin Alfa

A hematopoietic growth factor used to treat anemia in various conditions.

Filgrastim

A granulocyte colony-stimulating factor that increases neutrophil production.

Hemophilia

A hereditary bleeding disorder due to specific clotting factor deficiencies.

Hemarthrosis

Bleeding into joint spaces causing pain, swelling, and mobility issues.

Desmopressin

Medication used to increase factor VIII activity in mild hemophilia.

Gene Therapy

Future treatment for hemophilia involving the promotion of deficient clotting factor production.

Functional Health Patterns

A method to assess a patient's presenting problem by exploring symptoms, their duration, and accompanying symptoms like chest pain, orthopnea, and nausea, along with lifestyle factors such as weight changes, nutrition, and substance use.

Physical Assessment for Hematologic Disorders

Includes vital signs, heart and lung auscultation, capillary refill time, skin inspection, lymph nodes palpation, oral cavity assessment, abdominal palpation, and conjunctiva inspection to evaluate various systems affected by hematologic disorders.

Diagnostic Tests for R.D.

Include a 12-lead ECG for heart rhythm, complete blood count for RBC and platelets, metabolic panel for organ function, blood alcohol level, eGFR for kidney function, urinalysis, urine drug screen, and MRSA swab to aid in diagnosis and treatment planning.

Risk Factors for Anemia in R.D.

Low socioeconomic status, inadequate nutrition due to homelessness, and potential alcoholism history increase R.D.'s risk for anemia.

Priority Nursing Diagnoses for R.D.

Impaired gas exchange, decreased cardiac output, noncompliance, ineffective tissue perfusion, fatigue, excess fluid volume, and imbalanced nutrition are key nursing diagnoses for R.D.'s care plan.

Resources for R.D

Social services evaluation for government services, placement in special facilities or subsidized housing, registration at interim care shelters, and attendance at alcohol support group meetings can support R.D. after hospital discharge.

Hypervolemia

Condition of having more extracellular fluid than the body requires, leading to symptoms like weight gain, edema, and increased blood pressure.

Hypovolemia

Condition characterized by an equal loss of sodium and water, requiring isotonic fluids for treatment.

Hypertonic

Type of fluid imbalance where there is greater water loss than sodium, necessitating hypotonic solutions for correction.

Hypotonic

Imbalance involving greater sodium loss than water, requiring hypertonic solutions for treatment.

Sodium

Electrolyte crucial for neurological and neuromuscular functions, osmotic pressure regulation, and acid-base balance.

Potassium

Essential electrolyte for neuromuscular and cardiac function, primarily located intracellularly.

Calcium

Electrolyte vital for bone formation, nerve impulse transmission, muscle contraction, and blood clotting.

Magnesium

Intracellular electrolyte important for metabolism, muscle relaxation, nerve impulse transmission, and cardiac function.

pH

Measure of acidity or alkalinity in a solution, with blood pH ranging from 7.35 to 7.45 for normal function.

Acidosis

Condition of increased acidity or decreased pH, requiring buffers to maintain acid-base balance.

Alkalosis

State of decreased acidity or increased pH, necessitating buffers for pH regulation.

Respiratory Buffers

Lungs' role in controlling carbon dioxide levels to maintain blood pH within the normal range.

Metabolic Buffers

Kidneys' function in controlling bicarbonate levels to regulate blood pH.

Respiratory Acidosis

Condition marked by increased CO2 levels, leading to acidosis symptoms like confusion and dysrhythmias.

Respiratory Alkalosis

State characterized by decreased CO2 levels, causing alkalosis symptoms such as dizziness and tingling.

Metabolic Acidosis

Condition involving decreased bicarbonate levels and increased acidity, leading to symptoms like tachycardia and weakness.

Metabolic Acidosis

Condition where the body produces too much acid or the kidneys do not remove enough acid.

Diabetic Keto-Acidosis (DKA)

A type of metabolic acidosis common in diabetes.

Shock

Can lead to metabolic acidosis due to inadequate tissue perfusion.

Renal Failure

Can cause metabolic acidosis due to impaired acid excretion.

Diarrhea, ileostomy

Can result in metabolic acidosis due to bicarbonate loss.

Starvation

Prolonged fasting can lead to metabolic acidosis.

Lactic Acidosis

Build-up of lactic acid causing metabolic acidosis.

Heavy Exercise

Intense physical activity can lead to lactic acidosis.

Pancreatitis

Can cause metabolic acidosis due to acid accumulation.

Liver Failure

Can lead to metabolic acidosis due to impaired acid metabolism.

Spironolactone

Aldosterone antagonist rarely used alone for therapy, blocks aldosterone in the distal nephron

Triamterene

Nonaldosterone antagonist diuretic

Amiloride

Nonaldosterone antagonist diuretic

Mannitol [Osmitrol]

Osmotic diuretic promoting diuresis by creating osmotic force in the nephron

Hyperkalemia

Adverse effect of spironolactone, characterized by high potassium levels in the blood

Therapeutic uses of Spironolactone

Include hypertension, edematous states, heart failure, primary hyperaldosteronism, premenstrual syndrome, polycystic ovary syndrome, and acne in young women

Mannitol IV

Used for prophylaxis of renal failure, reduction of intracranial pressure, and reduction of intraocular pressure

Mannitol Adverse effects

Edema, headache, nausea, vomiting, fluid, and electrolyte imbalance

Mannitol Administration

Check for crystals, warm preparations with crystals, use a filter needle and in-line IV filter

Furosemide [Lasix] Dietary Teaching

Include high potassium foods like nuts, dried fruits, spinach, citrus fruits, potatoes, and bananas to prevent hypokalemia