Test 3 NOA

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What is the primary function of the hematologic system?

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1

What is the primary function of the hematologic system?

oxygenation and hemostasis (control of bleeding)

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2

What is bone marrow?

spongy center of the bones where the red blood cells and platelets are made

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3

How does the kidneys relate to hematology?

manufacture of hematopoietin which stimulates the production of RBCs in the bone marrow

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4

What is the function of hematopoietin?

released by the kidneys in response to hypoxia

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5

How does the liver relate to hematology?

manufactures the clotting factors

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6

How does the spleen relate to hematology?

removes old red blood cells from circulation

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7

How does blood relate to hematology?

transports oxygen from the lung to tissues and maintain hemeostasis

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8

What do red blood cells do? (RBCs or erythrocytes)?

hemoglobin in the red blood cells makes the transport of oxygen and carbon dioxide possible

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9

What do platelets (thrombocytes)?

activate the blood clotting system by going to a break in a blood vessel and forming a platelet plug

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10

What do clotting factors do?

form a stable fibrin matrix over the wounded area, protecting the injured site while the healing process is completed

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11

What does plasma do?

carries the red blood cells, platelets, and clotting factors through the circulatory system

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12

How is oxygenation obtained?

RBCs transport o2 from the lungs to the tissues and carry carbon dioxide from the tissues back to the lungs for excretion

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13

How is homeostasis obtained?

control of bleeding

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14

What is the coagulation cascade?

the series of events that occur in the process of blood clotting

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15

Why would a patient come to the hospital related to hematology?

easily bruises, bleeds for unusually long time, chronically fatigued

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16

What kind of diseases run in the family related to hematology?

sickle cell disease, hemophilia

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17

What would be seen on a skin assessment on a pt with low RBCs?

reddened, swollen areas, jaundice, dry, itchy skin and scalp, brittle fingernails and toenails, pale

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18

What is petechiae?

small red or reddish purple pinpoint spots on the skin from broken blood capillaries

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19

What is purpura?

small blood vessels leak under the skin

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20

What is ecchymosis?

bruising

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21

What would the nurse find in a head and neck assessment on a pt related to hematology?

jaundiced conjunctiva, assess for bleeding, cracking at the corners of the mouth from a vit B deficiency

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22

What would a nurse find on a thorax assessment on a pt with low blood cells?

clear lungs, tachypenic, shortness of breath with strenuous activity

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23

Why would an abdomen of a hematologic pt be full and tender?

the liver and spleen become enlarged with blood cell disorders

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24

What is is RBC count test?

total number of RBCs found in a cubic millimeter of blood

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25

What does a hemoglobin test show?

indicated the oxygen carrying capacity in the blood

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26

What does a hematocrit test show?

percentage of red blood cells in whole blood

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27

What do RBCs indices do? (MCV, MCH, RDW, MCRH)

helps determine the type of anemia

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28

What does WBC count and differential?

increased: consistent with infections, inflammation, tissue necrosis, or leukemic neoplasia

decreased: reduced bone marrow activity

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29

What is a prothrombin time, partial thromboplastin time activated , partial thromboplastin time?

measures how quickly blood clots

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30

What test is used to monitor heparin therapy?

partial thromboplastin time

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31

What is a bone marrow biopsy?

shows how well cells are being made in bone marrow

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32

What is the most common area for a bone marrow biopsy?

posterior superior iliac spine

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33

What are some nursing interventions for a pt at risk for injury from insufficient oxygenation related to anemia?

-administer oxygen-

-administer blood products

-administer erythropoietic growth factor to stimulate bone marrow production to produce RBCs

position change

extra blankets

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34

What are some nursing interventions for a pt at risk for injury from bleeding?

-administer blood products

-avoid damage to rectal mucosa

-inflate BP cuff until pulse is heard to prevent petechiae

-instruct pt to use a soft bristled toothbrush and an electric razor

-avoid drugs that interfere with platelet function: aspirin and NSAIDS

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35

What is the universal donor?

O negative

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36

What are the universal recipients?

AB postive

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37

What are some indications for a blood transfusion?

hemorrhage/ hypovolemic shock

-thrombocytopenia/ platelet dysfunction

-anemia

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38

What should the nurse assess/ monitor in the administration of a RBC transfusion?

-past reactions

-monitor the first 5 to 10 minutes after starting the infusion

-vital signs, respiratory status

-rate of infusion

-IV access of at lease 18 or 20 gauge

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39

Why is used to prime the IV tubing of an IV before a RN administers a blood transfusion?

NaCl

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40

never add meds to…..

blood product

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41

what does the nurse do if a pt is having a reaction to the blood?

stop the transfusion immediately

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42

How should blood transfusions be confirmed?

Blood should be check in bedside by 2 licensed people

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43

transfusions should be start…………. from leaving blood bank

30 minutes

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44

infuse blood over …….. hrs to prevent bacterial growth

4

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45

you may need a blood warmer to decrease potential ……..

hypothermia

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46

what are the four main types of reactions to blood transfusions?

hemolytic, anaphylactic, febrile, circulatory overload

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47

After about ……. days, the old red blood cells are filtered out of circulation by the liver and spleen?

120

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48

a person with type O blood would have?

neither the A and the B antigen

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49

What is polycythemia?

too many RBCs, WBCs, and platelets are produced

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50

What is anemia?

not enough RBCs

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51

What can cause anemia?

major blood loss over a short period of time, too few RBCs being made, or increased RBC destruction

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52

How does the body compensate for the anemia?

increased HR, RR

redistribution the blood away from the skin, GI tract, and the kidneys to the brain and heart

increasing the production of eyrythropoitin?

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53

What are the symptoms of ploythemia vera?

headache, dizziness, ringing in the ear (tinnitus), and blurred vision, reddish complexion, hypertension

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54

What is the treatment for polythemia vera?

have one unit phlebotomixed to keep pt Hct normal

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55

what is aplastic anemia?

results from complete failure of the bone marrow

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56

What kind of labs do people with aplastic anemia look like?

low RBC, low WBC, low platelet, low numbers of blood making cells in their bone marrow

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57

What are some signs and symptoms of aplastic anemia?

pallor, extreme fatigue, tachicardia shortness of breath hypotension, prolonged or spontaneous blooding and frequent infections that do not resolve

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58

what is the treatment for a liver?

-transfusions to replace RBCs and platelets

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59

What is a autoimmune hemolytic anemia?

antibodies that destroy RBC,s are active at body temperature

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60

What are some caueses for you to have autoimmune hemolytic anemia?

What are the signs and symptoms

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61

pallor, extreme fatigue, tachycardia, shortness of breath, and hypotension

What are some signs and symptoms of autoimmune hemolytic anemia

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62

Whow is iron deficiency anemia?

caused by diet too lo =w in room, body not absorbing enough from GI tract, blood loss

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63

What are some signs and symptoms

fatigue, weakness, headache, decreased, exercise tolerance, irritably, depression pallor

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64

What is pernicious anemia- vitamin B12 anemia?

occurs when a pt doesn’t absorb vitamin B12 from the stomach

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65

What are the symptoms of pernicious anemia vit b12 anemia

fatigue, pallor, weakness, sore tongue, and numbness of hands or feet

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66

What is the treatment for pernicious anemia b12 anemia?

bvitamin B12 given IM or PO

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67

What is sickle cell anemia?

disease in which the normally shaped disk shaped RBCs become sickles shaped

common in African American

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68

What must a person have to develop sickle cell anemia?

both recessive genes

carriers do not experience any kind of signs or symptoms

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69

What are some symptoms for sickle cell anemia?

persistently low RBC count, fatigue, jaundice

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70

What does a low RBC cause over time?

cardiomegaly, enlarge heart

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71

What is a sickened cell cirisis?

a sickle cell crisis occurs when the sickled cell crisis occurs when the sickled cell crisis occurs when the sickled cells become stick in larger blood vessels of the body, obstructing blood flow and causing severe pain

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72

What are the signs and symptoms of sickle cell crisis anemia?

dehydration, infection, overexertion, and smoking], cold weather changes, excessive alcohol

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73

Why do patients in a sickle cell crisis often have a fever?

either because infection precipitated the crisis or a part of the inflammatory response to tissue hypoxia

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74

How long can a sickle cell anemia crisis last?

1-10 days

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75

some experiences iris

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76

there is no cure for……..

sickle cell anemia, Iv fluid

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77

pt with sickle cell disease who regularly take hydroxyurea experience fewer crisis

hydoroxyurea does not work quickly enough to reduce the severity of the drama

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78

What is a coagulation disorder?

result from a platelet abnormality or a clotting factor deficiency

ex) thrombocytopenia, dissemination intravascular coagulation, hemophilia

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79

What is thrombocytopenia?

too few platelets circulating the blood

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80

What is a major cause of thrombocytopenia?

chemotherapy or radiation thrombocytopenia can be expected 10-14 days after treatment and lasts until bone marrow is able to make more platelets

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81

What are the symptoms of thrombocytopenia?

petechia, purpura, gingival bleeding, epistaxis, other unusual prolonged bleeding

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82

What is disseminated intravascular coagulation

hypercoagulative state, blood clotting is abnormally increased

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83

When does DIC occur?

overstimulation of the normal coagulation cascade results in

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84

DIC is always ….. to another pathologic process?

secondary

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85

What blood tests are done to test for DIC?

PT, PTT, fibrinogen degradation products FDP, D dimers

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86

hemophilia xmas disease?

genetic disease in which the affected person lacks some of the blood clotting factors normally found in plasma

women rarely have this deisease

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87

What are the symptoms of hemophilia?

uncontrollable bleeding that generally occurs into the joints, causing severe and swelling and pain

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88

How is a diagnosis made for hemophllloa?

measuring factors PTT and prolonged factors 8 and 9

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89

There is no ….. for hemophilia?

cure

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90

treatment of hemophilia?

symtomatic, transfusions of FFP or cryoprecipitate or both

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91

Pt with hemophilia A need factor ….. which is found in FFP and ………..?

f8 cryoprecipitate

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92

pt with hemophilia B need factor ….. which is found in ……?

4, cryoprecipitate

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93

A nurse’s inspecting a clients skin and notices multiple ecchymoses and petechiae. This should lead the nurse to suspect a deficiency of which blood component?

platelets

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94

What is a neoplasm?

new and abnormal growth of tissue can be benign and malignant

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95

Benign Harmless

not invasive or spreading, slow growth, usually not injuries unless on or around v/s

minor tissue damage

noncancerious

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96

What is metastasi

mot common it’s, liver brain, bone, lungs

tumors cells found away from the original site of malignant cells

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97

What are some factors for malignant transformation?

increasing age, diet, hormones, and chronic irritation

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98

Carcinogens

substances that damage cell DNA causing normal cells to become malignant

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99

Step one in malignant transformation

DNA exposed a carcinogen and irreversible changes occur

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100

What is step 2 of malignant transformation?

promotion, sufficient exposure to an agent to encourage enhance of cell growth

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