Term
| What are the two types of blood dyscrasias? |
|
Definition
|
|
Term
|
Definition
| The deficiency in the number of RBC's, the quality of HgB and/or the volume of RBC's which can lead to hypoxia |
|
|
Term
| What is used to determine the severity of anemia? |
|
Definition
|
|
Term
| What are some interventions for anemia? |
|
Definition
Blood or blood transfusions
Drug therapy
Volume replacement
O2 therapy
Dietary modification
Lifestyle changes |
|
|
Term
| What are the two classifications of anemias? |
|
Definition
|
|
Term
| What is morphologic anemia? |
|
Definition
abnormal shape, size, color etc.
Can be found with objective data |
|
|
Term
| What is etiologic anemia? |
|
Definition
| Has an underlying cause such as chemotherapy or blood loss |
|
|
Term
| What causes clinical manifestations of anemia? |
|
Definition
| Caused by body's response to tissue hypoxia |
|
|
Term
| What are the integumentary manifestations of anemia? |
|
Definition
Pallor (v HgB, v blood flow to the skin)
Jaundice (^ serum Bili)
Puritius (^ serum and akin bile salt) |
|
|
Term
| What are the cardiopulmonary manifestations of anemia? |
|
Definition
Additional attempts by the heart and lungs to provide adequate O2 to the tissues
^ HR
^ Stroke volume |
|
|
Term
| What are the RBC levels for mild anemia? |
|
Definition
|
|
Term
| What are the clinical manifestations of anemia? |
|
Definition
May exist without symptoms
Possible symptoms (Palpitations, dyspnea, diaphoresis) |
|
|
Term
| What are the RBC levels of moderate anemia? |
|
Definition
|
|
Term
| What are the clinical mainfestations of moderate anemia? |
|
Definition
| Increased cardiopulmonary symptoms during rest |
|
|
Term
| What is the RBC level for severe anemia? |
|
Definition
|
|
Term
| What are the clinical manifestations of the integument during severe anemia? |
|
Definition
|
|
Term
| What are the clinical manifestation of the eyes during severe anemia? |
|
Definition
| Icteric sclera (brown spots) |
|
|
Term
| What are the clinical manifestations of the mouth during severe anemia? |
|
Definition
|
|
Term
| What are the clinical manifestations of the CV system in severe anemia? |
|
Definition
Tachycardia
Systolic murmur
Angina
MI |
|
|
Term
| What are the clinical manifestation of the pulmonary system in severe anemia? |
|
Definition
|
|
Term
| What are the neurologic clinical manifestations of severe anemia? |
|
Definition
HA
Vertigo
Irritably
Depression |
|
|
Term
| What are the GI clinical manifestations of severe anemia? |
|
Definition
Anorexia
Heapaticmegaly
Spleenamegaly
Sores in the mouth
Difficulty swallowing |
|
|
Term
| What are the musculoskeletal clinical mainfestations of severe anemia? |
|
Definition
Bone pain
Weight loss
Sensitive to cold |
|
|
Term
| What subjective data should a nurse get to assess anemia? |
|
Definition
Health hx
Medications
surgery or other treatments |
|
|
Term
| What objective data should a nurse get to support anemia? |
|
Definition
General
Integumentary
Respiratory
Cardiovascular
Gastrointestinal
Neurologic |
|
|
Term
| What are common reasons for anemia in older adults? |
|
Definition
Chronic disease
Nutritional deficiencies |
|
|
Term
| Why are the S/S often unrecognized in older adults? |
|
Definition
| Mistaken for normal aging changes |
|
|
Term
| What is the life span of a RBC |
|
Definition
|
|
Term
| What are 3 alterations in erythropoiesis that decrease RBC production (results in anemia)? |
|
Definition
Decreased hemoglobin synthesis
Defective DNA synthesis in RBCs
Diminished availability of erythrocyte precursors |
|
|
Term
| What is one of the most common chroinc hematologic disorders? |
|
Definition
|
|
Term
| Who is affected by iron-deficiency anemia? |
|
Definition
Young
Old
Pregnant
Low socioeconomic status |
|
|
Term
| What does iron deficiency anemia develop from? |
|
Definition
Inadequate dietary intake
Malabsorption
Blood loss: usually GI or GU bleed
Hemodialysis |
|
|
Term
| What are the top two common clinical manifestations of iron-deficiency anemia? |
|
Definition
|
|
Term
| What are common diagnostic studies for iron-deficiency anemia? |
|
Definition
Lab
Stool guaiac test
Endoscopy
Clonoscopy |
|
|
Term
| What are common LAB tests for iron-deficiency anemia? |
|
Definition
HgB
Hct
MCV
MCHC
reticulocytes
Serum iron
Bili
Platelets |
|
|
Term
| What food have high levels of iron? |
|
Definition
Green leafy veggies
Red meat
Liver |
|
|
Term
| How long does iron therapy last? |
|
Definition
| 2 to 3 months after the HgB levels return to normal |
|
|
Term
|
Definition
| An autosomonal genetic disorder of inadequate production of normal HgB |
|
|
Term
| What are the common ethnic groups to get thalassemia? |
|
Definition
| Near the Mediterranean sea and equatorial regions of Asia and Africa |
|
|
Term
| What also occurs with thalassemia? |
|
Definition
|
|
Term
| What problem causes abnormal HgB synthesis in thalassemia? |
|
Definition
| problem with globulin protein |
|
|
Term
| What is it called when there is one thalassemic gene? |
|
Definition
|
|
Term
| What is it called when there are two thalassemic genes? |
|
Definition
|
|
Term
| What are the clinical manifestations of thalassemia minor |
|
Definition
Frequently asymptomatic
Moderate anemia: Splenomegaly; Mild jaundice |
|
|
Term
| What are the clinical manifestations of thalassemia major? |
|
Definition
Life threating
Develops by age of 2
Physical and mental growth often retarded
Pale
Symptoms develop in childhood 31-3
Splenomegaly
Hepatomegaly
Jaundice
Chronic bone marrow hyperplasia
Expansion of bone marrow space |
|
|
Term
| What is the treatment for thalassemia major? |
|
Definition
| Blood transfusions with IV deferoxamine (Desferal): a kilating agent that binds to the iroion when is given; over 25 will have hep C and HIV |
|
|
Term
| What are megaloblastic anemias? |
|
Definition
| Group of disorders caused by DNA synthesis |
|
|
Term
| What are the majority of megaloblastic anemias resulted from? |
|
Definition
Cobalamin (vitamin B12)
Folic acid |
|
|
Term
| What are megaloblastic anemias characterized by? |
|
Definition
|
|
Term
| What is the intristic factor? |
|
Definition
| Protein secreated by the arietal cells of the gastric mucosa |
|
|
Term
| What is the use of the intrinstic factor? |
|
Definition
| Coabalamin absorption in the small intestine |
|
|
Term
| What are the causes of coalamin deficiency? |
|
Definition
Pernicious anemia: most common
Gastritis and Gastrectomy
Chronic alcoholism
Nutritional deficiencies
Hereditary enzymatic defects |
|
|
Term
| What causes pernicious anemia? |
|
Definition
| An absence of intrensic factor: results in v Hydrochloric acid |
|
|
Term
| What is required fro intresensic factor secretion? |
|
Definition
|
|
Term
| What are some causes of decreased HCl that leads to decreased instrenic factor secretion |
|
Definition
GI surgery
Long term use of H2-histiamine receptor blockers |
|
|
Term
| What are the manifestations of coalamin deficiency? |
|
Definition
General symptoms of anemia
Sore tongue
Anorexia
Nausea
Vomiting
Abdominal pain
Neuromuscular manifestations |
|
|
Term
| What are the neuromuscular manifestations of cobalamin deficiency? |
|
Definition
Weakness-general and muscle
Paresthesias of the hands and feet
↓ Vibratory and position senses
Ataxia
Impaired thought process |
|
|
Term
| What diagnostic studies are used for cobalamin deficiency? |
|
Definition
RBC's are large & abnormally shaped
Decreased serum cobalamin levels
Normal serum folate levels and decreased cobalamin levels suggest megaloblastic anemia due to cobalamin deficiency
Schilling test: radioactive cobalamin and administer to pt; asscss about in urine |
|
|
Term
| What is nursing management for cobalmin deficiency? |
|
Definition
Familial disposition
Watch for injuries from lack of heat and pain sensations
Ensure treatment compliance |
|
|
Term
| What is another name for folic acid deficiency? |
|
Definition
|
|
Term
| What is folic acid required for? |
|
Definition
DNA synthesis
RBC formation and maturation |
|
|
Term
| What are common causes of folic acid deficiency? |
|
Definition
Poor nutrition
Malabsorption syndrome
Drugs
Alcohol abuse and anorexia
Lost during hemodialysis |
|
|
Term
| What are foods high in folic acid? |
|
Definition
Green Leafy veggies
Citrus fruits
Whole grain
Liver |
|
|
Term
| What are the clinical manifestations of folic acid deficiency? |
|
Definition
Similar to cobalamin deficiency
Insidious onset
GI disturbance, dyspesai, glossy tounge
Absence of neurologic problems |
|
|
Term
| How is folic acid deficiency treated? |
|
Definition
| Replacement therapy (1mg) |
|
|
Term
| What are the causes of Anemia of chronic disease? |
|
Definition
End-stage renal disease
Chronic liver disease
Chronic inflammation
Malignant tumors
Chronic endocrine diseases |
|
|
Term
| What is found in anemia of chronic disease? |
|
Definition
^ serum ferritin
^ iron stores
Normal folate
Normal cobalamin |
|
|
Term
| How is anemia of chronic disease treated? |
|
Definition
Treatment of the underlying cause
Rarely blood transfusions
Erythropoietin therapy |
|
|
Term
|
Definition
Not enough of any blood product
v WBC
v RBC
v Plateltes |
|
|
Term
| What is the etiology of aplastic anemia? |
|
Definition
Low incidence
Manageable with erythropoietin or blood transfusion
Can be critical |
|
|
Term
| What critical conditions can aplatic anemia cause? |
|
Definition
|
|
Term
| What are the two types of aplastic anemia? |
|
Definition
|
|
Term
| What is congenital aplastic anemia? |
|
Definition
|
|
Term
| What is acquired aplastic anemia result from? |
|
Definition
Ionizing radiation
Chemical agents
Viral and bacterial infestions
Prescribed medications |
|
|
Term
| How does aplastic anemia present? |
|
Definition
Abruptly
Week-months
Varies from mild to severe
Fatigue & dyspnea |
|
|
Term
| What are the symptoms of aplastic anemia caused from? |
|
Definition
| Suppression of any or all bone marrow elements |
|
|
Term
| How is aplastic anemia diagnosed? |
|
Definition
Decreased HgB, WBC, Platelets, reticulocyte
Bleeding time prolonged
RBC indices are normal |
|
|
Term
| What is the main nursing management for aplastic anemia? |
|
Definition
| Preventing complications from infection and hemmorrhage |
|
|
Term
| What is the prognosis for aplastic anemia? |
|
Definition
|
|
Term
| What are the treatment options for aplastic anemia? |
|
Definition
Bone marrow transplantation
Immunosuppressive therapy |
|
|
Term
| What are some causes of acute blood loss? |
|
Definition
Trauma
Complications from surgery
Disruption of vascular integrity |
|
|
Term
| What are some concerns from acute blood loss? |
|
Definition
Hypovolemic shock
Reduced plasma volume
Diminished O2 because of fewer RBC's |
|
|
Term
| What are the clinical manifestations of acute blood loss? |
|
Definition
Pain
Shock (major complication)
Numbness & tingling in the lower extremities |
|
|
Term
| What causes the clinical manifestations in acute blood loss? |
|
Definition
| Body's attempt to maintain an adequate blood volume and O2 |
|
|
Term
| What are diagnostic studies used for acute blood loss? |
|
Definition
| RBC's but does not adequately asses problems for 2-3 days |
|
|
Term
| What care is given to those with acute blood loss? |
|
Definition
Replacing blood volume
Identifying source
Stopping blood loss
Correcting RBC loss |
|
|
Term
| What is nursing care for those with acute blood loss? |
|
Definition
Monitor blood loss
No need for long-term treatment |
|
|
Term
| What are causes of chronic blood loss? |
|
Definition
Bleeding ulcer
Hemorrhoids
Menstrual and postmenopausal blood loss |
|
|
Term
| How is chronic blood loss managed? |
|
Definition
Identifying source
Stop bleeding
Possible use of supplemental iron |
|
|
Term
| What is hemolytic anemia? |
|
Definition
| Destruction or hemolysis of RBCs at a rate that exceeds production |
|
|
Term
| What is the 3rd major cause of anemia? |
|
Definition
|
|
Term
| What is intrinsic hemolytic anemia caused by? |
|
Definition
Abnormal hemoglobin
Enzyme deficiencies
RBC membrane abnormalities |
|
|
Term
| What is extrinsic hemolytic anemia caused by? |
|
Definition
|
|
Term
| What are the sites of hemolysis in hemolytic anemia? |
|
Definition
Intravascular
Extravascular |
|
|
Term
| What are some clinical manifestations of hemolytic anemia? |
|
Definition
Jaundince
Enlarged spleen and liver
Accumulation of HgB molecules in renal tubules |
|
|
Term
| What is sickle cell disease? |
|
Definition
| Autosomal recessive disorder characterized by abnormal form of HgB |
|
|
Term
| What is sickle cell disease? |
|
Definition
| Autosomal recessive disorder characterized by abnormal form of HgB |
|
|
Term
| What is the prognosis of Sickle cell disease? |
|
Definition
| Incurable and often fatal by middle age |
|
|
Term
| What causes fatality in sickle cell disease? |
|
Definition
| Renal and pulmonary failure |
|
|
Term
| What are the clinical manifestations of sickle cell disease? |
|
Definition
Pain
Sickling crisis
Anemic
v exercise tolerance |
|
|
Term
| What are the symptoms of a sickling crisis? |
|
Definition
Pain
Pallor
Jaundice
Pale mucous membranes
Activity intoleranec |
|
|
Term
| How is sickle cell disease managed? |
|
Definition
Alleviate symptoms
Pain assessment
Avoid high altidues
Provide O2
^ fluids
Treat infections promptly |
|
|
Term
|
Definition
abnormal production in erythrocytes
Body makes too many RBC's which makes blood thick which forms clots |
|
|
Term
| What are the two types of polycythemia? |
|
Definition
Polycthemia Vera
Secondary polycythemia |
|
|
Term
| What is polyctheica vera? |
|
Definition
| Bone marrow disorder characterized by an increaes in erthocytosis, leukocytosis, & thrombocytosis |
|
|
Term
| What is secondary polycythemia? |
|
Definition
| Caused by any source of hypoxia |
|
|
Term
| What are the s/s of polycythemia? |
|
Definition
| HA, HTN, vertig, tinnitus, blurred vision, epistaxis, ecchymosis, GI bleed, thromboembolism, intermittent claduiction, angina, CHF< hepatmegaly, spleenomegaly |
|
|
Term
| What diagnostic tests are used for polycythemia? |
|
Definition
HCT >53%
^ total RBC
^ WBC/basophila
^ platelets, uric acid, alkaine phosphate, vit B12 |
|
|
Term
| What are the major defects in hemostasis |
|
Definition
Thrombocytopenia
Hemophilia
Disseminated intravascular coagulation DIC |
|
|
Term
|
Definition
| Malignant cancer of the bone marrow and blood |
|
|
Term
| What are the 4 types of leukemia |
|
Definition
Acute
Chronic
Myelogenous
Lymphocytic |
|
|
Term
|
Definition
Progress abruptly
Cells don't develop normally & never function |
|
|
Term
| What is chronic leukemia? |
|
Definition
Slowly worsen
Mature cells, carry out normal function |
|
|
Term
| What is the defect is lymphocytoic leukemia? |
|
Definition
|
|
Term
| What is the defect is myeloid or myelogeneous leukemia? |
|
Definition
|
|
Term
| What are the risk factors for leukemia? |
|
Definition
Hereditary and genetic factors
Drugs to tx other types of cancers
Exposure to high doses of radiation
Chemicals
Certain viruses and diseases |
|
|
Term
| What are the four types of chemotherapy for leukemia? |
|
Definition
Induction
Intensification
Consolidation
Maintenance therapy |
|
|
Term
| What are the side effects of chemotherapy? |
|
Definition
| Leukopenia, Thrombocytopenia, Anemia, N&V, Diarrhea, alopecia, stomatitis, renal toxicity, hepatic toxicity, cardiac toxicity, anorexia |
|
|
Term
| What does nursing care include in leukemia/chemotherapy? |
|
Definition
Physical quality
Psychosocial
Spiritual |
|
|
Term
| What is the most common type of leukemia in adults? |
|
Definition
| Acute myelogenous leukemia |
|
|
Term
| What are the clinical manifestations of acute myelogenous leukemia? |
|
Definition
Comes on fast
Serious infections
Bleeding |
|
|
Term
| What gender is chroinc myelogeneous leukemia more common in? |
|
Definition
|
|
Term
| What are the clinical manifestaions of chronic myelogenous leukemia? |
|
Definition
| Stays stable, can go to an acute agressive, don't have long to live, can be controlled |
|
|
Term
| How long does chronic myelogeneous leukemia last? |
|
Definition
|
|
Term
| What leukemia is common in young children? |
|
Definition
| Acute lymphocytic leukemia |
|
|
Term
| What is the 5 year survival rate with acute lymphocytic leukemia? |
|
Definition
|
|
Term
| What are the clinical manifestations of acute lymphocytic leukemia? |
|
Definition
| Abrubt, bleeding, fever, progressive weakness, fatigue, bone or join pain, bleeding |
|
|
Term
|
Definition
| Neoplasmas of the cells of lymphoid orgin |
|
|
Term
| What are the 2 major types of lymphoma? |
|
Definition
Hodgkin's lymphoma
Non-hodgkin's lymphoma |
|
|
Term
| Who is affected in hodgkin's disease? |
|
Definition
| Twice as many men then women 15-25 over 50 most common |
|
|
Term
| What is the hallmark sign of hodgkin's disease? |
|
Definition
|
|
Term
| What are the clinical manifestations of hodgkin's disease? |
|
Definition
Weight loss
Fever
Night sweats |
|
|
Term
| What diagnostic studies are used for hodgkin's disease? |
|
Definition
Biospy (Lymphnode, bone marrow)
Pet scan, MRI, CT, etc (staging) |
|
|
Term
| What care is given for Hodgkin's disease? |
|
Definition
| Intensive chemo, radiation depends on site & presence of resistance, monitor infection & bleeding |
|
|
Term
| What is found in stage I hodgkin's disease? |
|
Definition
| Limited to a single node and contiguous structures or a single extralymphatic organ or site |
|
|
Term
| What is found is stage II hodgkin's disease? |
|
Definition
| Involves more than a single node or group of contiguous nodules, but is confided to one side of the diaphragm only |
|
|
Term
| What is found is stage III hodgkin's disease? |
|
Definition
| Disease is present both above and below the diaphragm and may include solitary involvement of the spleen, one extralymphatic site, or both |
|
|
Term
| What is found in stage IV Hodgkin's disease? |
|
Definition
| Disease has disseminated diffusely to one or more extralymphatic sites with or wihout associated lymph node involvement |
|
|
Term
| What is the prognosis of hodgkin's disease? |
|
Definition
Untreated this disease is progressive
Death is likely in 1-3 years w/o treatment |
|
|
Term
| What is the cause of non-hodgkin's lymphona? |
|
Definition
| Unknown; possible immunosuppresant therapy |
|
|
Term
| What are the clinical manifestations of non-hodgkin's lymphoma? |
|
Definition
Painless lymphnode enlargement
Can come and go
Don't find until it spreads |
|
|
Term
| What treatment is used for non-hodgkin's lymphoma? |
|
Definition
|
|
Term
| What organ is primarily affected by multiple myeloma? |
|
Definition
|
|
Term
| What are the clinical manifestations of multiple myeloma? |
|
Definition
Develops slowly
Not found until bone pain |
|
|
Term
| What diagnostic studies are used for multiple myeloma? |
|
Definition
|
|
Term
| What care is given for multiple myeloma? |
|
Definition
| Hydration to produce good urinary output |
|
|
Term
| What is the prognosis for multiple myeloma? |
|
Definition
Poor
Pt lives 2 years after diagnosis w/o treatment |
|
|
Term
| What is myelodysplastic syndrome? |
|
Definition
Bone marrow does not function normally
Not enough are made
Occurs most often in older people |
|
|
Term
| How is myelodysplastic syndrome developed? |
|
Definition
Following treatment with drugs or radiation
Unknown cause |
|
|
Term
| What are the S&S of myelodysplatic syndrome? |
|
Definition
Anemia
Infection or bleeding |
|
|
Term
| What diagnostic studies are used for myelodysplastic syndrome? |
|
Definition
|
|
