Heme & Lymph Exam Questions & Answers Graded A

What are the two main functions of the lymphatic system? - transport excess fluid from the interstitial spaces to the circulatory system Protect the body from infection and absorb fats What is the lifespan of an RBC? - 120 days What destroys RBC's? - spleen and liver What picks up oxygen? - hemoglobin What do we need to make hemoglobin? - iron What is the function of a WBC? - fight infection What is the total WBC count? - 3-5000Chronic How long do platelets live for? - 10 days How long should blood be administered within obtaining it from the lab? - 30 minutes What should you do before beginning a blood transfusion? - take full vitals What should you do 15 minutes after a transfusion starts? - take full vitals What do you do if a patient experiences s/s of a reaction to a blood transfusion? - stop the infusion immediately notify Dr How long should it take for a blood transfusion to be completed? - 4 hours What is the role of the nurse during a blood transfusion? - check client's wristband check their blood type have 2 nurses sign the consent form How long do we have to stay with the patient during a blood transfusion? - 15 min or first 50 mL What is the normal hemoglobin level for a male? - 14-17 g What is the normal hemoglobin for a female? - 12-15 g What is the most common anemia disorder? - iron deficiency anemia What causes iron deficiency anemia? - poor diet not eating iron rich foods slow chronic bleed growth spurts pregnancy heavy periods diseases such as: polyps, colon cancer, diverticulitis, bladder tumors What are the s/s of iron deficiency anemia? - fatigue palpitations tachycardia exertional dyspnea pica stomatitis glossitis brittle hair intolerance to cold confusion Which diagnostic tests can be used for iron deficiency anemia? - CBC H+H Iron levels TIBC (total iron binding capacity) What is the treatment for iron deficiency anemia? - iron preparations and changes in diet. Give iron w/ orange juice because it increases absorption. Why should liquid preparation of iron be given with a straw? - can stain the teeth Why is an iron injection given via z-track? - stains the skin What is the name of an iron preparation? - Ferrous Sulfate (Feosol) Why isn't iron given with food or milk? - they interfere with iron absorption Where is Iron Dextran (InFed) given? - upper outer quadrant of the buttocks. Deep IM w/ Z-Track method What kind of foods are high in iron? - red meat fish raisins apricots dried fruit dark green veggies dried beans eggs iron enriched whole grain breads Which vitamin helps assist in the absorption of iron? - vitamin C What causes aplastic anemia? - when bone marrow stops making enough blood cells. decrease in RBC and WBC and platelets. What is aplastic anemia also sometimes called? - pancytopenia Patients with aplastic anemia are what? - acutely ill With aplastic anemia, you have no _______, not enough ________, and absolutely no __________. - no RBC's not enough WBC's no platelets What are the s/s of aplastic anemia? - fatigue weakness fever palpitations headaches fever mouth ulcers petechiae gingival bleeding epistaxis How is a diagnoses of aplastic anemia made? - bone marrow aspiration What kind of treatments are used to treat aplastic anemia? - immunosuppressive therapy (Atgam) Cyclosporine is given to suppress the reaction causing the anemia and allow bone marrow to recover What kind of transfusions are given to patients with aplastic anemia? - packed red cells and platelets What is pernicious anemia? - inability to absorb vitamin B12 due to the absence of intrinsic factor. it is usually an autoimmune disease. What are the s/s of pernicious anemia? - weakness sore tongue edema ataxia (unsteady gait) dizziness dyspnea headache fever blurred vision edema in legs What is the treatment for pernicious anemia? - lifelong treatment of vitamin b12 cannot give it orally, has to be given via IM 1000 mcg once a month will also be on folic acid which helps the RBC What kind of foods are high in folic acid? - whole grains green leafy veggies What is the pharmacological treatment for pernicious anemia? - topical anesthetics are given to relieve oral discomfort during the acute phase of the disease What medication is given IM until hematocrit returns to normal? - cyanocobalamin crystalline (Rubesol-1000) What medication is given monthly for the rest of the patient's life after the initial doses? - cyanocobalamin crystalline What is the Schilling Test? - determines vitamin b12 absorption by the intestine. differentiates between pernicious anemia and GI malabsorption problems. What is the procedure associated with a Schillings Test? - collect urine for 24-48 hours. What is acquired hemolytic anemia? - destruction of the RBC occurs and iron and hemoglobin is released. it is an autoimmune disease. Transfusion reactions can lead to this. What are the s/s of hemolytic anemia? - mild fatigue pallor jaundice palpitations hypotension dyspnea back and joint pain What is the treatment of acquired hemolytic anemia? - treat to remove cause blood transfusion splenectomy medication What is erythrocytapheresis? - a procedure that removes abnormal RBCs and replaces them with healthy RBCs What is the pharmacological treatment of acquired hemolytic anemia? - corticosteroids are administered to decrease the autoimmune response. Folic acid is given to decrease the production of RBCs What is sickle cell anemia? - genetic disorder that causes abnormally shaped RBC. What are the s/s of sickle cell anemia? - anemia, enlarged heart, fatigue, jaundice, chronic leg ulcers, tachypnea, dyspnea, arrhythmias, severe pain, severe pain in joints, CVA, renal failure, pulmonary infarction, shock, and priapism. What is the name of the test done to see if an infant has sickle cell anemia? - sickledex or sickle cell test What are the assessments associated with sickle cell anemia? - extremity circulation frequently by doing capillary refill, peripheral pulses, and temperature. Application of warm compresses to painful areas to relieve pain. Avoid restrictive clothing. Avoid high altitudes and have adequate fluid intake What is the treatment of sickle cell anemia? - medications and symptomatic care during crisis. . Multidisciplinary approach to treatment. Need to do a lot of teaching about how to avoid crisis. Folic acid is given to stimulate production of RBC's. What would hydroxyurea be givin for and what does it reduce? - This med can relieve frequency of a sickle cell anemia crisis. It also reduces the need for blood transfusions Trental decrease? and what disease is it usually given for? - blood viscosity sickle cell anemia What is polycythemia? - increased production of RBCs. . Blood is thicker than normal. What is the nursing care associated with sickle cell crisis? - height and weight daily weight check pulses check for s/s of bruising, jaundice check respiratory status organize care so not getting dyspnea on exertion assess for paresthesia (sign of impaired blood flow) check for blurred vision What are the s/s of polycythemia? - headaches dizziness tinnitus blurred vision fatigue pruritis, exertional dyspnea, angina, increased BP and pulse. The client's complexion becomes red and the palms, earlobes, and cheeks are flushed. Some may experience burning in the feet. When you have polycythemia you are at an increased risk for what? - blood clots What usually causes polycythemia? - bone marrow defect What is patient teaching associated with patient teaching when a patient is diagnosed with polycythemia? - drink at least 3 L of water a day elevate feet when resting avoid tight clothing wear TEDS take meds as ordered report chest or joint pain, fever, or activity intolerance keep appts for labs & dr checks What kind of diet should a patient with polycythemia be on? - increased calories & protein low sodium to reduce fluid volume What is the medical management of polycythemia? - phlebotomy (remove 350-500 mL of blood) possible side effect of this is increased platelet count. More prone to develop leukemia What is the pharmacological treatment of polycythemia? - low dose aspirin is given to prevent clot formation and hydroxyurea (Hydrea) is a myelosuppressive agent, reduces the H+H and platelet formation. Allopurinol (Zyloprim) is an anti-gout drug. It is given to decrease the production of uric acid. Pruritus is relieved with the administration of antihistamines. What is leukemia? - malignancy in which the bone marrow produces increased numbers of immature white blood cells that cannot protect the body from infections. Increase in number of WBC and decrease in RBC and platelets. What are the names of the four types of leukemia? - Acute myelogenous (AML) Acute lymphocytic (ALL) Chronic myelogenous (CML) Chronic lymphocytic (CLL) What are the s/s of leukemia? - fever chills fatigue pallor malaise tachycardia tachypnea petechiae bruising epistaxis melena gingival bleeding increased menstrual bleeding What type of diet should a patient with leukemia be on? - bland If a person has a low WBC count (under 4000) what does that mean? - they may have leukopenia What is the treatment of leukemia? - chemotherapy radiation blood products antibiotics bone marrow transplant If a person has a high WBC count (over 10,000) what does that mean? - infection inflammation tissue necrosis leukemia