Hematopoiesis
There are _____ number of types of wbcs. Name them.
What is 5: Neutrophils, monocytes, basophils, eosinophils, lymphocytes
Measures the oxygen carrying capacity of the blood. What are the normal values?
When administering Lovenox (enoxaparin) to your patient, be sure to check this lab first.
What are the platelet levels
Green leafy veggies, orange juice, peanuts, avocado and enriched grain products are all full of this nutrient...
These three things are important to know about caring for a fresh BKA/AKA
1. Prevent flexion contractures by avoiding sitting upright or in chair more than one hour. Avoid propping stump on pillow.
2. Maintain compression bandages at all times to promote residual limb shrinkage except PT and bathing.
3. Sterile technique a must during immediate post op period.
This is made by the kidney and released in response to hypoxic states
What is erythropoietin
An elevated white blood cell count (WBC) tells us this- what are the normal values?
What is infection or inflammatory process (5000-10000/uL) or 5-10
Some education for patients receiving ferrous sulfate should include the following...
What is- take one hour before meals. Take with a form of Vitamin C (OJ), Do not give less than one hour before bedtime d/t gastric erosion.
Poor dietary intake, malabsorption, and acute blood loss or destruction of blood cells leads to this condition.
What is Iron-deficiency anemia
This is the rationale for use of an abduction pillow for a hip arthoplasty and not an ORIF.
What is use of abductor pillow prevents joint dislocation. Not necessary with ORIF
The first and second line defense system for infectious/inflammatory responses.
What are neutrophils and monocytes
This lab value would cause great concern for hemorrhage/death
And at this level we would consider holding any prescribed blood thinners
What is platelet levels less than 10,000
What is less than 150,000
Patients taking Toradol (ketorolac) should be advised to avoid this other medication
What is ibuprofen or other NSAIDS
Heart rate 115, RR 22, and BP 90/50, with complaint of fatigue, SOB, and cool clammy skin are all symptoms of this type of anemia
Acute blood loss (hemorrhage)
True of false: a suspected pelvic fracture patient should have a foley catheter placed before the swelling increases.
FALSE!!!! Never place a foley in a suspected pelvic fracture without CT scan first to detect for disruption of urethra.
The bi-product of red blood cells. And why would this be elevated?
What is bilirubin- decreased liver function
Red blood cell count tells us this piece of information
What is the measure of circulating red blood cells in systemic circulation.
Patients taking skeletal muscle relaxants should be educated to avoid the following types of medications
CNS depressants (ie, opioids) due to excessive drowsiness, resp depression and potential for OD).
An autoimmune disorder in which the patient has pancytopenia (decrease of all types of blood cells), and clinical manifestations include fatigue, dyspnea, high risk for infection, as well as increased risk of bleeding
What is aplastic anemia
Describe the care of a patient with a fractured extremity
What is RICE
Rest
Ice
Compression
Elevation
This is made in the liver that stimulates platelet production
What is thrombopoietin
The patients hematocrit is normal, yet they are bleeding. We know that...
But in 2-6 hours it would look like this...
What is low because of crystalloid replacement and plasma is catching up throwing off ratio of rbc to plasma.
This medication stimulates erythropoietin
What is Epogen (Epoetin)
A patient with this disease presents with the following:
BP 170/94, burning and red hands and feet, headache, dizziness, ringing in the ears, and itching with hot showers/baths.
The treatment is...
Polycythemia Vera
Tx. is phlebotomy 300-500ml of blood every few days until hct at 45%. Also hydration therapy to dilute the the blood.
This type of injury might cause the patient to have sudden incontinence of bowel and/or bladder
What is Herniated disc
These are made in response to immature destruction of RBCs or under utilization of HGb on the mature RBCs
What are reticulocytes
Low mean corpuscular hemoglobin (MCH) would be reflected in which type of anemias?
What is microcytic- iron deficiency or thalassemia
This medication alters the plasma membrane of platelets, making them "slippery"
The following are diagnostic for a diagnosis of Neutropenia
And the following rules must be followed for this pts.
Absolute neutrophil count <1000 cells/uL (found by multiplying total WBC by % of Neut)
No plants or flowers in the room, mask and gloves by ANYONE entering patient's room, no fresh salad on meal tray, SUPER GOOD HAND HYGIENE BY NURSE AND PATIENT
This would be included in post op education for a patient who underwent a spinal fusion.
Log roll is essential
Do not drive for 6 weeks or until cleared by MD
No bed trapeze or twisting/turning
No bending to lift objects
What is vascular injury,vasocontriction,adhesion,activation,aggregation, thrombin converts fibrin to fibrinogen to form fibrin clot.
An elevation of MCH could be an indicator of which type of anemia?
When transitioning your patient from a heparin gtt. to warfarin (coumadin), this is the most important thing to understand.
What is the therapeutic levels of coumadin take several days to achieve, so heparin gtt needs to continue while coumadin started, along with continued labs to make sure patient is not becoming too anticoagulated.
PT/INR-coumadin- (goal of INR 2-3)
aPTT- heparin (goal of aPTT 1.5-2x's pretreatment levels)
Patients with HIT (Heparin-induced thrombocytopenia) know that nurses suspect HIT when this happens...
The nurse knows they should be on the lookout for this..
And that the patient must never receive...
Bleeding in the form of petechiae,purpura,echymosis, bleeding of gums, nosebleeds, stroke, dvt, pulmonary embolus
Heparin or Low-molecular weight heparin. Should receive direct thrombin inhibitor Argatroban
When a patient is prescribed a combination analgesic for pain control following spinal, hip or knee surgery, it is important to stress the importance of avoiding these medications...
Use of skeletal muscle relaxants while using the opioids.
Use of acetaminophen while using the combo analgesics.