A is for Anemia
I am autosomal recessive, I have no cure, you can only treat my symptoms- what I am and how can you help?
Sickle cell anemia
-Vaccinate! (decrease risk of infections)
-Prevent crisis
At what level is it considered neutropenia?
<1,500
What is CLABSI?
How do we prevent this?
Central Line Associated Blood Stream Infection
-Daily CHG baths, limit access, dressing integrity, hand hygiene, proper technique for lab draws.......
Overproduction of all cells, primarily RBC. Increases risk of stroke/bleeding-What is this?
What is a treatment?
Polycythemia
Tx: therapeutic phlebotomy, myleosuppressionS/SX of Hypovolemia
wt loss, falsely high HCT, weak pulses, flattened neck veins, clammy, pale..
Describe hemolytic anemia and it's possible causes and what we might see
premature destruction of RBC
may be r/t meds, autoimmune, infections, DIC
hematuria, increased bilirubin (destruction of RBC=fragments aka schistocytes which build up causing increased bilirubin.)
>100.4 F for an hour = _____?
This type of line is placed in the bone marrow.
What are some complications?
Intraossuous or "IO"
-bone infection, compartment syndrome
Missing clotting factor, significant bleeding with any injury. What is this?
What do we have to think about pre-op?
Hemophilia, either A or B
Replace missing factors before surgery (or after injury)
Wt gain, ascites, decreased O2, HNT, SOB, decrease H&H r/t dilution
Impaired hemoglobin and RBC production r/t inherited autosomal recessive disorder.
Thalassemia
What are the first responders of the innate immunte system? (give examples of each)
-physical barriers:skin mucus membranes, stomach acid
-phagocytes:neutrophils, monocytes, macrophages
-cytokines: chemical messengers that regulate the immune system- target/flag invaders for destruction.
List some indications for TPN
If pt is unable to absorb nutrients thro GI for >/= to 10 days.
Loss of 10% of pre-illness weight
Albumin level <3.5
Bowel rest after complicated GI surgery
What is "Systemic activation of clotting cascade- depletion of clotting factors and platelets."
Common causes: _____?
DIC
Nursing Actions for extravasation
Stop infusion, switch to new site, attempt to aspiration any of the medication out, remove line, notify MD, call pharmacy, elevate arm
Administer antidote: phentolamine, hyaluronidase, nitro paste, apply warm compress
Type of anemia caused by destruction of bone marrow
Aplastic anemia
What is adaptive immunity and who are the players?
What is an example of adaptive immunity?
2nd responders- recognize antigens, produce antibodies to counter them.
T&B cells- have memory
Vaccines: trigger immune rxn to build up defense in case of future exposure
How often should tubing be changed on PPN/TPN?
Q24hr.
List some nursing interventions
-bleeding precautions, put pt on stool softeners, platelet transfusion if under 20,000
What guage IV are appropriate for blood transfusions
18 or 20 (14, 16 can be for massive transfusions)
what is Pancytopenia?
What precaution do we initiate?
-decrease production of ALL (blood) cell types: RBC, WBC, platelets..
-neutropenic precautions
which immunoglobulin is involved in a hypersensitivity rxn having to do with allergies and anaphylaxis?
IgE
What is a vessicant and list some examples?
Drug capable of causing tissue injury
Examples: Epi, Vanco, Potassium, Chemo agents, TPN, contrast, Dopamine, Dobutamine, Sodium bicarb, promethazine, calcium gluconate, phenylephrine.....
Describe HIT
Complication of heparin therapy.
Platelets become aggregated and removed from circulation, antibodies will attack, thrombi form--> platelet consumption-->decreased platelet count
* list heparin as an allergy, find new anticoag
How do you confirm line placement?
Chest xray