Hematology 1
RBCs, WBCs, H & H, and a platelet count are all components of what lab test?
What is a complete blood count.
What is a reticulocyte?
Mature in _____?
immature RBC
48 hrs
Treatment for sickle cell crisis includes
Oxygen for hypoxia, fluid and electrolyte replacement, Pain management, Transfusion therapy, teaching patients' ways to avoid SCC
Malignant condition characterized by proliferation of Reed Sternberg cells in lymph nodes, associated with genetic disposition and exposure to toxins.
What is Hodgkin Lymphoma?
Which has a higher survival rate? Hodgkin or non-hodgkin?
The client receiving blood transfusion suddenly begins to wheeze and complains of dyspnea. What should the nurse do first?
A. Call the PCP
B. Collect all tubing and send it out to the lab
C. Stop the transfusion
D. Document the incident
C. Stop the blood transfusion
What is the difference between Passive and active immunity?
passive in temporary, immediate protection
active is long-term, antibodies are developed
Naturally acquired from having disease
artificially acquired from vaccine
What medication can be prescribed to a patient with sickle cell to increase HGB F?
hydroxyurea
The average red blood cell has a life span of how many days?
What is 120.
Lab test for evaluating intrinsic coagulation
PTT
Care for joint bleeding and pain for patients with hemophilia includes
Administering coagulation factor. Immobilize the joint, pack the joint in ice. Give pain medications, AVOID Aspirin. When bleeding has stopped encourage mobilization of the joint
Which leukemia has Philadelphia chromosome?
CML
1. Treatment for Disseminated intravascular coagulation (DIC)?
2. DIC is always secondary to which underlying condition?
Heparin and (blood products) platelets infusion?
severe infections, solid or hematologic malignancies, trauma, or obstetric calamities?
What is the role of the B cells?
B cells produce antibodies
T-cells long term immunity-antigen specific
What is the rationale for prescribing prednisone for a patient with chronic immune thrombocytopenia (ITP)?
Steroids inhibit immune response
What are the 5 types of WBC?
What is Neutrophils, Eosinophils, Basophils, monocytes, and lymphocytes.
What is a "left shift"?
WBC-bands have increased indicating an infection is in progress.
What is a "right shift"?
Your patient has had her spleen removed after a motor vehicle accident. Your teaching should include that this could place her at increased risk for____
What is infection?
Priority nursing intervention post bone marrow aspiration
pain control
inherited disorder where abnormal form of HGB causes blood cell to stiffen and elongate
What is sickle cell anemia?
Name 4 things that help or strain your immune system
positive attitude - increase lymphocite cells
negative emotions-strain immune system
adequate sleep
diet - protein, Vit A,C,E, Vit B6, Zinc
What anticoagulant can be used when a patient has had a history of HITT?
argatroban
1. Removal of this organ can put your patient at greater risk for infection.
2. Two functions of RBCs
1. What is the spleen?
2. What is transportation of oxygen & carbon dioxide, and maintaining acid base balance.
Swollen cervical lymph node, non-painful
Fever, night sweats, weight loss
Alcohol induces pain in lymph nodes
Hodgkin's disease
What are key dietary nutrients to help in RBC production?
Iron, Vit B12, Folic Acid
Name 3 risks for a patient diagnosed with leukemia
infection
bleeding
possible anemia
Neutropenia plus ___________________ is considered a medical emergency
fever greater than 100F
What is the difference between humoral and cell-mediated immunity?
Humoral immunity sends antibodies to fight against antigens vs cell-mediated immunity sends T cells to fight.
Humoral is rapid and quick while cell-mediated can be delayed (primary vs secondary response)
What blook products can be used to replace Factors 8 & 9?
FFP
cryoprecipitate
1. In this cancer plasma cells (type of white blood cell in the bone marrow) becomes cancerous and multiplies. The disease can damage the bones, immune system, kidneys, and red blood cell count.
2. ___proteins are immunoglobulin light chains found in excessive quantities in urine in ________ and are believed to be one of the first tumor markers.
1. What is Multiple Myeloma?
2. Bence Jones proteins are immunoglobulin light chains found in excessive quantities in urine in multiple myeloma and are believed to be one of the first tumor markers
Two classifications of aplastic anemia.
Give an example of each
Acquired: trauma, antibody reactions, infections and toxins
Congenital: Sickle cell disease
.
What can you educate a patient in ways to lower their calcium levels?
Drink 3-4 liters of water to decrease load
Which disease process destroys bone and has Bence Jones proteins found in urine?
multiple myeloma (plasma cell myeloma)
Describe the "induction" phase of chemotherapy
What is nadir phase?
Most aggressive stage of chemotherapy
Lowest counts
Describe Hematopoietic stem cell transplant (HSCT)
Name highest risk
all cells (leukemia cells and bone marrow eliminated via chemo. New bone marrow cells infused from donor.
Infection
What is SLE?
Name at least 2 things triggers that exacerbate symptoms.
Sun exposure, stress
Name 2 medications that can push the calcium back into the bone and decrease release of calcium
Calcitonin
Biphosphates
1. This component of the hematological system is where non-functioning red blood cells are removed from the blood.
Fill in the blanks:
The most common disease-related reason for a spleen removal is a blood disorder called ___________. This is an autoimmune condition in which antibodies target blood platelets. Platelets are needed to help blood to clot, so a person with ITP is at risk for bleeding. The spleen is involved in making these antibodies and removing the platelets from the blood. Removing the spleen can be done to help treat the condition.
1. What is Spleen?
2. The most common disease-related reason for a spleen removal is a blood disorder called idiopathic thrombocytopenic purpura (ITP). This is an autoimmune condition in which antibodies target blood platelets. Platelets are needed to help blood to clot, so a person with ITP is at risk for bleeding. The spleen is involved in making these antibodies and removing the platelets from the blood. Removing the spleen can be done to help treat the condition.
Reduction of platelets below 150,000 /ul
Name causes
What is thrombocytopenia?
Describe HITT
What lab values would be monitored?
Heparin induced thrombocytopenia
PTT, platlets
Name the 4 types of leukemia
Which is most common in children?
What is leukostasis?
AML, ALL, CML, CLL
ALL
WBC >100,000
Name the 4 Hemophilia's and missing factors.
A - Factor VIII
B- (Christmas Tree)-Factor IX
C - Factor XI
VonWillebrand's - VWF
Name the 5 immunoglobins & specific characteristics
IgG-only to cross placenta and provide newborn with passive acquired immunity
IgA-lines mucus membranes (saliva, tears, breast milk)
IgM - antibodies to ABO blood antigens
IgD-assists differentiation of B lymphocityes
IgE-Causes symptoms of allergic reaction
Name 2 immunosuppressants used for SLE.
What are priority pt education facts?
Methotrexate-don't get pregnant
hydroxchloroquine-eye appts