hematologic

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Author:
mfernandez9222
ID:
123963
Filename:
hematologic
Updated:
2011-12-15 18:55:23
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health
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hematologic
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  1. Lymphatic vessels
    move fluid / proteins from interstitial spaces to venous circulation preventing edema

    reabsorb fats from small intestine
  2. Lymph Nodes
    cerviofacial

    supraclavicular

    axillary

    epitrochlear

    inguinal

    femoral
  3. Lymph
    composed - water / end product of cell metabolism

    fluid in interstitial spaces
  4. Tonsils
    lymphatic tissue producing lymphocytes that fight off pathogens
  5. Spleen
    lymphatic organ

    destroys - bacteria

    filters - blood

    reservoir - blood

    forms - lymphocytes / monocytes

    traps - formed particles
  6. Bone Marrow
    Red - hematopoiesis - production - erythrocytes, leukocytes, and trombocytes

    Yellow - red bone marrow that turned into fat
  7. Stem cells
    evolve - lymphocytes and may become B cells or T cells, phagocytes
  8. Erythrocytes

    -red blood cells
    formed in bone marrow containing hemoglobin, oxygen combines with it and circulates thoughout body
  9. Thrombocytes

    -platelets
    function - coagulation of blood
  10. Leukocytes

    -white blood cells
    provide - immunity / protection from infection by

    phagocytes (engulfing, digesting, destroying microorganisms
  11. Plasma
    liquid portion of blood

    water , protein, albumin, globuin, glucose, electrolytes
  12. Blood Types

    A

    B

    AB

    O
    O - has no A / B used for emergency

    AB - can recieve any kind of blood
  13. Acquired immunodeficiency syndrome

    -defect in Tcell mediated immunity
    exposure to HIV

    anorexia, disorientation, night sweats, opportunistic infections

    less than 200 tcell

    transfusions / antibiotics

    assess respiratory, maintain diet, standard precautions
  14. Anaphylaxis

    -acute atopic reaction that rapidly produces urticaria / respiratory distress
    chemicals, enymes, food

    cardiovascular / physical / respiratory distress

    CPR, epinephrine subq

    massage injection site to increase circulation, maintain airway, monitor blood pressure / urine output
  15. Ankylosing spondylits

    -inflammation of the spine and adjacent soft tissue between the sacrum and ileum
    lower back pain, stiffness of lumbar spine, symptoms progress unpredictably

    xray family history

    good posture, strectching

    anti-inflammatory meds

    offer support, heat therapy
  16. Aplastic anemia

    -suppression, destruction, apalasia of bone marrow, marrow is unable to produce erythrocytes, leukocytes, platelets
    dyspnea, epistaxis, melena, palpitations

    transfusion

    monitor infection, bleeding, bruising, monitor o2 sats, and no injections
  17. Calcium imbalance

    -imbalance leads to tetany, seizures, cardiac arrhythmias and coma
    • HYPO -
    • cardia arrhythmias, tetany

    • HYPER -
    • muscle weakness/tone, anorexia, polydipsia, polyuria

    serum calcium 4.5 -5.5

    diet with calcium, vitamin D, protein

    monitor serum calcium levels
  18. Chloride imbalance

    -an acid medium conducive to digestion and activation of enymes
    • HYPO-
    • shallow breathing, twitching, loss of gastric secretions

    • HYPER-
    • deep rapid breating, hypertension, tachycardia

    Serum Chloride level 98 meq/l - 108 meq/l

    hypo - salty broth, saline solution

    monitor serum chloride levels
  19. Disseminated intravascular coagulation

    -accelrated clotting in small vessels, organ necrosis, which can provoke hemorrhage
    abnormal bleeding, petechiae, hematomas, ecchymosis

    Prolonged PT <15sec PTT <60sec

    bedrest, transfusion

    check iv sites for bleeding, apply 10min pressure for sites, monitor HCT, Hb, coagulation times
  20. Hemophilia

    -mild to severe bleeding
    hematuria (bloody urine) tarry stools, joint tenderness

    monitor bleeding

    follow orders for treatment

    elevate joints to control bleeding
  21. Iron deficiency anemia

    - decrease iron affects formation of hemoglobin and RBCs, and decreases oxygen in the blood
    pallor, sensitivity to cold, weakness

    hematology shows decreases

    iron supplements

    assess cardio / respiratory, stool, urine, vomit for occuly blood
  22. Kaposis sarcoma

    -cancer of the lymphatic cell wall
    lesions on the skin, pain

    high calorie / protein, radiation therapy

    inspect skin qshift, pain meds, monitor effects of radiation therapy
  23. Leukemia

    -uncontrolled proliferation of WBC prescursors that fail to mature
    enlarged lymph nodes spleen, liver

    drug therapy

    monitor bleeding, pt with epistaxis in upright position leaning slightly forward to reduce vascular pressure and prevent aspiration
  24. Lymphoma

    -tumors that travel from one lymph node through the entire system
    enlarged lymph node in cervical region

    radiation therapy

    monitor bleeding, jaundice, infection
  25. Magnesium imbalance

    - affects muscle / bone movement,
    • HYPO-
    • arrhytmias, neuromuscular irritability, confusion

    • HYPER-
    • diminished deep tendon reflexes, heart block, weakness

    Serum Magnesium 1.5meq - 2.5meq

    hypo - diet / iv fluid

    hyper - lasix, diet

    monitor serum mag levels, intake and outputs, LOC
  26. Metabolic acidosis

    -lungs, kidneys, cells affected by excess acid accumulation
    • CNS depression, lethargy
    • kussmauls respirations

    • Arterial Blood Gas >7.35
    • Bicarbonate > 24meq

    sodium bicarbonate iv

    keep sodium bicarbonat ampules available, monitor LOC, VS, labs
  27. Metabolic alkalosis

    -loss of acid and increase of base bicarbonate causing metabolic , respiratory, and renal response, hypoventilation
    atrial tachycardia, hypoventilation, twitching

    • ABG pH <7.45
    • Bicarbonate <29meq

    monitor ammonium chloride infusion avoid giving to pts with hepatic or renal disease because of toxicity
  28. Multiple myeloma

    -abnormal proliferation of plasma cells, they invade bone marrow, lymph nodes, liver, spleen, kidneys triggering osteoblasctic activity leading to bone destruction
    severe bone pain, fractures, deformities, height loss

    orthopedic devices

    drug therapy

    assess renal, bone pain, iv fluids
  29. Pernicious anemia

    -vitamin B12 cannot be absorbed by ileum resulting in defective maturation of RBCs
    paresthesia of hands / feet

    vitamins

    assess cardiovascular
  30. Phosphorus imbalance

    -metabolic functions are changed
    • HYPO-
    • tremor, parasthesia, muscle weakness

    • HYPER-
    • no symptoms

    Serum Phosphorus level 1.7meq - 2.6meq

    diet, supplements

    record intake and outputs

    hyper- below 600ml per day notify dr
  31. Polycythemia vera

    -increase RBC mass, leukocytosis, thrombocytosis and Hb concentration with increased or normal plasma levels
    clubbing of digits, dizziness, thrombosis, hypertension, visual disturbance

    removal of blood 350ml-500ml a day

    drug therapy

    check vs monitor tachycardia, clamminess, or vertigo
  32. Rheumatoid arthritis

    -autoimmune disorder, affecting synovial lining of the joints eventually tendons and ligaments are affected
    painful swollen joints, crepitus, symmetrical joint swelling

    cold / heat therapy

    drug therapy

    check joints for swelling, spling inflammed joints
  33. Scleroderma

    -a diffuse connective tissue disease, inflammation and degenerative and fibrotic changes in the skin, vessels, membranes, muscles, internal organs
    pain, blue fingers, swelling, tight inelastic facial skin, renal problems followed my hypertension

    physical therapy, no cure exist

    drug therapy

    assess vs bp output
  34. Septic shock

    -bacterial infection, causes inadequate blood perfusion and circulatory collapse
    chills, oliguria, fever <101

    altered LOC, hyperventilation, hypotension, hypothermia, tachycardia, tachypnea

    decrease - platelet count, leukocytosis, creatinine levels

    increase - BUN, creatinine

    replace iv and foley tubes, o2 therapy, diuretics

    drug therapy

    normal saline infusion, systolic <80 increase o2 call dr
  35. Sickel cell anemia

    -RBC cells become rigid affecting circulation
    aching bones, jaundice, unexplained dyspnea

    • low RBC count, ESR
    • high WBC, serum iron

    iron and folic acid to treat anemia, iv fluid for hydration

    pain meds

    warm compresses, bedrest, fluid intake
  36. Sodium imbalance

    -major cation, positively charged ion
    • HYPO-
    • abd cramps, cyanosis, seizures, hypotension

    • HYPER-
    • hypertentsion, flushed skin, pitting edema, thirst, rough dry tongue

    Serum Sodium Levels 135meq - 145meq

    • HYPO-
    • saline infusion, potassium supplement

    • HYPER-
    • sodium restricitons

    watch levels, monitor q6, record intake and output
  37. Systemic Lupus erythematosus

    -autoimmune disorder, tcell drop antibody increase, immune responds to veins / arteries causing pain, swelling and tissue damage
    butterly rash on face, fatigue, pain, joint stiffness

    drug therapy

    asswss musculoskeletal, minimize environmental stress
  38. Vasculits

    -inflammation and necrosis of blood vessels
    • wegeners granulomatosis
    • (respiratory tract and kidneys)
    • cough, fever, malaise

    • temporal arteritis
    • (carotid artery)
    • headache, jaw claudication, myalgia

    • takayasus arteritis
    • (aortic arch)
    • bruits, loss of distal pulse, paresthesia distal to the affected area

    diet, removing environmental antigen

    regulate room temp, vs, intake and outputs
  39. Systemic lupus erythematosus, should monitor there body temp when discharged
    Epistaxis

    sit up right leaning slightly forward
  40. Pernicious anemia

    teach pt importance of receiving monthly vitamin b12 injections for the rest of their life
    Lymphoma ( Hodgkins disease )

    stage 1 single lymph node / organ

    stage 2 two nodes on one side of diaphragm or organ

    stage 3 both sides fo diaphragm and organ, spleen or both

    stage 4 diesase dessemninates

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