Medsurg Chapter 30

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Author:
Anonymous
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172698
Filename:
Medsurg Chapter 30
Updated:
2012-09-23 02:05:31
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Medical Surgical Nursing
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Description:
Chapter 30: Hematologic System
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  1. If the recipients blood group is A:
    What is their RBC antigen?
    Their Plasma/Serum Antibody?
    Compatible donor for RBC transfusions?
    Compatible donor for plasma transfusions?
    • Their RBC antigen is A
    • Their Plasma/Serum Antibody is Anti-B
    • Compatible donors for RBC transfusions are A and O
    • Compatible donors for plasma transfusions are A and AB
  2. If the recipients blood group is B:
    What is their RBC antigen?
    Their Plasma/Serum Antibody?
    Compatible donor for RBC transfusions?
    Compatible donor for plasma transfusions?
    • Their RBC antigen is B
    • Their Plasma/Serum Antibody is Anti-A
    • Compatible donors for RBC transfusions are B and O
    • Compatible donors for plasma transfusions are B and AB
  3. If the recipients blood group is AB:
    What is their RBC antigen?
    Their Plasma/Serum Antibody?
    Compatible donor for RBC transfusions?
    Compatible donor for plasma transfusions?
    • Type AB is the universal recipient
    • Their RBC antigens are A and B
    • Their Plasma/Serum Antibody Neither Anti-A nor Anti-B
    • Compatible donors for RBC transfusions are A, B, AB, and O
    • Compatible donors for plasma transfusions are AB
  4. If the recipients blood group is O:
    What is their RBC antigen?
    Their Plasma/Serum Antibody?
    Compatible donor for RBC transfusions?
    Compatible donor for plasma transfusions?
    • Type O is the universal donor
    • Their RBC antigen is Neither
    • Their Plasma/Serum Antibody is Anti-A and Anti-B
    • Compatible donors for RBC transfusions are O
    • Compatible donors for plasma transfusions are A, B, AB, and O
  5. Finding: Pallor of skin or nail beds

    Description?
    Possible Etiology?
    Description: Paleness; decreased or absence of skin coloration.

    Possible Etiology: Low Hb level (anemia)
  6. Finding: Flushing

    Description?

    Possible Etiology?
    Description: Transient, episodic redness of skin (usually around face and neck).

    • Possible Etiology: Increase in Hb (polycythemia), congestion of capillaries,
    • Flushing of the palms of the hands or soles of the feet may indicate anemia
  7. Finding: Jaundice

    Description?
    Possible Etiology?
    Description: Yellow appearance of skin and mucous membranes.

    Possible Etiology: Accumulation of bile pigment caused by rapid or excessive hemolysis or liver damage.
  8. Finding: Cyanosis

    Description?
    Possible Etiology?
    Description: Bluish discoloration of skin and mucous membranes.

    Possible Etiology: Reduced Hb, excessive concentration of deoxyHb in blood
  9. Finding: Pruritis

    Description?

    Possible Etiology?
    Description: Unpleasant cutaneous sensation that provokes the desire to rub or scratch the skin

    Possible Etiology: Hodgkin's lymphoma, cutaneous lymphomas, infiltration leukemias, increased bilirubin
  10. Finding: Leg Ulcers

    Description?

    Possible Etiology?
    Description: Prominent on the malleoli on the ankles

    Possible Etiology: Sickle Cell disease
  11. Finding: Angioma

    Description?

    Possible Etiology?
    Description: Benign tumor consisting of blood or lymph vessels

    Possible Etiology: Most are congenital; some may disappear spontaneously
  12. Finding: Telangiectasia

    Description?

    Possible Etiology?
    Description: Small angioma with a tendency to bleed; focal red lesions, coarse or fine red lines

    Possible Etiology: Dilation of small vessels
  13. Finding: Spider Nevus

    Description?

    Possible Etiology?
    Description: Form of  of telangiectasia characterized by a round red central portion and branching radiations resembling the profile of a spider; usually develop on face, neck, or chest.

    Possible Etiology: Elevated estrogen levels as in pregnancy or liver disease.
  14. Finding: Purpura

    Description?

    Possible Etiology?
    Description: Any of a small group of conditions characterized by ecchymosis or other small hemorrhages in skin and mucus membranes.

    Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma
  15. Finding: Petechiae

    Description?

    Possible Etiology?
    Description:  Pinpoint, nonraised, perfectly round area < 2 mm; purple, dark red, or brown in color.

    Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma
  16. Finding: Ecchymosis (Bruise)

    Description?

    Possible Etiology?
    Description: Small hemorrhagic spot, larger than petechiae; non-elevated; round or irregular

    Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma
  17. Finding: Hematoma

    Description?
    Possible Etiology?
    Description: A localized collection of blood, usually clotted.

    Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma
  18. Finding: Chloroma

    Description?

    Possible Etiology?
    Description: A tumor arising from myeloid tissue and containing a pale, green pigment

    Possible Etiology: Acute myelogenous leukemia that has infiltrated the skin.
  19. Finding: Plasmacytoma

    Description?

    Possible Etiology?
    Description: A tumor arising from abnormal plasma cells

    Possible Etiology: Multiple myeloma that has infiltrated tissue
  20. Finding: Jaundiced Sclera

    Description?

    Possible Etiology?
    Description: Yellow appearance of the sclera

    Possible Etiology: Accumulation of bile pigment resulting from rapid or excessive hemolysis or liver disease or infiltration.
  21. Finding: Conjunctival Pallor

    Description?

    Possible Etiology?
    Description: Paleness; decreased or absence of coloration in the conjunctiva.

    Possible Etiology: Low Hb level (anemia)
  22. Finding: Blurred vision, diplopia, visual field cuts

    Description?

    Possible Etiology?
    Description: Decreased visual acuity or areas of blindness (field cuts)

    • Possible Etiology: Anemia, extreme leukocytosis, polycythemia may cause visual abnormalities
    • Thrombocytopenia may cause intracellular hemorrhage with visual abnormalities. Excessive clotting may cause thromboses in the circulation to the brain that cause visual cuts.
  23. Finding: Epistaxis

    Description?

    Possible Etiology?
    Description: Spontaneous bleeding from the nares

    Possible Etiology: May occur with low platelet counts, especially if the patient bends down for a long time period, tries to lift a heavy item or with an intense valsalva maneuver.
  24. Finding: Gingival and Mucous Membrane Changes

    Description?

    Possible Etiology?
    Description: Pallor, Gingival/mucosal ulceration, swelling or bleeding.

    Possible Etiology: Neutropenia; inability of impaired leukocytes to combat oral infections; thrombocytopenia
  25. Finding: Smooth Tongue

    Description?

    Possible Etiology?
    Description: Tongue surface is smooth and shiny; mucosa is thin and red from decreased papillae

    Possible Etiology: Pernicious anemia, iron deficiency anemia
  26. Finding: Lymphadenopathy

    Description?

    Possible Etiology?
    Description: Lymph nodes are enlarged (< 1 cm), may be tender to touch

    Possible Etiology: Infection, foreign infiltration, or systemic disease such as leukemia, lymphoma, Hodgkin's lymphoma and  metastatic cancer
  27. Finding: Tachycardia

    Description?

    Possible Etiology?
    Description: Heart Rate > 100 beats/min

    Possible Etiology: Compensatory mechanism in anemia to increase cardiac output
  28. Finding: Palpitations

    Description?

    Possible Etiology?
    Description: Sensation of feeling the heart beat, flutter, or pound in the chest.

    Possible Etiology: Anemia, fluid volume overload, hypotension with impending syncope, and dysrhythmias cause palpitations
  29. Finding: Altered blood pressure

    Description?

    Possible Etiology?
    • Description:
    •        Orthostasis: heart rate > 20 bpm increase or blood pressure > 20 mm Hg decrease from baseline when moving from a lying position to either sitting or standing.
    •        Hypotension: < 90 mm Hg systolic or > 40 mm Hg drop from baseline.
    •        Hypertension: > 130/90 mm Hg

    Possible Etiology: Orthostasis is a common manifestation in anemia, especially if also accompanied by low blood volume
  30. Finding: Sternal Tenderness

     Description?

    Possible Etiology?
    Description: Abnormal sensitivity to touch or pressure on sternum.

    Possible Etiology: Leukemia resulting from increased bone marrow cellularity, causing increase in pressure and bone marrow erosion; multiple myeloma as a result of stretching of periosteum.
  31. Finding: Low Oxygen Saturation

    Description?

    Possible Etiology?
    Description: Oxygen carrying capacity is reflected by the oxygen saturation by pulse oximetry

    Possible Etiology: Oxygen saturation may be decreased in cases of severe anemia
  32. Finding: Hepatomegaly

    Description?

    Possible Etiology?
    Description: Palpable liver

    Possible Etiology: Leukemia, cirrhosis, or fibrosis secondary to iron overload from sickle cell disease or thalassemia
  33. Finding: Splenomegaly

    Description?

    Possible Etiology?
    Description: Palpable spleen

    Possible Etiology: Anemia, thrombocytopenia, leukemia, lymphomas, leukopenia, mononucleosis, malaria, cirrhosis, trauma, portal hypertension
  34. Finding: Distended Abdomen

    Description?

    Possible Etiology?
    Description: Distended abdomen is a larger than normal abdominal profile. It may be soft or firm, tender or nontender, and accompanied by other symptoms such as nausea, vomiting, or rebound tenderness

    Possible Etiology: Lymphoma may manifest as abdominal adenopathy, mass(es), or bowel obstruction.
  35. Finding: Paresthesias of Hands and Feet; Ataxia

    Description?

    Possible Etiology?
    Description: Numbness sensation and extreme sensitivity experienced in central and peripheral nerves; impaired muscle movement

    Possible Etiology: Cobalamin (Vitamin B12) deficiency or folate deficiency
  36. Finding: Weakness

    Description?

    Possible Etiology?
    Description: Lacking physical strength or energy

    Possible Etiology: Low Hb level (anemia)
  37. Finding: Headache, nuchal rigidity

    Description?

    Possible Etiology?
    Description:  Pain in the cranium, potentially involving one area or extending from the frontal area to the back of the neck.

    Possible Etiology: Generalized headache is a common manifestation of mild to moderate anemia. Severe headache with or without visual disturbances may signal intracranial hemorrhage due to thrombocytopenia.
  38. Finding: Bone Pain

    Description?

    Possible Etiology?
    Description: Pain in pelvis, ribs, spine, sternum

    Possible Etiology: Multiple myeloma related to enlarged tumors that stretch periosteum; bone invasion by leukemia cells; bone demineralization resulting from various malignancies; sickle cell disease.
  39. Finding: Joint Swelling

    Description?

    Possible Etiology?
    Description: Fluid-Filled spaces surrounding the joints

    Possible Etiology: Occurs with hemophilia and sickle cell anemia as bleeding occurs into the joint (hemarthria) causing inflammation.
  40. Finding: Arthralgia

    Description?

    Possible Etiology?
    Description: Joint Pain

    Possible Etiology: Sickle cell disease from hemarthrosis

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