Med Surg

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Med Surg
2013-07-11 10:27:19
Chapter 27

Hemo and Lymph System
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  1. General functions of blood?
    transportation of nurtients, oxygen, cellular wastes

    Regulation of blood pressure, pH, fluid balance

    transportation of cells
  2. blood cells are suspended in what?
    the blood plasma
  3. The blood is made of what?
    formed elements: RBC, WBC, platelets and plasma
  4. The formed elements in the blood are made by what? Which is found where?
    Produced by the red bone marrow a hemopoietic tissue found in the flat bones, irregular bones and the epiphyses of long bones ( in children)
  5. Liquid portion of the blood
  6. Plasma contains what clotting factors?
    prothrombin and fibrinogen
  7. Fibrinogen and Prothrombin are made synthesized where?
    the liver
  8. Albumin?
    synthesized by the liver, and helps to maintain blood pressure and blood volume by pulling tissue fluid into the venous ends of the capillary network
  9. Alpha and beta globulins are what? and are found where to do what?
    they are antibodies, that are found in the plasma, and hlep with immunity
  10. Mature RBC do not have what
    a nucleus
  11. RBC carry what?
    Oxygen bonded to the iron on the hemoglobin
  12. Lack of iron, hemoglobin or RBC can cause what?
    Anemia, SOB and weakness
  13. Rate of RBC production is influenced by what?
    the blood oxygen level
  14. When the blood O2 level is low, the _____ will secrete ____ in order to _____ (increase/decrease) RBC production
    kidneys; erythropoeitin; increase
  15. reticulocyte
    immature red blood cell
  16. What are some of the dietary requirements required for the normal production of RBC
    • Protein
    • Iron
    • Folic Acid
    • Vitamin B12
  17. RBC live for about how long?
    120 days
  18. When RBC die, they are phagocitized by what?
    the liver
  19. Iron is returned to where after the RBC die?
    Red bone marrow or is stored in the liver
  20. The heme portion of the hemoglobin is converted to what?
    The liver converts heme to bilirubin which is excreted into bile for elimination into the feces
  21. Increased bilirubin levels can cause what?
  22. Neutrophils
    First line of defense in an infection
  23. Eosinophils
    are increased in an allergic rxn; combat the effects of histamine
  24. Basophils
    apart of the inflammatory response
  25. Capillaries do not have what?
    they do not have smooth muscle so they cannot constrict
  26. How do platelets form a platelet plug?
    they become sticky and adhere to the rough edges of the broken capillary and to one another
  27. prothrombinase converts _____ to _____?
    prothrombin to thrombin
  28. thrombin converts _____ to _____?
    fibrinogen to fibrin to form the clot
  29. What mineral is needed for clotting?
  30. If the red bone marrow fails to produce RBC, which to organs will perform this function?
    the liver and spleen
  31. The spleen contains _____; that conduct immune responses...
    B cells and T cells
  32. Signs and symptoms of abnormal bleeding?
    • petechiae
    • ecchymoses
    • purpura
  33. small purplish hemorrhagic spots under the skin?
  34. Larger areas of discoloration from hemorrhage under the skin/ bruising...
  35. Hemorrhage under the skin, mucous membranes and organs
  36. Subjective Data
    • bleeding tendency
    • - any nosebleeds or unusual bleeding?
    • - bloody or black stools?
  37. Objective Data
    Clubbed fingers == hypoxia or anemia
  38. Less efficient immune system
    === risk for infection
  39. iron deficiency
    risk for anemia
  40. slowed erythrocyte production
    risk for anemia
  41. reduced plasma volume
    increased risk for dehydration
  42. Bone marrow Biopsy
    obtained from the sternum, spinous processes of vertebrae, or iliac crest
  43. INR
    • International normalization ratio
    • ---Therapeutic Range : 2.0 - 3.0
  44. What size needle can you use for blood administration?
    18 - 20 G
  45. What is the only solution that you should use with blood administration?
    Normal Sterile Saline
  46. How long can you allow blood to hang for?
    • No longer that 4 hours
    • Usually 2-4 hours
  47. When administering blood; a transfusion reaction usually occurs when?
    During the first 5 - 15 mins
  48. Hemolytic Reaction to blood signs and symptoms?
    back pain, chest pain, chills, fever, SOB, N/V,
  49. At the first sign of a tranfustion reaction what should you do?
    Stop transfusion and stay with the patient
  50. What is circulatory overload caused by?
    A rapid transfusion in a short amount of time
  51. Signs and symptoms of Circulatory Overload?
    Chest pain, cough, frothy sputum, distended neck veins, crackles and wheezes