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blood and lymphatic
adult health nursing ch7 care of a pt with blood or lymphatic disorder
| Question | Answer |
|---|---|
| a viscous (thick), red fluid that contains red blood cells, white blood cells, and platelets. | blood |
| plasmalight yellow fluid that suspends the blood. | plasma |
| plasma constitutes ___% of the blood's volume. | 55% |
| how many percent of blood is composed of blood cells and platelets? | 45% |
| what is the concentration of NaCl in the body? | 0.9% NaCl |
| what is the average adult blood volume? | 5 to 6 Liters (10-12pints) |
| what are the three critical functions of the of the blood? | 1. TRANSPORT oxygen/nutrients/hormones 2. REGULATES the acid-base balance (pH) with buffers, aids in body temperature. 3. PROTECTS the body against infection. |
| what is the medical term for red blood cells | erythrocytes |
| what is the average RBC in MALE? | 5.5 million per cubic millimeter. |
| what is the average RBC in WOMEN | 4.8 million per cubic millimeter. |
| a red, iron containing pigment that transports oxygen to the tissues and the waste product carbon dioxide to the lungs. | hemoglobin (Hgb) |
| what is the normal hemoglobin level for MEN? | 14 - 18 g/dL |
| what is the normal hemoglobin in WOMEN? | 12 - 16 g/dL |
| what is the average life span of a red blood cell (RBC)? | 120 days |
| where are erythrocytes produced? | in the red bone marrow of the vertebrae, ribs, sternum, and proximal ends of the humerus and femur. |
| the process of RBC production | erythropoiesis |
| dietary substances needed for erythropoiesis (production of RBC | iron, copper, essential amino acids, vitamin B12, folic acid, vitamin B2 (riboflavin), and vitamin B6 (pyridoxine) |
| a decrease of oxygen to the kidneys, triggers the release of this enzyme? | renal erythropoietic factor (erythropoietin) |
| a laboratory test that measures the total blood volume (%) of red blood cells in a sample | hematocrit |
| what is the normal hematocrit in MEN? | 42% - 52% |
| what is the normal hematocrit in WOMEN? | 37% - 47% |
| what happens if the hemoglobin falls below the normal level? | 1.less oxygen transported to cells. 2.slower breakdown and use of nutrients by cells. 3.less energy is produced by the cells. 4.decreased cellular function. |
| what is the medical term for white blood cells (WBC)? | leukocytes |
| a blood cell composed mainly of cytoplasm and hemoglobin | red blood cell; erythrocyte; RBC |
| a blood cell that is colorless, has a nucleus, and is primarily involved in body defense. | white blood cells (WBC); leukocytes |
| the average WBC in the blood | 5,000 - 10,000 per cubic millimeter of blood |
| 2 catagories of WBC | 1.granulocytes 2.agranulocytes |
| what are the 3 types of granulocytes? | 1. neutrophils 2.eosinophils 3.basophils |
| what are the 2 types of agranulocyte? | 1.lymphocytes 2.monocytes |
| a chemical solution that is used to stain WBC | Wright's stain |
| granular circulating leukocytes with segmented nuclei, essential for phagocytosis, these cells show lavender granules when stained. | neutrophils |
| the primary phagocytic cells involved in acute inflamatory response | neutrophils |
| normal value range of neutrophils | 60% - 70% |
| what is the life span of a mature neutrophil? | 7 hours |
| what does the presence of excess band cells in the blood indicate? | severe infection |
| a type of leukocyte that plays a role in allergic reactions; show as a bright pink under stain. | eosinophils |
| normal value range of eosinophils | 1% - 4% |
| a type of leukocyte that is essential to nonspecific immune response to inflammation; release histamine during tissue damage. | basophils |
| normal value range for basophils | 0.5% - 1% |
| the largest WBC, that engulf foreign antigens and cells debris | monocytes |
| normal value range for monocytes | 2% - 6% |
| the second most numerous of WBC | lymphocytes |
| normal value range of lymphocytes | 20% - 40% |
| a lymphocyte that search, identify, and bind with specific antigens. | B cells |
| a lymphocyte that divide rapidly and produce large numbers of new cells that are sensitized to that antigen. | T cells |
| normal value range of lymphocytes | 20% - 40% |
| what would cause an increase of RBCs? | 1.dehydration 2.polycythemia 3.high altitudes 4.chronic hypoxemia |
| what causes a decrease of RBCs? | 1.anemia 2.leukemia 3.posthemorrhage |
| what causes increase of eosinophils? | allergic reactions and parasitic disorders |
| normal value range of erythrocyte sedimentation rate (ESR) in male | 0-15 mm/hr |
| normal value range of erythrocyte sedimentation rate in female | 0-20 mm/hr |
| normal values of reticulocyte count | 0.5% - 2% |
| what does an increase of reticulocytes indicate? | bone marrow hyperactivity and hemorrhage |
| normal values of platelet counts | 150,000 - 400,000 per cubic millimeter |
| normal value range of prothrombin time (PT) | 11 - 12.5 seconds |
| normal value range of international normalized ratio (INR) | 0.7 - 1.8 |
| normal value range of partial thromboplastin time (PTT) | 60 - 70 seconds |
| normal bleeding time | 1 - 9 minutes |
| clotting time | 3 - 9 minutes |
| cellular fragments that assist in clotting formation | thrombocytes (platelets) |
| platelets are fragments of which cell? | megakaryocytes |
| what is the average life span of thrombocytes (platelets)? | 10 days |
| what is the normal amount of platelets in the blood? | 150,000 - 400,000 per cubic millimeter |
| the pocess that arrests the flow of blood and prevents hemorrhage. | homeostasis |
| what are the 3 events that take place in homeostasis? | 1.contraction of the blood vessel (vasoconstriction) 2.formation of a platelet plug 3.formation of a blood clot |
| type A blood contains... | type A antigens and anti-B antibodies |
| type B blood contains... | type B antigens and anti-A antibodies |
| type AB blood contains... | both type A and type B antigens; has neither anti-A or anti-B antibodies |
| type O blood contains... | neither type A or type B antigens; but has both anti-A and anti-B antibodies |
| which blood type is the univeral donor? | type O |
| which blood type is the universal recipient | type AB |
| what are the 2 types of reactions that can occur in mismatch of blood types? | 1.agglutination 2.hemolyzation |
| another name for the Rh factor | D antigen / Rhesus monkeys |
| a condition where the mother is Rh negative and her fetus is Rh positive? | hemolytic disease of the newborn (HDN) |
| HDN or hemolytic disease of the newborn is prevented by the administration of what? | IM dose of Rho-GAM to the mother during pregnancy and to the newborn |
| what are the 3 basic functions of the lymphatic system? | 1.maintenance of fluid balance 2.production of lymphocytes 3.absorption and transportation of lipids from the intestine to the blood stream |
| fluid in the lymphatic system | lymph |
| a lymphatic vessel that conveys chyle from the intestine | lacteals |
| bean-shaped bodies located along the course of lymphatic vessels | lymph node |
| 2 functions of the lymph nodes | 1.filter impurities from the lymph 2.produce lymhpocytes |
| a short vessel that recieves only the lymph that comes from the superior right quadrant of the body: the right side of the head, neck, and thorax | right lymphatic duct |
| recieves lymph from all parts of the body except those superior to the diaphragm on the right side | thoracic duct or left lymphatic duct |
| a temporary storage pouch of the lymphatic vessel | cisterna chyli |
| the milky fluid that drains from the intestinal lacteals | chyle |
| lymph nodes located in the neck, become enlarged during upper respiratory infections | cervical nodes |
| lymph nodes located in the armpits; become enlarged after infection of the upper extremities and the breast | axillary nodes |
| lymph nodes near the trachea and the large bronchial tubes | tracheobronchial nodes |
| nodes that are between the 2 layers of peritoneum | mesenteric nodes |
| nodes located in the groin, recieve lymph from the lower extremities | inguinal nodes |
| inguinal nodes that have become enlarged | buboes |
| masses of lymphphoid tissue embedded in the mucous membrane of the oral cavity | tonsils |
| oval bodies located at the each side of the soft palate | palatine tonsils |
| lymphoid tissue located behind the nose on the posterior wall of the upper pharynx | pharyngeal tonsils or adenoids |
| lymphoid tissue at the back of the tongue | lingual tonsils |
| surgical removal of the palatine tonsils | tonsillectomy |
| surgical removal of the adenoids | adenoidectomy |
| an organ that contains lymphoid tissue that filters blood. | spleen |
| functions of the spleen | 1.filtration of blood impurities 2.destroy old, worn-out RBCs 3.produce RBC before birth 4.reservoir for blood (300-400ml) |
| surgical removal of the spleen | splenectomy |
| where is the thymus located? | upper thorax behind the sternum |
| what kind of immune system cells develop in the thymus? | T lymphocyes |
| a fingerlike tube of lymphatic tissue attached to the large intestine | appendix |
| clusters of lymphatic nodules located in the mucous membranes lining the small intestine | peyer patches |
| macrophages located in the lining of the liver sinusoids | kupffer cells |
| macrophages located in the lungs | dust cells |
| cells that destroy worn-out blood cells, bacteria, cancer cells and other foreign substances | reticuloendothelial system |
| diagnostic test that detects many disorders of the hemotological system. | complete blood count (CBC) |
| measurements of the sizes and hemoglobin content of red blood cells | erythrocyte indices |
| measurement that provides information about the average volume of size of a single RBC | mean corpuscular volume (MVC) |
| measure of the average amount (weight) of hemoglobin within an RBC | mean corpuscular hemoglobin |
| a measure of the average concentration or the percentage of hemoglobin within an RBC | mean corpuscular hemoglobin concentration |
| examination of the size, shape and structure of individual RBCs and platelets | peripheral smear |
| a laboratory blood test that measures the absorption of radioactive vitamin B12. | Schilling test or megaloblastic anemia profile |
| bone marrow aspiration or biopsy is done on which bone? | posterior iliac crest, sternum. |
| a radiologic examination used to detect metastatic involvement of the lymph nodes | lymphagiography |
| inflammation of the lymphatic vessels | lymphangitis |
| blood poisoning | septicemia |
| inflammation of the lymph nodes | lymphadenitis |
| edema due to obstruction of lymph flow | lymphedema |
| enlargement of the lower extremities resulting from lymphatic vessel blockage by small worms | elephantiasis |
| worm that causes enlargement of the lower extremity | filariae worm |
| enlargement of the lymph nodes; early sign of HIV | lymphadenopathy |
| acute viral infection, marked by enlargement of the cervical lymph nodes. | infectious mononucleosis or "kissing disease" |
| enlargement of the spleen | splenomegaly |
| any tumor, benign or malignant that occurs in lymphoid tissue | lymphoma |
| a chronic malignant disease that appears as painless enlargement of lymph nodes, with the presence of Reed-Sternberg cells in biopsy of node. | Hodgkin disease |
| a chronic malignant disease that appears as painless enlargement of lymph nodes, without Reed-Sternberg cells in biopsy of node. | non-Hodgkin lymphoma |
| abnormally low level of hemoglobin or red cells in the blood | anemia |
| an increase in the number of white cells | leukemia |
| anemia caused by excessive destruction of red cells | hemolytic anemia |
| signs and symptoms of anemia | anorexia, fatigue, headache, pallor mucous membranes and skin, vertigo |
| lab tests to identify anemia | 1.blood studies 2.reticulocyte count 3.bone marrow study 4.peripheral blood smears 5.megaloblastic anemia profile |
| medical management of anemia | intervention depends on the cause. 1.blood transfusion 2.replacement of iron and vitamin B12 |
| abnormally low circulating blood volume from hemorrhage of 1000mL or more | hypovolemic anemia (blood loss anemia) |
| jehovah's witness consideration | opposed to blood transfusion. always ask for the card that show the different types of blood expanders to use. |
| signs and symptoms of hypovolemia | weakness, irritability, pale cool moist skin, oliguria, hypotension, tachycardia, and hypothermia |
| medical management for hypovolemia | control bleeding and replace the volume of fluid loss. oxygen therapy. supplemental iron |
| nursing interventions for hypovolemia | monitor blood and fluid restoration. control bleeding. keep patient flat and warm. vital signs are obtained frequently. measure I&O. |
| the result of the absence of a glycoprotein intrinsic factor secreted by the gastric mucosa that is essential for absorption of vitamin B12 (cyanocobalamin) | pernicious anemia |
| signs and symptoms of pernicious anemia | extreme weakness, weight loss, slight jaundice with pallor, complaints of palpitations, nausea, flatulence, indigestion, sore red tongue, dysphagia, partial or total paralysis |
| diagnostic tests to identify pernicious anemia | Schilling test, megaloblastic anemia, bone marrow aspiration, gastric analysis, |
| medical management of pernicious anemia | cyanocobalamin (vitamin B12), folic acid, iron replacement, blood transfusion, |
| nursing interventions for pernicious anemia | interventions depend on the extent, and the symptoms of the disease. vitals are frequently monitored. frequent oral care. diet should be high in protein, vitamins and minerals. keep pt warm. |
| failure of the normal process of cell generation and development in the bone marrow are reduced or absent | aplastic anemia |
| signs and symptoms of aplastic anemia | general malaise, bleeding tendencies, pallor, dyspnea, and tachycardia |
| diagnostic tests for aplastic anemia | bone marrow study, peripheral blood smears |
| medical management for aplastic anemia | identify the cause of acquired aplastic anemia and discontinue exposure. blood transfusions are AVOIDED. splenectomy. bone marrow transplant. |
| nursing interventions for aplastic anemia | prevent infection. prevent hemorrhage. prevent fatigue |
| a condition in which RBCs contain decreased levels of hemoglobin, or excessive iron loss. | iron deficiency anemia |
| causes of iron deficiency anemia | inadequate dietary intake, malabsorption of iron, blood loss. |
| signs and symptoms of iron deficiency anemia | pallor, glossitis (inflammation of the tongue), pagophagia (desire to eat ice, clays, or starches), headache, paresthesia, tachycardia, fingernails may be fragile and spoon-shaped, MM of the mouth are inflamed. |
| diagnostic tests used to identify iron deficiency anemia | peripheral blood counts. |
| medical management for iron deficiency anemia | iron salts (900mg ferrous sulfate), ascorbic acid, food sources, Z-track IM administration of iron dextran (DexFerrum), IV administration of iron sucrose (Venofer) |
| nursing interventions for iron deficiency anemia | interview pt for the posibble causes of anemia, educate pt about foods high in iron, explain the side effects of iron therapy such as black tarry stools, report signs and symptoms of diarrhea and nausea to the physician. |
| abnormal cresent-shaped RBC that occurs predominantly in the african american population | sickle cell anemia |
| signs and symptoms of sickle cells anemia | pt is asymptomatic except during sickle cell crisis, where the pain is severe due to tissue ischemia. aching joints of the hands and feet. abdominal enlargement. jaundice. edema of the exremities. |
| diagnostic tests for sickle cell anemia | electrophoresis. blood staining. |
| medical management for sicke cell anemia | there is no specific treatment for sickle cell anemia. tratment is usually to alleviate the symptoms. |
| nursing interventions for sickle cell anemia | supportive treatment follow signs and symptoms: hydration, analgesia, monitor for fever and infection |
| a myeloproliferative disorder of circulating erythrocytes, granulocytes, and platelets. | primary polycythemia (polycythemia vera) |
| an abnormal increase in the number of circulating red blood cells | erythrocytosis |
| a physiologic response in which the production of red blood cells are stimulated to compensate for a hypoxic problem rather than a pathologic response | secondary polycythemia |
| signs and symptoms of polycythemia(erythrocytosis) | venous distension, esophageal varices, epistaxis, GI bleeding, petechiae, hepatomegaly, splenomegaly, complaints of satiety and fullness, sensitivity to hot and cold, generalized pruritus, headaches, vertigo, tinnitus, blurred vision, eczema, hypertension |
| medical management for polycythemia (erythrocytosis) | phlebotomy of 500-2000mL of blood, treatment is directed at reducing blood volume and viscosity, and bone marrow activity. myelosuppressive agents:busulfan(myleran), hydroxyurea(hydrea), radioactive phosphorus and allopurinol. |
| nursing interventions for secondary polycythemia | maintain adequate oxygenation;controlling chronic pulmonary disease, avoiding high altitudes. |
| nursing interventions for polycythemia vera | carefully monitor I&O, avoid fluid overload and dehydration.Avoid foods that contain iron,while increasingcalories and protein.Active or passive ROMs to prevent thrombus formation.phlebotomy to reduce blood volume. |
| a condition in which the number of leukocytes in the circulating blood is lower than normal | leukopenia |
| an acute condition characterized by pronounced leukopenia | agranulocytosis |
| signs and symptoms of agranulocytosis | fever, chills, headache, fatigue are symptoms associated with infection. Ulceration of mucous membrane. Bronchial pneumonia, UTI. |
| medical management of agranulocytosis | the main objective is to alleviate the factors responsible for bone marrow depression and to prevent or treat infection. Immunocompromised (neutropenic) precautions are instituted. |
| nursing interventions for agranulocytosis | protect the pt from potential sources of infection. monitor for signs of infection. provide soft, bland diet high in protein, vitamins, and calories. meticulous handwashing and strict asepsis are mandatory. |
| a malignant disorder of the hematopoietic system in which an excess of leukocyte accumulates in the bone marrow and lymph nodes | leukemia |
| 4 major types of leukemia | acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML) |
| signs and symptoms of leukemia | enlarged lymph nodes and painless splenomegaly are the first signs of leukemia, hepatomegaly, lymphadenopathy, bone pain, meningeal irritation, pain in bones and joints, fatigue, malaise, activity intolerance, and irritability. |
| diagnostic tests for leulemia | bone marrow biopsy, lymph node biopsy, peripheral blood smear |
| medical management of leukemia | treatment is aimed at eradicating the leukemia with chemotherapy or bone marrow transplant. medications commonly used are: chlorambucil (Leukeran), hydroxyurea, corticosteroids, and cyclophosphamide (Cytoxan). |
| nursing interventions for leukemia | prevent infection by neutropenic precautions. provide gentle care to avoid hemorrhage. Promote positive nurse-patient-family relatonship. |
| any manifestation that alters the clotting mechanism. | coagulation disorder |
| signs and symptoms | petechiae, ecchymoses, epistaxis, gingival bleeding, circulatory hypovolemia, GI tract bleeding, complaints of headache, extremity pain and numbness, pain on pressure to the abdomen, revealing liver and spleen tenderness, joint pain. |
| signs and symptoms of hypovolemic shock | hypotension, pallor, cool clammy skin, tachycardia |
| diagnostic tests for coagulation disorders | platelet counts will be low, coagulation time is altered, abnormal bone marrow cells |
| medical management of clotting disorders | the underlying cause is assessed and corrected, replacement transfusions may be ordered. medication toxicity is considered. |
| nursing interventions for coagulation therapy | interventions depend on signs and symptoms, monitor vital signs for hypovolemic shock, move pt gently to prevent trauma to tissues. |
| an abnormal hematological condition in which the number of platelets is reduced to fewer than 150,000/mm3. | thrombocytopenia |
| the most common cause of increased destruction of platelets, which may be drug induced or immune thrombocytopenic purpura. | thrombocytopenic purpura |
| an autoimmune disease where platelets reach the spleen, recognized as foreign, and are destroyed by macrophages in the spleen. | immune thrombocytopenic purpura (ITP) |
| signs and symptoms of thrombocytopenia | major signs are petechiae and ecchymoses, bleeding in the mucous membranes, cutaneous sites, and internal organs, epistaxis, gingival bleeding, intracranial pressure may be caused by cerebral hemorrhage. |
| diagnostic tests for thrombocytopenia | complete laboratory studies, platelet count, peripheral blood smear, bleeding time, bone marrow aspiration. |
| medical management of thrombocytopenia | primary treatments are corticosteroid therapy(suppress the phagocytic response of splenic macrophages), splenectomy, immunosuppressive drugs. transfusions with platelet concentrates. |
| nursing interventions for thrombocytopenic | support medical treatment. if medication toxicity is the cause, medication is discontinued.infections are prevented by meticulous asepsis. avoid trauma, use stool softeners, maintain high-fiber diet to prevent constipation, check for bleeding. |
| a hereditary coagulation disease characterized by the absence of antihemophilic factor VIII (essential for conversion of prothrombin to thrombin) | hemophilia A |
| a herediatary coagulation disorder characterized by a deficiency of factor IX with the absence of plasma thromboplastin component, resulting in the nonformation of thromboplastin | hemophilia B (christmas disease) |
| an X-linked hereditary trait that affects mainly males; females are carriers | hemophilia |
| signs and symptoms of hemophilia | internal or external hemorrhage, large ecchymoses in tissue, joints are ankylosed, hemarthrosis(bleeding in the joint space) is a hallmark sign. pain, edema, erythema, and fever accompany hemarthrosis, blood in the urine or stool. edematous immobile joint |
| diagnostic tests for hemophilia | coagulation profiles, PTT, INR, PT |
| medical management for hemophilia | preventing and treating bleeding, relieving pain are the main focus in care. Transfusions and administration of factor VIII or IX concentrate may be prophylactic or to stop hemorrhage. |
| nursing interventions for hemophilia | control hemorrhages by applying pressure and cold to the site. Monitor transfusions. Pt should NOT be given aspirin. wear medical bracelet ID tag. Immobilize affected part, apply pressure and ice, notify the physician. |
| a hereditary bleeding disorder characterized by abnormally slow coagulation of blood and spontaneous episodes of GI bleeding, epistaxis, and gingival bleeding caused by a mild deficiency of factor VIII | Von Willebrand's Disease |
| treatment for von willebrand's disease | administration of cryoprecipitate containing factor VIII, fibrinogen, or fresh plasma. Desmopressin (DDAVP)-a synthetic form of vasopressin. |
| a synthetic of the human diuretic hormone, vasopressin. causes an increase in factor VIII release from storage sites of the body. Often administered as a prophylactic to pts with mild hemophilia who require surgery or dental extractions. | Desmopressin (DDAVP) |
| a grave coagulopathy resulting from the overstimulation of clotting and anticlotting processes in the response to disease or injury. | Disseminated Intravascular Coagulation (DIC) |
| signs and symptoms of DIC | bleeding in the mucous membranes, venipuncture or surgical sites, GI and urinary tracts, generalized bleeding. Dyspnea, hemotypsis, purpura on the chest and abdomen, fibrin deposits in capillaries is the common first sign of DIC. |
| diagnostic tests for DIC | coagulation profile, platelet count, D-dimer test. tests show deficits in factors V, VII, VIII, X XII. |
| medical management for DIC | in treating DIC the underlying cause is addressed and corrected and transfusion replcement and cryoprecipitate are ordered. Heparin therapy. Fibrinolytic inhibitors. Fresh frozen plasma. |
| nursing interventions for DIC | protection from bleedinf and trauma and pressure to sites of hemorrhage are important. provide a quiet nonstressful environment.Side rails are padded, foam is used to brush teeth.blood pressure cuffs is used INFREQUENTLY. |
| a malignant neoplastic immunodeficiency disease of the bone marrow, where plasma cells destroy osseous tissue | Multiple myeloma or Plasma cell myeloma |
| specific immunoglobulin produced by the myeloma cells is present in the blood and/or urine. This protein is a helpful marker to monitor the extent of plasma cell myeloma. | monoclonal protein |
| signs and symptoms of multiple myeloma or plasma cell myeloma | complaints of bone pain that increases with movement. disease process will show proliferation of malignant plasma cells. |
| diagnostic tests for multiple myeloma or plasma cells myeloma | radiographic skeletal studies, bone marrow biopsy, and laboratory examination of blood and urine. Serum or urine electrophoresis. |
| an abnormal globulin protein found in the urine of a pt with multiple myeloma and can result in renal failure. | Bence Jones protein |
| medical management of multiple myeloma or plasma cell myeloma | treatment is symptomatic since multiple myeloma is not curable.Radiation and chemotherapy to reduce tumor size.Alkylating agents, such as melphalan (Alkeran), cyclophosphamide (Cytoxan), chlorambucil (Leukeran), carmustine (BCNU). |
| nursing interventions for multiple myeloma or plasma cell myeloma | interventions are focused of pain relief, preventing infection and bone injury, administrating chemotherapy and radiation, and maintaining hydration. Ambulation and weight bearing helps reabsorb some calcium. handle pt carefully. |
| inflammation of one or more lymphatic vessels caused by streptococcal or staphylococcal infection. | lymphangitis |
| signs and symptoms of lymphangitis | fine red streaks from the affected area in the groin or axilla. Diffused edema. Chills, fever, local pain, headache, myalgia, septicemia may occur;lymph nodes are enlarged. |
| medical management for lymphangitis | penicillin or other antimicrobial drugs to control infection. Hot, moist heat-soaks or packs-bring comfort. |
| nursing interventions | aseptic technique promotes healing. Rest and extremity elevation may relieve pressure. |
| a primary or secondary disorder characterized by the accumulation of lymph in soft tissue and edema, caused by obstruction in the lymph channels | lymphedema |
| signs and symptoms of lymphedema | massive edema and tightness cause pressure and PAIN in the extremity. |
| diagnostic test for lymphedema | Lymphangiography is used to differentiate lymphedema from venous disorders. |
| medical management for lymphedema | diuretics, antimicrobials, mechanical management such as compression pumps, and elastic sleeves or stockings. Restrict sodium and spicy food intake, limit fluid intake. |
| nursing interventions for lymphedema | the primary goal is to increase lymphatic drainage and avoid trauma. Elevate extremities.Avoid constrictive clothes.meticulous skin care to prevent infections. |
| a malignant disorder characterized by painless, progressive enlargement of lymphoid tissue.disease occurs more frequenly in people who have had mononucleosis(an infection caused by the EpsteinBarr Virus) | Hodgkin's disease |
| atypical histiocytes consisting of large, abnormal, multinucleated cells in the lymphatic system found in Hodgkin's disease. | Reed-Sternberg cells |
| signs and symptoms of Hodgkin's disease. | initial development is often enlargement of the cervical, axillary, or inguinal lymph nodes. Enlarged lymph nodes are NOT painful, anorexia, weight loss, night sweats, malaise, and extreme pruritus. |
| diagnostic tests for hodgkin's disease | peripheral blood studies, chest radiographic examination, CT scans, lymph node biopsy,bone marrow biopsy. |
| medical management of hodgkin's disease | treatment depends on the staging process. Radiation therapy is used for stage 1 and stage 2. Chemotherapy and radiation therapy is used to treat stage 3 and stage 4. |
| drugs used to treat Hodgkin's disease | MOPP or mechlorethamine(Mustargen) aka nitrogen mustard, vincristine(Oncovin), procarbazine(Matulane), and prednisone. Cyclophosphamide(Cytoxan). ABVD or doxorubicin(Adriamycin), bleomycin(Blenoxane), vinblastine(Velban), and dacarbazine(DTIC-Dome). |
| Neupogen | used to decrease infection in patients recieving antineoplastics that suppress neutrophil production. |
| nursing interventions for Hodgkin's disease | comfort measures focus on skin integrity.Soothing baths with an antipuritic medication. Fever and perspirations may be controlled with medications. Provide information on radiotherapy and chemotherapy. |
| a neoplastic disorder of lymphoid tissue characterized as a neoplasm of the immune system | Non-Hodgkin's Lymphoma (NHL) |
| signs and symptoms of NHL or non-hodgkin's lymphoma | painless, enlarged lymph nodes found in the cervical area, fever, weight loss, night sweats, anemia, pruritus,pleural effusions, bone fractures, and paralysis are complications. complaints of fatigue, malaise, and anorexia. |
| diagnostic tests for NHL | bone scan study, blood studies, Coomb's test, chest roentgenogram, CT scans of the chest, abdomen, and pelvis, gallium scan, lymphangiogram, biopsies of lymph nodes, liver and bone marrow. |
| medical management for NHL | Accurate staging is crucial to determine the treatment regimen. Chemotherapy and radiation.clyclophosphamide(Cytoxan), vincristine(Oncovin), prednisone, doxorubicin(Adriamycin), bleomycin, methotrexate, rituximab(Rituxan), ibitumomab(Zevalin) |
| nursing interventions for NHL | supportive care of the pt during radiationand chemotherapy is primary in nursing management.Observe for compilcations. |
| stage 1 of Hodgkin's disease | abnormal single lymph nodes |
| stage 2 of Hodgkin's disease | two or more abnormal lymph nodes on the same side of the diaphragm |
| stage 3 of Hodgkin's disease | abnormal lymph node regions on both sides of the diaphragm |
| stage 4 of Hodgkin's disease | diffuse and disseminated involvement of one or more extralymphatic tissues and/or organs |
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justaboredpinay
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