A lot of nursing stuff
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| Iron level in men | show 🗑
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| Iron level in women | show 🗑
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| RBC's in Men | show 🗑
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| RBC's in Women | show 🗑
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| Hgb levels in Men | show 🗑
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| HGB levels in Women | show 🗑
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| Reticulocytes in Men | show 🗑
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| show | .5-2.5
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| show | 45-54
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| show | 36-46
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| show | 81-98
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| show | low mcv, low mchc, low hgb, low hct, low serum iron, HIGH tibc
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| Pernicious anemia (vit B12 deficiency anemia) lab values | show 🗑
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| show | HIGH mcv, NORMAL mchc, low hgb, low hct, low folate
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| MCHC levels in men and women | show 🗑
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| show | 150,000-400,000
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| show | 11-15 sec
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| PTT normal value | show 🗑
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| APTT normal value | show 🗑
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| show | 200-200
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| show | <400-500
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| The nurse should be aware that following a gastrectomy, a client may develop pernicious anemia becaus | show 🗑
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| show | b. Decreased production of platelets
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| show | a. Lack of production of RBC’s
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| show | a. Iron deficient anemia
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| A physican prescribes one tablet of ferrous sulfate daily experiences heavy menstral cycles. The nurse advises the patient and her mother that this over the counter medication must be taken for how long for iron replenishment to occu | show 🗑
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| Sickle shaped erythrocytes cause: | show 🗑
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| Nursing assessment of a patient with leukemia should include observation for which of the following signs/symptoms (select all that apply). | show 🗑
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| show | not able
to absorb this vitamin.
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| show | medications,
stomach or bowel surgery, and certain diseases
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| Sometimes vitamin B12 deficiency occurs in strict vegetarians and people who eat less | show 🗑
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| In older people, the most common cause of vitamin B12 deficiency is when their bodies | show 🗑
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| Folate deficiency is often caused by an unbalanced diet that does not include | show 🗑
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| show | pregnancy, breastfeeding, alcohol abuse, and growth spurts
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| show | fatigue, poor appetite,
weight loss, and diarrhea
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| show | weakness, poor coordination, and
numbness or a “pins and needles” feeling in the hands and
feet. Mild irritability and forgetfulness are other early signs
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| A severe untreated deficiency can result in serious damage to | show 🗑
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| Ferritin: Normal levels | show 🗑
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| show | means the mass of the RBCs is low.
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| show | the heme, or oxygen-carrying capacity
of the RBC, is low
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| MCV: Normal 82 to 98 cmm. A value of 31.6 cmm means | show 🗑
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| show | the cells are large and defi cient in iron. This is helpful in
distinguishing anemia of chronic disease from iron defi ciency anemia.
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| Fe: Normal 65 to 165 mcg/dl. An iron value of 30 mcg/dl indicates | show 🗑
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| Ferritin: Normal 18 to 160 mg/dl. Ferritin is more specifi c and sensitive than the iron level. A low level indicates | show 🗑
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| show | Number of erythrocytes (red blood cells or RBC’s)
Quantity of hemoglobin
Volume of packed RBC’s (hematocrit)
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| anemia causes | show 🗑
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| show | Mild 10-14 g/dl
Moderate 6-10 g/dl
Severe < 6 g/dl
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| show | Iron Deficiency (blood Loss)
Nutritional deficiency (Vitamin B12 or Folate)
May not tolerate well if underlying cardiac or pulmonary disease is present
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| anemia pallor | show 🗑
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| show | ↑ concentration of serum bilirubin
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| anemia puritis...itching | show 🗑
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| show | Genetic
Viral pathogens
Radiation damage
Chemical exposure
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| show | suddenly
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| acute Leukocyte development is halted causing a | show 🗑
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| show | several months to years
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| chronic Leukocyte development is not halted and therefore progresses | show 🗑
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| show | Monocytes
Granulocytes
Erythrocytes
Platelets
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| show | Most common nonlymphocytic leukemia
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| AML Affects all ages with a peak at age ??? | show 🗑
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| show | Fever and infection (Neutropenia)
Weakness and fatigue (Anemia)
Bleeding tendencies (Thrombocytopenia)
Pain from an enlarged liver or spleen (Proliferation of leukocytes)
Hyperplasia of the gums (Proliferation of leukocytes)
Bone pain (Expansion
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| show | Complete Blood Count (CBC)
↓ erythrocytes
↓ Platelets
Bone marrow analysis
↑ immature blast cells
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| show | Infection (Lack of mature granulocytes)
Bleeding (Thrombocytopenia)
Purpura
Gastrointestinal
Intracranial
Pulmonary
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| show | achieve REMISSION
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| show | aggressive chemotherapy
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| show | (Irradiate leukemic cells
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| AML supportive care | show 🗑
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| show | ↑ Potassium
↑ Phosphate
↑ Uric acid (renal stone formation and Acute Renal Failure ARF)
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| show | Tumor Lysis Syndrome
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| Gastrointestinal complications of AML treatment | show 🗑
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| show | Mutation of myeloid stem cell with uncontrolled proliferation of cells (Philadelphia chromosome)
Marrow expand into the lone bones and the liver & spleen
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| show | 20 under incidence increases with age (mean is 55-65 and life expectancy 2-5 years)
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| CML clinical manifestations | show 🗑
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| show | Chronic Stage
Gleevevc (imatinib mesylate)
Injectable chemotherapeutic agents
Roferon A (interferon alfa)
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| show | Induction therapy
Consolidation
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| A patient with chronic myeloid leukemia (CML) is receiving chemotherapy. What precautions should this patient be taking while on chemotherapy | show 🗑
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| show | Uncontrolled proliferation of immature cells from lymphoid cells
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| show | Most common in young children
Boys
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| All'''' | show 🗑
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| All has the following | show 🗑
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| show | Expected outcome is complete remission
Induction Therapy
Corticosteroids
Vinc Alkaloiods
Chemotherap
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| CLL definition | show 🗑
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| CLL is--------- | show 🗑
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| show | Early
↑ Lymphocyte count (>100,000 mm3)
Small lymphocytes
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| show | Late
Anemia
Thrombocytopenia
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| show | Fever
Sweats
Weight loss
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| Other CLL manisfestations | show 🗑
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| show | no treatment/ most often initiated in the later stage
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| CLL nursing diagnosis | show 🗑
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| CLL manage bleeding by: | show 🗑
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| CLL manage bleeding by: | show 🗑
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| show | Permit no flossing of teeth and no commercial mouthwashes.
Use only soft-bristled toothbrush for mouth care.
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| CLL mouth care | show 🗑
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| show | Avoid suctioning if at all possible; if unavoidable, use only gentle suctioning.
Discourage vigorous coughing or blowing of the nose.
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| show | Use only electric razor for shaving.
Pad side rails as needed.
Prevent falls by ambulating with patient as necessary
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| show | Control mucocitis
Analgesics and Antiemetics
Small, frequent feedings of foods that are soft in texture and moderate in temperature (avoiding uncooked fruits or vegetables and those without a peelable skin)
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| show | Nutritional supplements
Daily body weight with I and O is useful in monitoring fluid status
Both calorie counts and more formal nutritional assessments are useful.
Parenteral nutrition is often required to maintain adequate nutrition
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| show | Acetaminophen is typically given to decrease fever, but it does so by increasing diaphoresis
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| show | Sponging with cool water may be useful, but cold water or ice packs should be avoided because the heat cannot dissipate from constricted blood vessel
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| CLL sheets and massage | show 🗑
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| CLL and Faigue | show 🗑
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| CLL and fluids | show 🗑
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| CLL nursing fluid actions | show 🗑
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| what happens in the cardiac during anemia | show 🗑
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| what happens in the GI during anemia | show 🗑
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| what happens nueromuscular in anemia | show 🗑
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| show | Fatigue r/t decreased hemoglobin and decreased oxygen carrying capacity of the blood
Altered nutrition: less than body requirements
Altered tissue perfusion r/t inadequate blood volume
Noncompliance with therapeutic regime
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| show | Decrease Fatigue
Maintain Adequate Nutrition
Increase Tissue Perfusion
Compliance with Therapeutic Regime
Absence of complications
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| facts on iron oral meds | show 🗑
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| show | Stain teeth
Take with a straw/Rinse after use
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| show | iron, vitamin B12, or folate deficiency, decreased erythropoietin production, cancer
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| Hemolytic: excess destruction of RBCs Due to | show 🗑
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| 3 alterations in Erythropioesis that ↓ RBC production | show 🗑
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| Most common type of anemia Related to ↓ hemoglobin synthesis AT Risk Groups | show 🗑
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| Most common cause of anemia is? | show 🗑
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| General manifestations of anemia What is the most common finding | show 🗑
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| Lab values for iron def. anemia? | show 🗑
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| show | Side lying or prone
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| patient education on aspiration/bone biopsy | show 🗑
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| location for bone aspiration or biopsy | show 🗑
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| Post biopsy/aspiration care | show 🗑
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| show | Diet teaching
Supplemental iron
Discuss diagnostic studies
Iron therapy for 6-12 months after the hemoglobin levels return to normal (sometimes lifelong)
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| megoblastic anemia is caused by | show 🗑
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| show | Large erythrocytes
Abnormal ↑ in the number of cells (Hyperplasia)
Pancytopenia (↓leukocytes and platelets)
Increased MCV due to large erythrocytes (110um3)
Majority of deficiencies from Folic Acid and Vitamin B
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| show | no, there is Absence of IF
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| causes for absence of IF | show 🗑
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| what is another name for Vit b12 deficiency? | show 🗑
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| show | by a B12 Deficiency
No secretion of IF
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| show | General symptoms of anemia
Gradual onset
Glossitis
Gastrointestinal
Anorexia
Nausea
Vomiting
Abdominal pain
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| show | Weakness
Paresthesias of the feet and hands
↓ Vibratory and position senses
Ataxia
Muscle weakness
Impaired thought process
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| what test due you use for pernicious anemia? | show 🗑
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| show | 24H urine test determine if patient lacks intrinsic factor by measuring excretion of radioactive, oral Vitamin B12
RBC's large abnormal contributes rbc destruction
Normal folate levels, ↓ iron levels suggest megaloblastic anemia due to iron deficiency
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| what is IF | show 🗑
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| show | DNA synthesis
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| A deficiency in iron can be detected in about | show 🗑
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| Erythrocyte (RBC) formation and maturation is altered in? | show 🗑
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| causes for Folic Acid Deficiency | show 🗑
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| Clinical manifestations for Folic Acid deficiency are? | show 🗑
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| show | Fortified soy milk
Folic Acid is found in green leafy vegetables
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| medication for Folic Acid deficiency are? | show 🗑
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| show | Assessment of the skin and mucous membranes is important
Jaundice
Vitiligo
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| Nutritional counseling for folic acid def. related to eating with | show 🗑
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| show | gate
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| Aplastic anemia definition | show 🗑
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| show | the marrow cells
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| in aplastic anemia, Bone Marrow is replaced with | show 🗑
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| show | and impairs the production of:
Erythrocytes
Platelets
Leukocytes
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| aplastic anemia Acquired Idiopathic-------- | show 🗑
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| aplastic anemia can be genetic due to | show 🗑
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| clinical maifestation of aplastic anemia | show 🗑
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| medical management for aplastic anemia | show 🗑
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| show | Red blood cells (which carry oxygen to your tissues)
White blood cells (which fight infection)
Platelets (which help your blood clot
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| In a bone marrow transplant, you will receive | show 🗑
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| show | is the soft, fatty tissue inside your bones. Stem cells are immature cells in the bone marrow that give rise to all of your blood cells
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| show | Autologous
Allogeneic
Umbilical cord blood transplant
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| show | Monitor patient for Pain, Chills, Fever, Hives, Chest pain, Drop in blood pressure, Shortness of breath, Nausea, Flushing, Headache, and Funny taste in the mouth
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| show | Infection
Neutropenia (↓ neutrophils)
Bleeding
Thrombocytopenia (↓ platelets)
Safety
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| Neutrophil count <2,000 mm3 this is neutropenia, why? | show 🗑
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| show | Corticosteroids
Withholding or reducing chemotherapy dosage
Hospitalization
If febrile cultures of urine, blood and sputum are obtained for adequate treatment
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| neutropenic precautions | show 🗑
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| show | No visitors with colds
No fresh flowers
No fresh fruits or vegetables
Have patient wear HEPA filter mask when they ambulate
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| show | Oral Care
Preventing Infections
Self-care
Nutrition
Photosensitivity
Monitoring for potential problems
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| what is Graft-versus-host disease (GVHD | show 🗑
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| show | Erythrocytes have a shortened life span ↓ the number present in circulation and O2 levels (related to diminished availability of erythrocyte precursors)
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| show | ↑ production of erythropoietin from the kidneys to produce more erythrocytes
Erythrocytes are released prematurely as reticulocyte
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| Causes of hemolytic anemia | show 🗑
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| clinical manifestations of hemolytic anemia | show 🗑
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| complications of hemolytic anemia? | show 🗑
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| show | Signs & Symptoms
Pain
Swelling
Fever
Cold/Chills
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| show | Bone Marrow Transplantation (BMT)
RBC Transfusion (long-term)
Hydroxyurea (Chemotherapy Agent)
Arginin
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| show | Monitor/Treat Complications
Infection
Acute Chest Syndrome
ABX
Incentive Spirometry
Fluid Restriction
Supportive Therapy
Pain Management
Hydration
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| Blood loss and anemia | show 🗑
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| diagnostic studies for blood loss anemia | show 🗑
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| show | Hypovolemic Shock
↑ Plasma Volume
↓ O2 related to ↓ RBC’s
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| what should nurse do for blood loss | show 🗑
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| show | Administration of Blood Products
PRBC’s
Platelets
Plasma
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| show | Neoplasm of lymph origin
Start in lymph nodes but can involve lymphoid tissue in the spleen, GI tract, liver or bone marrow
Lymphocytes undergo malignant changes and produce tumors
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| what is hodgkins | show 🗑
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| show | Painless, enlarged, firm lymph nodes are a hallmark of both types of Hodgkin’s
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| hodgkins has to types???? | show 🗑
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| show | symptoms include fatigue, weight loss 10%, fever w/o chills, and night sweats)
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| show | Lymph node biopsy (Reed-Sternberg cell)
Staging is performed to determine the extent of the disease
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| staging tests for hodgkins | show 🗑
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| show | Stage I – involves a single lymph node or localized involvement
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| 2nd stage of hodgkins | show 🗑
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| show | Stage III – involves several lymph node regions on both sides of the diaphragm
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| show | Stage IV – involves extralymphatic tissue, such as the bone marrow
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| show | Preferable for early disease staging. May be used after aggressive chemotherapy for more advanced disease staging. Used for bulky disease types
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| show | Used in advanced stages or with reoccurrence of Hodgkin’s
Standard ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) regimen is used.
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| chemo long term errors in hodgkins | show 🗑
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| show | Multiple lymphoid tissues become infiltrated with malignant B lymphocytes that spread unpredictably; localized disease is rare
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| NHL causes | show 🗑
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| clinical manifestations of NHL | show 🗑
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| show | Computed tomography (CT) scans of the head and neck, chest, abdomen, and pelvis
Positron emission tomography (PET) of the entire body.
Bone Marrow Biopsy
Bence-Jones protein (urine
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| show | Bence-Jones protein
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| show | reed-sternberg cell
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| show | Fatigue
Mylosuppression
Nausea
Hair loss
Infection
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| show | YES
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| what is treat for non aggressive nhl? | show 🗑
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| treatment for aggressive NHL | show 🗑
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