Iron Deficiency Anemia
- Malnutrition/Malabsorption
- Hemorrhage
- Microcytic, Hypochromic Anemia
- Decreased Heme Synthesis
- Decreased Reticulocytes
- Decreased Ferritin
- Increased Red Cell Distribution Width (RDW)
- Poikilocytosis
- Anisocytosis
- Increased Central Pallor
Red Blood Cell Count (RBC) Lab Values
- Women: 3.5-5.5 million cells/ MuL
- Men: 4.3-5.9 million cells/ MuL
Hemoglobin (Hgb) Lab Values
- Men: 13 - 17 g/dL
- Women: 12 - 16 g/dL
Hematocrit (Hct) Lab Values
- Women: 36% - 46%
- Men: 41% - 53%
Types of Blood Products
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Use within 24 Hours
- Washing Removes Antibodies
- Irradiation Destroys WBCs
Blood Transfusion Administration
- Proper Patient Identification
- Large Bore Needle
- Y Tubing
- Baseline Vital Signs
- Slow IV Infusion
- Monitor During First 15 Minutes or 50 mL of Blood
- Monitor for Reactions
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
Iron (Ferrous Sulfate)
- Ferrous Salts
- Anemia
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
Cobalamin (Vitamin B12)
- Vitamin B12
- Vitamin Deficiency
- Pernicious Anemia
- Hypokalemia
- Arthralgia
- Dizziness
- IM Injection for Pernicious Anemia
- Never Give IV
Sickle Cell Anemia Assessment
- Hemoglobin S (Genetic Defect)
- Sickle Shaped RBCs
- Jaundice
- Vaso Occlusive Crisis
- Fever
- Priapism
- Severe Pain
- Prominent in African Americans
- May be Asymptomatic
- Increased Risk of Infection
Sickle Cell Anemia Interventions
- Increase Hydration
- Analgesics
- Oxygen
- Warm Compress
- Bone Marrow Transplant
- Hydroxyurea
- Avoid High Altitudes
- Prophylactic Antibiotics
- Avoid Strenuous Exercise
- Vaccines
Leukemia Assessment
- Immature WBCs
- Recurrent Infections
- Easy Bruising
- Bleeding
- Anemia
- Fatigue
- Weight Loss
- Bone Pain
- May Have Normal or High WBC Count
Leukemia Interventions
- Bone Marrow Aspiration
- X-Rays
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
Chloramphenicol (Chloromycetin)
- Bacteriostatic
- Gram Positive or Gram Negative Infections
- Bone Marrow Suppression
- Aplastic Crisis
- Gray Syndrome
- Toxicity Limits Use
- Monitor Blood Counts
Lumbar Puncture
- CSF Sample
- CSF Pressure
- Empty Bladder
- Side-lying Position
- Between 3rd and 4th Lumbar Vertebrae
- Number Tubes
- Supine Position After Procedure
- Increased ICP (Intracranial Pressure)
- Infection at Puncture Site
Cyclophosphamide
- Requires Bioactivation by Liver
- Cross-links DNA
- Guanine N7 Position
- Autoimmune Disorders
- Leukemia
- Lymphoma
- Solid Tumors
- Myelosuppression
- Hemorrhagic Cystitis
- Prevent with Mesna
Cisplatin (Platinol)
- Alkylating Agent
- Cross-Links DNA
- Testicular Cancer
- Ovarian Cancer
- Nausea and Vomiting
- Myelosuppression
- Nephrotoxicity
- Ototoxicity
- Peripheral Neuropathy
- Antiemetics Before Administration
- Aggressive Hydration
Busulfan
- CML
- Bone Marrow Ablation
- Cross-Links DNA
- Myelosuppression
- Pulmonary Fibrosis
- Hyperpigmentation
Methotrexate
- Rheumatoid Arthritis
- Cancer
- Medical Abortion
- Folic Acid Analog
- Inhibits Dihydrofolate Reductase
- Pulmonary Fibrosis
- Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
- Macrocytic Anemia
- Hepatitis
- Teratogenic
- Mucositis
Bleomycin
- Testicular Cancer
- Hodgkin's Lymphoma
- Induces Free Radical Formation
- Breaks in DNA Strands
- Pulmonary Fibrosis
- Skin Changes
- Mucositis
Hydroxyurea
- Inhibits Ribonucleotide Reductase
- Decreased DNA Synthesis
- S-phase Specific
- Melanoma
- Chronic Myelogenous Leukemia (CML)
- Sickle Cell Disease
- Through Increased HbF (Fetal Hemoglobin)
- Myelosuppression
- GI Distress
Vincristine (Oncovin)
- Vinca Alkaloid
- Inhibits Microtubules
- Leukemias
- Lymphomas
- Peripheral Neuropathy
- Paralytic Ileus
- Vesicant
Prednisone (Glucocorticoids)
- Glucocorticoid
- Inflammatory Conditions
- Organ Transplant Rejection
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Adrenal Insufficiency
- Taper Gradually
Leuprolide
- GnRH Agonist (Pulsatile Use)
- GnRH Antagonist (Continuous Use)
- Upregulates FSH And LH
- Downregulates FSH And LH
- Infertility
- Prostate Cancer
- Precocious Puberty
- Uterine Fibroids
- Endometriosis
- Anti-androgenic Effects
Tamoxifen
- Selective Estrogen Receptor Modulator (SERM)
- Antagonist on Breast Tissue
- ER-positive Breast Cancer
- Decreased Risk of Osteoporosis
- Increased Risk of Endometrial Cancer
- Increased Risk of Venous Thromboembolism (VTE)
Steroid Hormones
- Nuclear Membrane
- Long-Lived and Slow-Acting
- Cholesterol-Derived
- Intracellular Receptors
- DNA Transcription
- Testosterone
- Aldosterone
- Estrogen
- Cortisol
Rituximab
- Chronic Lymphocytic Leukemia (CLL)
- Non-Hodgkin Lymphoma
- Rheumatoid Arthritis
- Microscopic Polyangiitis (MPA)
- Granulomatosis with Polyangiitis (Formerly Wegener's)
- Monoclonal Antibody Against CD20
- Found on B Cell Neoplasms
- Infusion Reactions
- Skin and Mouth Reactions
- Reactivation of Hepatitis B Virus (HBV)
- Progressive Multifocal Leukoencephalopathy (PML)
Erythropoietin
- Stimulates RBC Production
- Chronic Renal Failure
- Anemia
- Increased Risk of Thrombosis
- Pelvic and Limb Pain
- Hypertension
- Do Not Shake
- Monitor Hemoglobin (Hgb) Weekly
- May Accelerate Tumor Progression
Promethazine (Phenergan)
- Histamine H1 Receptor Antagonist
- Weak Dopamine Antagonist
- Nausea and Vomiting
- Motion Sickness
- Respiratory Depression
- Sedation
- Anticholinergic Effects
- Extrapyramidal Symptoms
- Use Large Bore IV
- Monitor for Tissue Necrosis
Metoclopramide
- Antiemetic
- Promotility Agent
- Increased Resting Tone
- Antagonist at D2 Receptor
- Parkinsonian Symptoms
- Galactorrhea
- Small Bowel Obstruction
- Parkinson's Disease
Haloperidol (Haldol)
- High Potency Antipsychotic
- Migraine
- Schizophrenia
- Extrapyramidal Symptoms
- Weight Gain
- QT Prolongation
- Restlessness
- Caution in Seizure Patients
- Neuroleptic Malignant Syndrome
First Generation Antihistamines
- Histamine H1 Receptor Antagonist
- Allergies
- Nausea and Vomiting
- Motion Sickness
- Anaphylaxis
- Diphenhydramine (Benadryl)
- Promethazine (Phenergan)
- Chlorpheniramine
- Sedation
- Anticholinergic Effects
Ondansetron
- Postoperative Vomiting
- Chemotherapy-induced Nausea and Vomiting
- 5-HT3 Serotonergic Antagonist
- Centrally-acting Antiemetic
- Headache
- Constipation
- QT Prolongation
Bleeding Precautions
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
Macroscopic Bone Structure
- Compact Bone
- Yellow Bone Marrow
- Spongy Bone
- Red Bone Marrow
- Long Bone
- Epiphysis
- Epiphyseal Plate
- Diaphysis
- Metaphysis
- Periosteum
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
Hodgkin's Lymphoma Assessment
- Lymph Node Cancer
- Contiguous Spread
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Bimodal Age Distribution
- Reed-Sternberg Cells
Hodgkin's Lymphoma Interventions
- Biopsy
- Staging
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Secondary Cancer Screening
Non-Hodgkin's Lymphoma Assessment
- Lymphatic Cancer
- Non-Contiguous Spread
- B or T Cells
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Mediastinal or Abdominal Mass
- Older Adults
- > 60 Subtypes