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Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020/
37 - Concepts of Care for Patients with Hematologic ProblemsAce Your Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid
Sickle Cell Anemia Assessment
- Cause/Mechanism
- Hemoglobin S (Genetic Defect)
- Sickle Shaped RBCs
- Assessment
- Jaundice
- Vaso Occlusive Crisis
- Fever
- Priapism
- Severe Pain
- Considerations
- Prominent in African Americans
- May be Asymptomatic
- Increased Risk of Infection
2 mins
Sickle Cell Anemia Interventions
- Interventions
- Increase Hydration
- Analgesics
- Oxygen
- Warm Compress
- Bone Marrow Transplant
- Hydroxyurea
- Considerations
- Avoid High Altitudes
- Prophylactic Antibiotics
- Avoid Strenuous Exercise
- Vaccines
3 mins
Hydroxyurea
- Mechanism
- Inhibits Ribonucleotide Reductase
- Decreased DNA Synthesis
- S-phase Specific
- Indications
- Melanoma
- Chronic Myelogenous Leukemia (CML)
- Sickle Cell Disease
- Through Increased HbF (Fetal Hemoglobin)
- Side Effects
- Myelosuppression
- GI Distress
2 mins
Iron Deficiency Anemia
- Causes
- Malnutrition/Malabsorption
- Hemorrhage
- Signs
- Microcytic, Hypochromic Anemia
- Decreased Heme Synthesis
- Labs
- Decreased Reticulocytes
- Decreased Ferritin
- Increased Red Cell Distribution Width (RDW)
- Poikilocytosis
- Anisocytosis
- Increased Central Pallor
2 mins
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Leukocyte Differential
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
2 mins
Leukemia Assessment
- Cause
- Immature WBCs
- Assessment
- Recurrent Infections
- Easy Bruising
- Bleeding
- Anemia
- Fatigue
- Weight Loss
- Bone Pain
- Considerations
- May Have Normal or High WBC Count
2 mins
Hodgkin's Lymphoma Assessment
- Cause
- Lymph Node Cancer
- Contiguous Spread
- Assessment
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Considerations
- Bimodal Age Distribution
- Reed-Sternberg Cells
2 mins
Hodgkin's Lymphoma Interventions
- Diagnosis
- Biopsy
- Staging
- Interventions
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Considerations
- Secondary Cancer Screening
2 mins
Heparin (Unfractionated)
- Mechanism of Action
- Suppresses Coagulation
- Indications
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Side Effects
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Considerations
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Antidote
- Protamine Sulfate
2 mins
Heparin Induced Thrombocytopenia (HIT)
- Pathophysiology
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Symptoms
- Thrombocytopenia
- Diagnosis
- Serotonin Release Assay (SRA)
- Treatment
- Stop Heparin, Start Direct Thrombin Inhibitor
2 mins
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
- Considerations
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
3 mins
Blood Types and Compatibilities
- ABO Compatibility
- No Antigens (Type O Blood)
- Universal Donor
- A Antigen (Type A Blood)
- B Antigen (Type B Blood)
- AB Antigen (Type AB Blood)
- Universal Recipient
- Rhesus (Rh) Compatibility
- Rh (Rhesus) Antigen
- Never Rh+ to Rh-
- Considerations
- Blood Transfusion
- Obstetric Patient
2 mins
Types of Blood Products
- Types
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Considerations
- Use within 24 Hours
- Washing Removes Antibodies
- Irradiation Destroys WBCs
2 mins
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
2 mins
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