Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid
Whole Blood Composition
- Plasma
- Electrolytes And Other Solutes
- Proteins
- Albumin
- Fibrinogen
- Globulins
- Water
- Formed Elements
- Buffy Coat
- White Blood Cells (WBC)
- Platelets
- Red Blood Cells (RBC)
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%)
Hemoglobin
- Hemoglobin Has Four Iron Hemes
- Lots Of Hemoglobin In Red Blood Cells
- High O2 Levels Increase O2 Binding
- High Temperature Reduces O2 Binding
- High CO2 Levels Reduce O2 Binding
- Low pH Reduces O2 Binding
- Myoglobin Binds Oxygen in Muscle
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
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
Clotting Overview
- Endothelial Cells are Damaged
- Platelets Respond to Exposed Collagen and Stick
- Platelets Release Recruiting Factors
- More Platelets are Attracted
- Soluble Fibrinogen Turns to Insoluble Fibrin
- Fibrin Seals the Clot
- Clot Dissolves
- Liver Produces Clotting Factors
Coagulation Cascade Overview
- Secondary Hemostasis
- Intrinsic Pathway
- Partial Thromboplastin Time (PTT)
- Heparin
- Extrinsic Pathway
- Prothrombin Time (PT)
- Warfarin
- Common Pathway
- Thrombin
- Convert Fibrinogen to Fibrin
- Stabilizes the Platelet Plug
Lymphatics
- Recycles 10% of Interstitial Fluid
- Transport Large Lipids from Lacteals
- Unidirectional Valves
- Lymph Nodes Filter Lymph
- WBCs Monitor Lymph for Pathogens
- Merge with Veins
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%
Blood Types and Compatibilities
- No Antigens (Type O Blood)
- Universal Donor
- A Antigen (Type A Blood)
- B Antigen (Type B Blood)
- AB Antigen (Type AB Blood)
- Universal Recipient
- Rh (Rhesus) Antigen
- Never Rh+ to Rh-
- Blood Transfusion
- Obstetric Patient
RhoGam [Rho(D) Immune Globulin]
- Antepartum Prevention at 28 weeks
- Suppress Antibody Production
- Lysis of Fetal RBC in Maternal Bloodstream
- Myalgia and Lethargy
- Negative Coombs Test
- Standard Dose 300 mcg
- Microdose 50 mcg
- Blood Product
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
Cobalamin (Vitamin B12)
- Vitamin B12
- Vitamin Deficiency
- Pernicious Anemia
- Hypokalemia
- Arthralgia
- Dizziness
- IM Injection for Pernicious Anemia
- Never Give IV
Magnetic Resonance Imaging (MRI)
- Internal Body Images
- Detects Variations of Soft Tissues
- No Metal Objects
- No Pacemakers
- Contrast is Non-Iodine
- Safe During Pregnancy
- Long Procedure
- Antianxiety Medications