hematology 2

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hemoglobin norm is: 12-16g/dl
hemocrit norm is: 38-47percent
rbc norm is: 4.2-6
wbc norm is: 5,000 to 10,0000
neutrophils make up what percent of the differential.: 40-70
basophils make up what percent of the diff: 1 percent
lymphocytes make up what percent of the diff: 20-40
monocytes make up what percent of the diff: 4-8
esoninophils make up what percent of the diff: 2-4
platelents counts are: 150k-400k
shift to the left in diff means: infarction, infection, stress, bacteria
shift to the right in diff means: virus, anemia
hi neutrophil and hi bands mean/: shift to left
hi lymph and hi mono mean: shift to right
what does the MCV determine?: size of RBC
macro rbc's are seen with what anemias: periucous, and folic acid anemias
micro- no iron are seen with what anemia: sickle cell.
MCH measures what>?: weight" amt of hemoglobin
what is the best place to do a marrow aspiration: illiac crest.
what to monitor pt for after a marrow aspiration: soreness and tenderness.. there is no bleeding
what is the shillings test used for?: measures the absorption of vit-b12. (pernicious anemia)
if tablet shows up in urine when doing a shillings test, what does this indicate?: does not have pernicious anemaia because they are able to absorb it.
pernicious anemia is the absence of what/: vit-b12
what are some foods with vit-b12: organ meats, liver, muscle meats. eggs
what leads to the pheripheal neuropathy found with pernicious anemia: decreased myelin, decreased potential of cells
sources of iron are: green leafy veggies, potatoes, liver, eggs, raisins approcots
sources of folic acid are: green veggies, fish whole grain
sources of vit-b6 are: meat potatoes
sources of amino acids are: eggs nuts.
sources of vitamin c are: strawberries, green leafty veggies
folic acid helps with?: red blood cell maturation
iron does what for the body: synthesis of hemoglobin
amino acids do what?: synthesis of nuclear protein
vit c helps with what kind of absorbtion: iron
iron aborbtion is increased with what vitamine: C
an immobilized pt wihh receive what medication and what dose?: heprin. 5000u/12hr
reverse heprin with what?: protamine sulfate
when reversing heprin give how much protamine sulfate?: 1ml/100u hep
serrum ferritin test shows what 0-12: iron deficiency, anemia, measures stored iron.
what is a reticulocyte: immature rbc. 1% of all rbc
increased number in reticulocytes means what?: anemia
large amount of protein in urin is what?: bence jones protein
multiple myeloma is cancer of what?: plasma cell
what exposure to chemicals can cause hematological cancers: benzine
jaundice is prevelant in sicke cell anemia how do you assess for it: conjuntiva. sclera.
vit c deficit can lead to what problem with the lips: cheilitis, dry cracking inflamation
iron deficit can cause a smooth tongue texture also called: glottis
bone pain in leukemia is do to: the rapid production of abnormal cells
with accute blood loss when is it evident through cbc's: 12hrs
when doing a bone marrow aspiration how to you postiion the pt.: on the side.
what is the benefit of packed rbc's: 1/2 the volume when fluid overload is an issue.
what gauge needle is used for blood transfusions: 18-16-14
blood transfusions must be complete in: 2-3hrs
when blood is on the floor, must start administration within how long: 30mins
what volume loss is it mostly noticable that the pt is in trouble: 30
with a 40% volume loss you see what: bp below normal at rest, rapid pulse, cold clammy skin
with a 30% volume loss you see what?: tachycardia
postural hypotension
with a 50% volume loss you see: shock and potential death
type 0 blood has what antigen: none
type a has what antigens: A
when giving blood check vitas pulse resp and temp how often?: every 5 minutes for 15 minutes.
what to give if pt has fluid v overload while giving blood: lasix
when giving blood start out at what rate.: 1ml/ min for 15 minutes.
how is febril non hemolitic reaction caused: sensitive to wbc, platelets or plasma antigen.
signs of febril non hemolitic reaction are: chills, fever of 101 within one hr of giving, HA, N&V
what to do if you suspect febril nonhemolitic reaction: stop blood, keep ns going, give tylenol, monitor vs, call dr
how is allergic urticaria reaction caused: allergic to what donor took before donation. chocolate, penicillin, pollen.
signs of allergic urticaria are: skin rash, hives
what to do if you suspect allergic urticaria: stop blood, keep vein open with ns,notify blood bank or dr. give antihistamine and/or corticosteroid turn blood back on and monitor.
signs of delayed hemolytic reaction include: extreme fatigue 6 weeks to 6 months, gradual decline in cbc.persistent low grade fever.
nursing interventions for someone with delayed hemolytic reaction are.: give ferrous sulfate,
improve nutrition
ferous sulfate can result in what: constipation and dark stools.
nutrition for a person with delayed hemolytic reaction is: eggs, spinach , oj, increase iron and vit c
how long does it take ferous sulfate to restore cbc's to norm: 6 months
anaphylactic blood reaction happens most often in individuals with: multiple transfusions
what to ask apt with multiple transfusions: how did you handle it?
signs of anaphylactic blood reaction: flushing, bronchospasms, chest pain, loss of airway
what to do if you suspect an anaphylactic reaction: stop blood, keep ns running, Code, cpr, maintain airway, give epinephrine
what to do if the person had an anaphylactic reaction to a prior infusion: ask blood bank for blood from donor lacking IgA, use filter, frozen washed cells.
what is the causes for an acute hemolytic reaction: ABO compatibility problem, or improper storage of blood.
signs of acute hemolytic reaction: flank pain,
decreased bp, N&V,anxiety, restlessness.
most fatal reaction from a blood infusion is: acute hemolytic reaction
what to do do if you suspect acute hemolytic reaction: stop blood, keep vein open, change tubes, hang D5W, give o2, give epinephrine and nitro, insert foley, monitor I and O. may need clotting factors infused. notify lab immediatley..
what drugs do you administer when you suspect an acute hemolytic reaction: epinephrine and vasopressors.
circulatory overload is due to: fluid being administered faster than the circulation can accommodate.
monitor what with circulatory overload: breath sounds., distended neck veins, rales, Ha, dyspnea
nursing interventions for a pt with circulatory overload.: place in high fowlers with feed dependent, give diuretic,give o2, may need phlebotomy.
if you suspect sepsis while giving blood you should do what?: stope blood, give tylenol, dc tubing, lines, bags, send to blood bank to culture. give antibiotic, vassopres, corticosteriods.
corticosteroids given with allergic urticaria and with sepsis include: prednisone, decadron, solu-medrol.
neutrophils life span is: 12 hrs
anemia is characterized by an imbalance of how many mls or more per day.: 3ml
iron deficiencey anemia usually occurs in who: children or elderly
with iron dificency anemia, rebs are: microcytic
what med is given with an iron def anemia.: ferrous sulfate,
dextran
goods to encourage with iron deficiency anemia are: red meats, eggs, green leafy vegs, carrots, oj, raisins
NI's with iron deficiency anemia are: increase fiber-rt ferrous sal
give before meals,
dextram im must be given how: IM, Z-track, air lock.5ml
with iv iron, watch for this: anaphlactic reactions
megablastic anemias include: pernicious anemia and folic acid anemia
pernicious anemia results because there is a lack in: intrinsic factor
B-12
pernicious anemia is evident by what test: shillings test.
peripheral neuropathy ret decreased production of myelin is evident with what anemia: perniciouis anemia.
what med is given with pernicious anemia.: cyanocobalamine IM. 100-200mcg/month
how to give cyanocobalamine: 100-200mcg/month to replenish then 1 injection each day for a week.
with folic acid deficiency give what med: folite PO.
folic acid deficiency is promonent in who: alcoholics
hemolytic anemias are: an inadequate number of circulating red blood cells (anemia) caused by premature destruction of red blood cells.
one type of hemolytic anemia is: sickle cell anemia.
excellerated erythropoiesis is found in: sickle cell anemia
treatment for sicke cell is: hydration, avoid stress, pain med. give folic acid, genetic counceling

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