1. injury occurs (blood vessel damaged) 2. hemorrhage begins 3. platelets activated, clump at site of damage 4. thromboplastin, released from platelets, reacts with calcium ions 5. prothrombin is converted to thrombin 6. fibrinogen forms fibrin 8. fibrin traps RBC’s and platelets, forming a blood clot 9. blood clot seals the damaged vessel

What blood types are the universal donor and universal recipient?

Type O universal donor type AB universal recipient

What is the function of the thymus?

The thymus functions in utero, and for a few months after birth to help develop the immune system

What site is most commonly used for bone marrow aspiration?

Posterior iliac crest because there are no vital organs, blood vessels, or nerves (tibia can also be used but not preferred site)

What can anemia be caused by?

Excessive blood loss (such as hemorrhage), prolonged menstrual periods, and GI bleeding

What happens if a patients Hgb falls below 5 g/dL?

May experience shock, hypotension, MI, stroke, confusion, and sometimes death

Signs of hypovolemia

Anxiety or agitation confusion cool, clammy skin decreased or no urine output diaphoresis general weakness hypotension low body temp pale skin color (pallor) weak and threads pulse rapid breathing tachycardia unconsciousness

Average adult has a total blood volume of how many mL’s? and how much can you tolerate losing?

6000mL’s and can lose 500mL’s

Nursing interventions for pernicious anemia

Lifetime therapy with vitamin B12

Possible causes of aplastic anemia

-autoimmune disorders -certain inherited conditions -certain medications -injections such as hepatitis, HIV -pregnancy -radiation therapy and chemo for cancer -toxic substances, such as pesticides -unknown causes

All three major blood elements (red cells, white cells, and platelets) is known as

Pancytopenic

Medical management of aplastic anemia

Avoid blood transfusions, if possible, to prevent iron overloading and to minimize the risk of rejection for a bone marrow transplant candidate

People who have higher iron needs

Ill children, pregnant and lactating women

RBC’s do what

Carry oxygen and carbon dioxide

WBC’s do what

Fight infections

Causes of iron deficiency anemia

Blood loss, mainly GI or genitourinary systems, and inadequate daily iron intake

Food sources of iron

-dark green vegetables: spinach, swiss chard, kale, greens -dried fruits: apricots, dates, figs, prunes, raisins -eggs -iron-enriched/fortified breads or cereals -legumes and nuts -muscle meats, especially dark poultry meat -organ meats:liver, kidney, heart, tongue -shellfish -whole-grain breads and cereals

Iron administration rule

If dosage is missed, continue with the schedule; do not double a dose

Sickle cell anemia medical management

Adequate hydration

Nursing interventions for sickle cell anemia

Proper anatomic alignment, protect joints, position patient slowly and gently, warm soaks or compresses

Agranulocytosis pathophysiology (normal neutrophil value is 3000-7000/mm3)

Potentially fatal condition of the blood characterized by a servers reduction in the number of granulocytes, low WBC count, and a neutrophil count of less than 200/mm3

Nursing interventions for agranulocytosis

Avoid fresh flowers and plants and raw foods such as sushi

Different types of leukemia (4)

1. acute lymphocytic leukemia 2. acute myeloid leukemia 3. chronic lymphocytic leukemia 4. chronic myeloid leukemia

Leukemia clinical manifestations

First signs: enlarged lymph nodes and painless splenomegaly patient is predisposed to: anemia and thrombocytopenia

Most common cause of increased destruction of platelets is

Thrombocytopenic purpura

Medications with thrombocytopenic effects

-aspirin -furosemide -oral hypoglycemics -penicillins -rifampicin -thiazides -sulfonamides -digitalis derivatives -nonsteroidal antiinflammatory agents

Thrombocytopenia medical management

Corticosteroids may help if the disorder is related to an autoimmune problem

Hemophilia pathophysiology

Genes causing hemophilia are inherited, it affects mainly males and females are typically carriers

Blood transfusions are now safe because

Viral detection processes and viral inactivation of blood products have restored safety to transfusing blood products

Hemophilia diagnostic tests

Blood clotting factors VIIII and IX are absent or deficient, and coagulation profile reveals a normal platelet count

Hemophilia nursing interventions

Control hemorrhages by applying pressure and cold to the site, and do not give aspirin or aspirin products because it can further complicate bleeding tendency

Disseminated intravascular coagulation (DIC) pathophysiology

Results from disease or injury including septicemia, obstetric complications, malignancies, tissue trauma, transfusion reaction, burns, shock, and snake bites. another whose fetus dies in utero, especially when delivery of the fetus is delayed

Multiple myeloma nursing interventions

Administer chemotherapy and radiation, maintain hydration, encourage ambulation, fluid intake of 3-4 L/d and urinary output of 1.5-2 L/d

Chemotherapy side effects

-alopecia (hair loss) -appetite changes -bleeding problems -constipation/diarrhea -fatigue -infection -mouth and throat changes -N/V -nerve changes -pain -sexual infertility changes in women -skin and nail changes -swelling (fluid retention) -urination changes

Hodgkin’s lymphoma pathophysiology

No major risk factors but occurs more frequently in people who have has mononucleosis (infection caused by Epstein-Barr virus), congenital immunodeficiency syndromes, taking immunosuppressive drugs after organ transplantation, exposed to occupational toxins, have a genetic predisposition