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49 Cards in this Set
- Front
- Back
complete blood count CBC
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RBC, WBC, PLTS, blood types,
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RBC
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4.5-5.9 x10^12/L
delivers oxygen and removes waste |
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polycythemia
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overproduction of RBC
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erythropoietin
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stimulates production of RBCs by bone marrow
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hemoglobin
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12-17
contains iron and protein. gives blood its red color. measures the severity of anemia and polycythemia monitor the response to treatment. |
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hematocrit
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36-51%
-evaluate the degree of blood loss, anemia, polycythemia & dehydration. -determines the proportion of RBC in plasma -expressed in percentage: HCT of 30% is 30ml of RBC in 100ml of whole blood. |
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sickle cell anemia
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RBC destruction
-misshapen Hgb and RBC -supportive interventions: prevent infection, relieve pain, provide fluid and o2. |
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Thalassemia
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RBC destruction
-mutated Hgb -iron overload and excessive hematopoisis -requires transfusions or removal of excess iron from blood. -splenectomy/bone marrow transplant. |
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nursing interventions with Plts
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critical values: <50,000, >1,000,000.
report to MD stat. -low counts, teach pt measures to prevent bleeding. |
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thrombocytopenia: assessment
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-monitor pt's ksin for bruising, indicates bleeding under teh skin
-protect from bruising. -electric razor -soft tooth brush -avoid use of aspirin because it worsens the ability to clot. |
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WBC
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-monitor bone marrow response to cancer treatment
-attack and destroy bacteria, virus, or foreign org. -detects anemia, infection, and leukemia |
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lab values for bone marrow disorder
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up/down RBC
up/down HGB up/down HCT up/down PLTS |
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lab values for hemoconcentration
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up RBC
up HGB up HCT |
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lab values for dehydration
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up RBC, HGB, HCT
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lab values for diarrhea/vomiting
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up RBC, HGB, HCT
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lab values malignant tumors
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down RBC, HGB, HCT,
up PLTS |
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lab values for hemorrhage
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down RBC, HGB, HCT
up PLTS |
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lab values for anemia
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down everything
platelet either way |
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hemodilution--lab values
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everythign down. doesn't affect PLTS
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chemo/rt--lab values
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everythign down.
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pt with low RBC, Hgb, adn Hct
Intervention |
-assess vital signs
-monitor frequently for safety -give blood transfusion -assist with ADLs -encourage food intake e.g. increase red meat -iron and B12 |
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PTT reflects?
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effect of heparin anticoagulant therapy, dose is adjusted based on test results.
-PTT reflects serum heparin at the moment the sample is taken (heparin activity varies from moment to moment) |
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antidote to heparin
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protamine sulfate
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PT ??
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monitor oral anticoagulant therapy--coumadin/warfarin (range monitored through INR)
-SNAIDS, aspirin, and other anti-platelet agents can affect PT level. |
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antidote to coumadin
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vitamin K
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INR??
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needs to be monitored for clients on coumadin for:
-deep veing thrombosis DVT -pulmonary embolism PE -myocardial infarction MI -mitral valve replacement MVR |
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what decreases INR level
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vitamin K
FFP |
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albumin
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maintains osmotic pressure within cell walls.
helps investigate symptoms of disease: swelling of the ankles (pedal edema) or abdomen (ascites). |
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prealbumin
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evaluate nutritional status to determine whether a diet contains enough protein.
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BUN
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-protein metabolism--urea nitrogen
-exretion primarily by kidneys -used to evaluate renal function |
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elevated BUN
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kidney damage
acute/chronic renal failure dehydration |
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creatinine
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waste product of creatinine phosphate
-muscle tissue energy metabolism--creatinine -excretion primarily by kidneys -sensitive to kidney dysfunction/muscle mass -evaluates renal dysfunction |
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increased Cr+
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renal damage/failure, nephrotoxic drugs, etc.
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uric acid
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-end product of protein metabolism
-excreted by kidney as waste product -monitor pt with renal failure |
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GOUT and treatment of
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disease associated with consistently high serum uric acid levels (more common in men)
treatment: allopurinol prevents elevation |
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cardiac enzymes
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found in all tissues, heart, brain, and skeletal muscle.
-cardiac enzyme studies measure the levels of the ensymes Troponin (Tnl, TnT) and creatine phosphokinase (CPK, CK) in the blood. -Levels rise, peak & normalize -diagnose MI |
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troponin-basic
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protein that helps to regulate cardiac contractility
-three types -troponin I specific to cardiac muscle injury. -gives faster diagnosis that other enzymes |
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troponin: onset, peak, duration
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TnI:
onset: 2-6 hours peaks: 16hrs dure: 5-9 days TnT: onset: 3-4hrs peaks: 12-48 hrs dure: 10-14 days |
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interventions: MI
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-baseline VS, monitor CPK & troponin level
-cardiac monitor monitors cardiac rhythms for arrhythmias -02 therapy -aspirin and nitrates -intravenous access -thrombolytic therapy -close monitoring of pt as needed. |
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parathyroid hormone PTH regulates what?
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calcium and phosphorus ions in the blood...they have inverse relationship.
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hydrogen ions
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calcium, phosphorus, magnesium
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calcium
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-maintains proper heart function, nerve transmission and blood clotting
50% bound to albumin, 50% ionized or free. |
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2 regulators of calcium
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parathyroid hormone
calcitonin increase in PTH = increase in Ca |
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cause of hypocalcemia
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-hypoparathyroidism
-excess phosphorous -vit D deficiency -low albumin -prolonged IV fluid therapy -diuretics -malnutrition |
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S&S of hypocalcemia
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-neuromuscular excitability
-muscle twitching -numbness -tingling -trousseau's & Chvostek's signs -seizures -irregular heart beat -DIARRHEA |
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interventions for hypocalcemia
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-place pt on seizure precautions
-IV calcium as ordered -oral calcium supplements, taken w/ vit D -foods -calcium should never be given IM. |
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causes of hypercalcemia
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-hyperparathyroidism
-metastatic bone cancer -bone loss -high ca intake antacids -vit D intoxication -dehydration -immobilization |
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S & S of hypercalcemia
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-neuromuscular weakness
-lack of coordination -lethargy -confusion -convulsions -coma -impaired memory -irregular puse/heartbeat -CONSTIPATION |
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interventions for hypercalcemia
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-assess pt for s/s of hypercalcemia
-assess pt level of consciousness -seizure precautions -assess if pt is on digoxin therapy -intravenous fluids -IV bisphosphonates -check pt EDG for changes. |