NURS 403 Pathophysiology / Pharmacology I_Quiz 3 Review_Module 5
QUIZ 3: Wednesday 10/14/20 COVERS MOD 5 Blood MODULE 5
Lehne’s
Chapter 52
... [Show More] Anticoagulant, Antiplatelet, and Thrombolytic Drugs Chapter 54 Drugs for Hemophilia
Chapter 55 Drugs for Deficiency Anemias Chapter 56 Hematopoietic Agents
Story’s
Chapter 3 Hematopoietic Function
What is the term for the process of blood formation?
Hematopoiesis
What is produced by bone marrow?
Stem cell precursors
What is the term for liquid protein and what is it responsible for?
Plasma
-transport of blood cells, antibodies, nutrients, electrolytes, hormones, lipids, and waste
What type of blood cells are erythrocytes and what are they responsible for?
Red blood cells
-O2 and CO2 transport
What component of red blood cells/erythrocytes gives it red color?
Hemoglobin (Hgb)
Define hematocrit
The percentage of blood volume that contains RBCs
What are leukocytes and what are they responsible for?
White blood cells
-inflammatory response
What are thrombocytes and what are they responsible for?
What are the steps by which thrombocytes carry out their function?
What substance dissolves blood clots?
-Coagulation through clotting factors
Once there is damage to tissue cells production of thromboplastin carry out clotting
Plasmin
recap- RBCs contain hemoglobin; define globin
How much hemoglobin is
globin: the polypeptide chain/the structure
250 million Hgbs/RBC
found in every red blood cell?
Globin contains heme; what is heme responsible for?
heme contains iron which binds to oxygen
How many hemes are found in each globin structure?
4 hemes; which each bind to an oxygen, thus 4 oxygens
recap- hematocrit is the % of RBCs per total blood volume
what is hematocrit an indicator of?
-red blood cell size
-red blood cell number
How many RBCs are there for every micro-centiliter?
5 million RBCs/1µcL
What is the term for a condition in which there is a reduction of red blood cell count?
Anemia
-low red blood cell count
-low hemoglobin (Hgb)
-low hematocrit (Hct)
What is considered a low Hgb count for males and females respectively?
Males: < 13.5 g/dL (normal 13.5-18.0 g/dL, or 8.6 to 11.2 mmol/L)
Females: < 12 g/dL (normal 12.0 to 15.1 g/dL, or 7.5 to 9.4 mmol/L)
What is considered a low hematocrit count for males and females respectively?
Males: < 41% (normal 41-52%)
Females: < 37% (normal 37-46%)
What is the normal RBC count for males and females respectively?
When patients have a loss of RBCs, their oxygen will
Males: 4.7 to 6.1 million cells/mcL
Females: 4.2 to 5.4 million cells/mcL
Respiratory rate will increase [tachypnea (or dyspnea, which is more defined as difficult/labored breathing)]
decrease; how does the body compensate for this? Pulse/Heart rate will increase (tachycardia and angina)
What CNS effects does anemia have on a patient?
anemia decreased O2 delivery fatigue, HA (headaches), irritability, syncope, reduced concentration, RLS (restless leg syndrome)
What organ will be targeting upon anemia?
Ch. 56
1. A nursing student asks a nurse why patients with chronic renal failure (CRF) have low erythrocyte counts. Which response by the nurse is correct?
anemia decreased O2 delivery targets kidneys
kidneys will produce erythropoietin stimulation of bone marrow to increase production of RBCs
What are signs of decreased oxygen to tissues?
-pallor
-koilonychia (spoon nails; abnormally thin nails which have become flat or even concave in shape)
-cyanosis
-decreased healing
Normally, how are red blood cells produced?
kidney produces erythropoietin erythropoiesis is carried out bone marrow will be stimulated hemopoietic stem cell is produced matures into an erythroblast matures into reticulocytes erythrocytes
What is the life span of an RBC?
120 days
What can lead to a reduction in the DNA precursors for erythropoiesis?
-tumors
-fibrosis
-viral dx
-CKD, RF (chronic kidney disease and renal failure)
What type of anemia(s) are a result of a reduction in the DNA precursors for erythropoiesis?
-pernicious anemia (megaloblastic or B12-deficiency)
-folate deficiency type anemia
Abnormal Hgb production will result in what types of
-Fe deficiency anemia, anemia of chronic dx, sideroblastic anemia, thalassemia, sickle-cell anemia
anemia?
What can lead to either aplastic anemia or hemolytic anemia?
-autoimmune disorders, bacterial infections, viral infections, deficiency of 6GPD, or blood loss due to menstruation, surgery, ulcers
Reticulocytes in patients with an increase in bone- marrow activity
Reticulocytes in patients with a decrease in bone- marrow activity
> 3%
< 3%
Genetics plays a role in what type(s) of anemia?
-aplastic anemia
-hemolytic anemia
What helps to classify the type of anemia?
MCV (mean corpuscular volume)
What does it mean when the MCV is between 80- 100, < 80, and >100?
MCV 80-100 = normocytic anemia MCV < 80 = microcytic anemia MCV > 100 = macrocytic anemia
List examples of microcytic anemia
List examples of normocytic anemia
List examples of macrocytic anemia
iron deficiency, thalassemia, chronic disease, lead poisoning
acute bleeding, aplastic anemia, hemolytic anemia, low erythropoietin, malignancy
pernicious anemia, low folate
What problem causes microcytic anemia (e.g. thalassemia)?
What problem causes Fe deficiency anemia or anemia associated with chronic disease?
-Problem with globin; abnormal alpha and beta chains of the globin structure
-Problem with heme part of Hgb
When taken in from the diet and absorbed through our GI, how does iron then move to our blood?
How is our iron then stored in our liver?
Transferrin carries iron out of our GI and into our blood
Ferritin, another protein, stores iron in our liver
To diagnose anemia, what lab levels do we measure, and what would we expect to see?
CBC & Iron Studies
-Serum Fe: decreased
-% of iron saturation (% of Fe bound to transferrin): decreased (normal =
~33%)
-Total Fe-binding capacity (transferrin): increased (for compensation)
-Ferritin (stored Fe): decreased (w/ prolonged anemia)
Ch. 55
1. A nurse is reviewing a patient's most recent blood count and notes that the patient has a hemoglobin of 9.6 gm/dL and a hematocrit of 33%. The nurse will notify the provider and will expect initial treatment to include: [Show Less]