the fluid portion of blood that contains proteins, albumin and globulin, fibrinogen along with other clotting factors like electrolytes, nutrients and waste products
leukocytes, erythrocytes, platelets
name three cellular components of plasma
how long do RBC's live before they break down into bilirubin
primary site of hematopoises
carries oxygen absorbed from the lungs and nutrients absorbed from the GI tract to the body's cells for the purpose of cellular metabolism
As the adult ages, a portion of active marrow is gradually replaced by ______, but in a healthy person, it can convert back to marrow when blood cell production needed.
Stem cells in the marrow have the ability to ____ _____. This ensures a continuous supply of stem cells throughout one's life cycle.
___ stem cells produce T and B cells (antibodies)
___ cells go to the thymus to differentiate
site of t-cell maturation and differentiation
___ stem cells produce erythrocytes, leukocytes, platelets
with the exception of ______, all blood cells are derived from the myloid stem cells
absorption of digested fat
The primary function of the lymphatic system is the ____ __ ____ ____ from the intestines to the blood stream.
filter out, destroy
Lymph nodes ___ ___ and ____ infectious toxic material
After birth, the spleen takes on the function of producing ____, and removing old RBC's, old platelets, and microorganisms from the blood and produces bilirubin
stores RBC's and pumps them into the circulation when needed.
To see injury to the spleen, a dr. would order a ___ ___ x-ray
caused by a reaction between protein antibodies in the blood plasma and surface antigens on the red blood cell membrane
Type ____ blood individuals have no antibodies in their blood plasma
Type ____ is known as "unversal recipients"
Type ___ is known as the "universal donor"
Rh-negative mothers carrying an Rh-positive baby can be treated with a drug called _____ to protect the developing fetus.
____ transport oxygen to cells and take carbon dioxide to the lungs
tests that aid in describing the anemias
tells about the size of RBC's
tells about the concentrations of RBC's
tells about the weight of RBC's
refers to the number of packed RBC's found in 100 ml of blood
is the oxygen carrying component of the RBC's and is more reliable in determining the severity of anemia
___ is decreased in pt's with loss of blood, leukemia, and Hodgkin's disease
immature, non-nucleated RBC's that are formed in the bone marrow, pass into circulation and in 1-2 days are mature RBC's
measures the rate at which RBC's settle out of unclotted blood.
sickle cell anemia, CHF
Decreased levels in Sed Rate are indicative of what two conditions
Hodgkin's disease, rheumatoid arthritis
increased levels in sed rate are indicative of that two conditions
useful in differentiating an acute from a chronic disorder
Increased serum iron = excessive ____ _____
iron deficient anemia
decreased serum iron = ___ ____ ____
total iron-binding capacity
measures amounts of additional iron that transferin is able to combine with
plasma protein responsible for iron
sickle cell anemia, hemolytic anemia
decreased TIBC levels is indicative of what two disorders
increased TIBC levels usually means a(n) _____ disorder
formed from the breakdown of hemoglobin and is carried in the plasma to the liver
direct reacting (soluble) bilirubin
indirect reacting (protein bound) bilirubin
Increased ____ bilirubin = obstructive jaundice caused by stones or neoplasms, liver cancer, Wilson's disease
accumulation of copper in brain, liver, kidneys, corneas
increased ____ bilirubin = sickle cell anemia, transfusion reaction, hemolytic anemias, pernicious anemia
used to diagnose pernicious anemia in which the intrinsic factor is deficient and in which a reduction of vit b12 absorption results
When Vit ____ can not be absorbed, it passes through the GI system and does not appear in the urine.
To perform the Schilling test, a _______ urine collection must be made.
gastric mucosa, pernicious anemia
Instrinsic factor is produced by the ___ ____ and when this factor is missing, ___ _____ develops
decreased _____ = pernicious anemia
AML, CML, hepatitis
increased vit B12 = what three conditions
serum folate level
useful in classifying anemias; b6 test
b6 anemia, folic acid anemia
decreased serum folate level = what 2 conditions
elevated serum folate = what condition
test in which gastric contents is aspirated and analyzed
normal range for WBC's
aids in the dx of infection and blood disorders such as leukemias
blood culture and sensitivity
aids in determination of type of infection, taken prior to administration of antibiotics
helps analyze each type of WBC and determines the number
type of WBC produced in the red bone marrow - neutrophils, eosinophils and basophils
type of WBC produced in the lymphatic tissue of the spleen, lymph nodes and thymus as well as in red bone marrow - lymphocytes, monocytes
decreased ____ = leukemias, iron deficient anemia
decreased ____ = cancer, leukemia, aplastic anemia
normal range for platelet count
leukemia, aplastic anemia, ITP
decreased platelets = what 3 conditions
infection, blood loss, polycythemia
increased platelets = what 3 conditions
After a bone marrow biopsy, the nurse should apply pressure to the biopsy site for _____ minutes
used to replace erythrocytes, effective response to infusion is the resolution of the symptoms of anemia
used to treat thrombocytopenia and bleeding
____ ____ is done in which donor RBC's are combined with the recipient's serum and Coomb's serum.
Before blood infusion, the nurse should check the pt's ____.
When doing a blood infusion, the nurse should start the IV with an ____ gauge needle and a 0.9% NS to prevent agglutination
BP, dyspnea, urine, allergic
Immediate transfusion reactions may include: decreased ____, ______, increased ____ output, and ____ reactions that would include rashes, itching and swellin.
Iron Deficiency Anemia
most common type of anemia, results in a decreased supply of iron for the manufacture of hemoglobin in RBC's
orange juice, milk, antacids
For Iron preparations:
*Take oral dose with _______ to enhance absorption
*Avoid ____ products, and ____ that may inhibit absorption
Parental admin of iron- use ____ to decrease trauma to surrounding tissue.
vitamin b12 deficiency anemia, an autoimmune disorder in which parietal cells are destroyed
Pernicious anemia usually results from a loss of the ____ ____ of the GI tract
sickle cell anemia
caused by inheritance of a gene for a structurally abnormal portion of hemoglobin, in which the cells become rigid and clump together, obstructing capillary blood flow causing agglutination
Hemoglobin S (HgS)
the sickle hemoglobin
name two situations that precipitate sickling in sickle cell pts
Teach pt's with sickle cell anemia to avoid _____ by avoiding high altitudes and non-pressurized airplanes
Encourage adequate fluids as dehydration causes sickle cell ___ in sickle cell pts.
severe pain, fever, swollen joints
name three sign/symptoms of sickle cell crisis
O2, pain, morphine, hydration, restrictive clothing, cardiac system
Treatment for sickle cell crisis include:
* administer ____ as prescribed
*administer ____ meds as prescribed, usually ____.
*Maintain adequate _____ (IV fluids may be prescribed)
*remove any ______ _____
monitor ____ _____ MOST IMPORTANT*
a deficiency of circulating blood cells resulting from arrested development of cells within the bone marrow, caused by chronic exposure to myelotoxic agents, NOT CONGENITAL
HLA sibling donor
With aplastic anemia pts, if there is no response to treatment, a bone marrow transplant may be performed from a matched ___ ____ _____.
genetic disorder resulting in abnormal Hgb synthesis, usually in people of Mediterranean ancestry
Thalassemia is treated with chelation therapy with _____ to prevent organ damage from elevated levels of iron caused by multiple blood transfusion
increased production of red blood cells causing an increase in blood volume and viscosity
removal of blood to treat polycythemia - removes 350-500 ml every other day
usually in children between ages 2-6 and has a rapid onset.
If ALL goes untreated the survival rate is ____ months
bone marrow biopsy
test done to identify leukemic blast phase cells
Infection is a major cause of death for immunosuppressed pts. When dealing with these pts, such as one with leukemia, the nurse should take ____ precautions
4, flowers, unpeeled fruits, vegetables
When pt is in protective isolation, monitor temps every ___ hours, and make sure no ___ or _____ _____ and ___ are in the room
severely decreased number of cells (monocytes, lymphocytes, neutrophils, eosinophils, basophils) caused by medications or viral infections
Nursing intervention for pt with agranulocytosis is ______ control.
swelling of the tissues drained by the lymphatic system, prominent in mastectomy patients
Characterized by the presence of Reed-Sternberg cells in the lymph nodes.
Hodgkin's may be indicated if a pt has ____ ___ of the lymph nodes.
condition in which there is alternating clotting and hemorrhaging
process in which the body tries to rid itself of clots thus causing hemorrhage, as with pts with DIC
classic hemophillia, results from a deficiency of factor VIII
aka Christmas disease - is a defiency of factor IX
In hemophilia, males inherit it from their ____, and females inherit the ____ status from their fathers.
Hemophilia pts may present with ____ ____ and a normal bleeding time
bleeding, bleeding precautions
A nurse should monitor a hemophilia pt for ____ and maintain ____ _____.
Hemophilia pts should avoid activities, such as ____ ____.
decrease in the number of platelets
inhibits the formation of fibrin to prevent clot cormation
aspirin, nsaids, coumadin, heparin
name for examples of anticoagulants
promote digestion of fibrin to dissolve blood clots.
name an example of a thrombolytic
Name a main condition treated by thrombolytics
APTT, PTT, PT/INR
name three labs to monitor when administering anticoagulants
antidote to heparin
inhibits the dissolution of blood clots
name an example of a hemolytic agent
medications for this are supplements or replacements of essential vitamins and minerals
Warn pts about _____ ______ when taking iron, and that it is not indicative of bleeding.
Do not give iron supplements with ____, take them with _____