AVN 1425 Med-Surg II Quiz 3 Study Guide

AVN 1425 Med-Surg II Quiz 3 Study Guide

• Spleen Function: Along with the liver, the spleen removes old and damaged red blood cells (RBCs). It filters blood, removing pathogens and debris while producing lymphocytes (white blood cells, WBCs).

CBC Components and Normal Ranges

• Red Blood Cells (RBCs):
• Females: 4.2-5.4 million/mm³
• Males: 4.7-6.1 million/mm³
• White Blood Cells (WBCs): 5,000-10,000/mm³
• Hemoglobin:
• Females: 12.0-16.7 g/dL
• Males: 13.0-18.0 g/dL
• Platelets: 150,000-400,000/mm³ of blood
• Hematocrit:
• Females: 37% - 47%
• Males: 42% - 52%

Anemia Clinical Manifestations

• Symptoms: Symptoms associated with anemia, including shortness of breath (SOB), fatigue, a pounding heartbeat, dizziness, and headaches.
• Iron Deficiency Anemia: A condition involving insufficient iron levels in the body, which can lead to various symptoms.
• Vitamin Deficiency Anemia: A condition resulting from a lack of vitamins, typically Vitamin B12.

Bone Marrow Biopsy Post-Procedure Interventions

• Immediate Interventions: Observe for swelling, tenderness, and signs of infection. These signs indicate if bleeding, or infection are occurring.

Platelet Anatomy and Physiology

• Thrombocytes: Platelets are small, specific blood components crucial for clotting.
• Adherence and Clumping: They adhere to damaged vessels and clump together to stop bleeding.
• Clotting Function: Platelets initiate blood clotting, preventing further bleeding. The fibrin attaches to platelets which then create a clot.

Decreased Immunity in the Elderly

• Reduced Bone Marrow Function: The elderly often experience reduced bone marrow function, impacting antibody production.
• Weakened Immunity: The reduced bone marrow function contributes to a decrease in immune response, making them more susceptible to infection.
• Less Effective Antibody Response: The ability to mount an appropriate immune response to foreign substances is lessened in the elderly.

Sickle Cell Anemia

• No Symptoms in Circulation: If sickle cells do not cause blockages in circulation, there are no associated symptoms.
• Symptoms: Include pallor, lethargy, pain, indicating low oxygen and blood flow.
• Sickle Cell Crisis: Pain episodes due to a lack of blood flow in blood vessels and low oxygen. Sickle cell crisis episodes indicate the need for medical attention.
• Signs of Anemia: After a sickle cell crisis, anemia symptoms will often become apparent.
• Hand-Foot Syndrome: Painful swelling in the hands and feet, a specific manifestation.

Pernicious Anemia

• Megaloblastic Anemia: Another name for Pernicious anemia. It's caused by vitamin deficiency, often vitamin B12.
• Abnormal Erythrocytes: Abnormal red blood cell production that does not function normally.
• Reduced RBC Production: Reduced red blood cell production, due to a lack of intrinsic factor that does not absorb vitamin B12.

Iron Deficiency Anemia

• See question #3:
• Symptoms: Clinical manifestations are listed in an earlier section.

Anemia Causes

• Blood Loss: One of the causes of anemia, involving blood loss.
• Failure in Cell Production: Another cause of anemia occurring from the lack of cell production.
• RBC Destruction: Another cause of anemia arising from the destruction of red blood cells.

Ferrous Sulfate (Feosol) Patient Education

• Indications: Treat iron deficiency anemia.
• Mechanism of Action (MOA): Increases elemental iron for hemoglobin formation.
• Nursing Implications: May cause gastrointestinal upset (nausea, diarrhea, constipation). Inform the patient the stool will turn black.
• Patient Teaching: Take with vitamin C-rich foods; avoid taking with milk (reduces absorption).

Aplastic Anemia

• Causes: Develop after viral infections or reaction to medicines. Drug and chemical toxicity can cause it too.
• Symptoms: Anemia symptoms, ecchymosis, petechiae, hemorrhage, frequent infections.
• Potential Complications: Possible bleeding emergencies from these symptoms.
• Treatment: Elimination of underlying issues, administering packed red blood cells, and platelets. Antibodies for infections, and supplemental oxygen as needed.

Sickle Cell Anemia Complications

• Blood Vessel Blockage: Causes impaired blood flow, leading to organ damage.
• Anemia: Resulting from a rapid destruction of sickle cells and loss of normal hemoglobin.
• Crises: Episodes of pain caused by blood vessel blockage.

Sickle Cell Crisis Prevention

• Folic Acid: Regular intake of folic acid is crucial for RBC production.
• Sufficient Protein: Eating a diet with sufficient protein helps build RBCs.
• Immunizations: Encourage vaccinations to prevent infections.
• Hydration: Adequate fluid intake is vital to keep blood flowing smoothly.
• Limit Alcohol/Drugs: Avoid alcohol and recreational drugs.
• Hydroxyurea (Hydrea): Can reduce sickling episodes, and potentially L-glutamine can be used in addition to hydroxyurea.

Polycythemia Vera

• Clinical Manifestations: Reddish face, deep red-purple lips, fatigue, weakness, dizziness, headaches, enlarged spleen, congested liver and tendency for excessive bleeding if blood vessels rupture. -High Blood Pressure and Heart Problems: Potential development of elevated blood pressure and heart enlargement due to the higher blood volume.
• Excessive Bleeding: Tendency to experience bleeding, even from minor injuries.

Acute Myelogenous Leukemia (AML) Pathophysiology

• Abnormal Myeloblasts: Bone marrow produces abnormal immature white blood cells (WBCs) called myeloblasts that cannot mature properly into granulocytes.

Transfusion Reaction

• Mild Reactions: Symptoms include rash, hives, itching, and facial flushing.
• Severe Reactions: Symptoms include shock, rising body temperature by 2 degrees or more.

Hemophilia

• Nursing Diagnoses: Priority nursing diagnoses often involve physical examinations, CBC, and coagulation profiling.

Bleeding/Coagulation Disorder Assessment

• Questions: Ask about previous transfusions, family history of hemophilia, joint pain, swelling, convulsions, and frequent nosebleeds.
• Bruising: Assess easy bruising.
• Surgical Procedures: How soon does bleeding stop?

Iron Deficiency Anemia Nursing Diagnoses

• Common Problems: Altered activity tolerance, altered gas exchange, altered nutrition.
• Knowledge Deficit: Poor knowledge regarding nutrition and medication management.

Disseminated Intravascular Coagulation (DIC)

• Manifestations: Continued bleeding from IV sites, extensive bruising, ecchymoses (bruising in no-trauma areas). formation of petechiae.

Sickle Cell Crisis Priority Interventions

• Pain Management: Prioritizing pain management is crucial for patient comfort.
• Rehydration: Maintaining proper hydration to improve the blood's flow.

Opioid Medication Seeking

• Concerns: Assessing and determining if the patient is seeking opioid medication inappropriately due to pain.

Hematologic Disorder Patient Prioritization

• Assessment: Assess the patient's overall situation and prioritize based on urgency and safety concerns for the patient's specific condition.

Prepare for your Med-Surg II exam with this comprehensive quiz covering spleen function, CBC components, and anemia clinical manifestations. Test your knowledge on normal ranges for red and white blood cells, hemoglobin, and the symptoms of various types of anemia. This study guide is essential for nursing students specializing in medical-surgical nursing.