Bone Marrow Aspiration and Biopsy Quiz
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Questions and Answers

What is the main purpose of bone marrow aspiration and biopsy?

  • To assess the quantity and quality of cells produced within the marrow (correct)
  • To evaluate kidney function
  • To monitor glucose levels in the blood
  • To check for respiratory infections

    • Which of the following is a potential complication of a bone marrow biopsy?

  • Dizziness
  • Persistent pain at the biopsy site (correct)
  • Improved sleep quality
  • Increased appetite

    • In which condition is a splenectomy indicated?

  • Osteoporosis
  • Hypersplenism (correct)
  • Asthma exacerbation
  • Hyperthyroidism

    • What type of transplant involves using the patient’s own stem cells?

    <p>Autologous transplant (A)</p> Signup and view all the answers

    Which therapeutic approach is specifically used for conditions like myasthenia gravis and sickle cell disease?

    <p>Therapeutic apheresis (D)</p> Signup and view all the answers

    Which analgesic agent should be avoided immediately after a bone marrow aspiration due to potential bleeding issues?

    <p>Aspirin (C)</p> Signup and view all the answers

    During a bone marrow procedure, what is a suggested nursing intervention to help the patient?

    <p>Promote deep breathing and relaxation (A)</p> Signup and view all the answers

    What does therapeutic phlebotomy involve?

    <p>Removal of a certain amount of blood under controlled conditions (A)</p> Signup and view all the answers

    What is a common dietary recommendation for managing iron deficiency anemia?

    <p>Diet high in iron, avoiding teas and coffee (D)</p> Signup and view all the answers

    What are typical laboratory findings in a patient with iron deficiency anemia?

    <p>Decreased ferritin and microcytic hypochromic RBCs (D)</p> Signup and view all the answers

    Which condition is least likely to result in fatigue and increased feelings of depression in a 50-year-old woman?

    <p>Chronic fatigue syndrome (A)</p> Signup and view all the answers

    The presence of brittle nails in a patient should raise suspicion for which condition?

    <p>Iron deficiency anemia (B)</p> Signup and view all the answers

    Which of the following would most likely indicate a nursing diagnosis of imbalanced nutrition related to iron deficiency anemia?

    <p>Inadequate intake of iron-rich foods (D)</p> Signup and view all the answers

    What is the primary reason for transfusion therapy in cases of iron deficiency anemia?

    <p>To increase hemoglobin levels quickly (C)</p> Signup and view all the answers

    Which vitamin is commonly prescribed to enhance iron absorption in patients with iron deficiency anemia?

    <p>Ascorbic acid (Vitamin C) (A)</p> Signup and view all the answers

    A patient is diagnosed with iron deficiency anemia. Which symptom would least likely be associated with this condition?

    <p>Heightened sense of energy (D)</p> Signup and view all the answers

    Which of the following medications is NOT typically used to treat iron deficiency anemia?

    <p>Antidepressants (B)</p> Signup and view all the answers

    What could be a non-dietary contributing factor to the development of iron deficiency anemia?

    <p>Heavy menstrual bleeding (B)</p> Signup and view all the answers

    What role does erythropoietin play in response to red blood cell destruction?

    <p>It stimulates bone marrow to produce new erythrocytes. (A)</p> Signup and view all the answers

    Which statement about sickle hemoglobin (HbS) is true?

    <p>HbS forms a crystal-like structure in low oxygen tension. (C)</p> Signup and view all the answers

    What is the approximate lifespan of sickled erythrocytes?

    <p>10 to 12 days (B)</p> Signup and view all the answers

    How does cold exposure affect sickle cell disease?

    <p>It slows blood flow through vasoconstriction. (A)</p> Signup and view all the answers

    What is the carrier status referred to as sickle cell trait?

    <p>A person carries the gene but does not exhibit symptoms. (B)</p> Signup and view all the answers

    What are the potential complications that arise from sickle cell disease?

    <p>Chronic hemolysis or thrombosis. (C)</p> Signup and view all the answers

    What happens to erythrocytes containing HbS when there is decreased oxygen in venous blood?

    <p>They lose their biconcave shape and become rigid. (D)</p> Signup and view all the answers

    What process leads to the formation of bilirubin from hemoglobin?

    <p>Excessive breakdown of the heme component (A)</p> Signup and view all the answers

    What are the clinical manifestations of sickle cell disease primarily caused by?

    <p>Chronic hemolysis or thrombosis. (B)</p> Signup and view all the answers

    Which statement about the sickling episodes in sickle cell disease is accurate?

    <p>They are intermittent and can be affected by environmental factors. (A)</p> Signup and view all the answers

    What is a characteristic of chronic leukemia?

    <p>It progresses slowly and can last for years (B)</p> Signup and view all the answers

    Which symptom would most likely indicate thrombocytopenia?

    <p>Prolonged bleeding after minor injuries (A)</p> Signup and view all the answers

    Which of the following symptoms is not commonly associated with leukemia?

    <p>Constant high blood pressure (C)</p> Signup and view all the answers

    Which clinical finding suggests the presence of anemia?

    <p>Pallor and fatigue (A)</p> Signup and view all the answers

    What specifically characterizes the bleeding associated with leukemia?

    <p>Occurs as both overt and occult types (D)</p> Signup and view all the answers

    What is a common non-bleeding symptom experienced in patients with leukemia?

    <p>Joint pain and swelling (C)</p> Signup and view all the answers

    What does the presence of ecchymosis and petechiae indicate in a patient?

    <p>Blood clotting disorders (B)</p> Signup and view all the answers

    What is the most common cause of an aplastic crisis in sickle cell patients?

    <p>Human parvovirus infection (D)</p> Signup and view all the answers

    Which of the following is NOT a complication commonly associated with chronic anemia in sickle cell disease?

    <p>Fibromyalgia (A)</p> Signup and view all the answers

    In sickle cell disease, what is the term used to describe the abnormal accumulation of red blood cells in an organ?

    <p>Sequestration (B)</p> Signup and view all the answers

    What is a typical hemoglobin value range for a patient with sickle cell disease?

    <p>7 to 10 g/dL (C)</p> Signup and view all the answers

    Which organ is most commonly involved in sequestration crisis in children with sickle cell anemia?

    <p>Spleen (A)</p> Signup and view all the answers

    What is a potential long-term consequence of repeated splenic sequestration in children with sickle cell disease?

    <p>Auto splenectomy (C)</p> Signup and view all the answers

    Which condition is characterized by painful acute vaso-occlusive crisis due to tissue hypoxia in sickle cell patients?

    <p>Vaso-occlusive crisis (A)</p> Signup and view all the answers

    What is the most effective potential cure for sickle cell disease?

    <p>Hematopoietic Stem Cell Transplant (D)</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with chronic anemia in sickle cell disease?

    <p>Elevated blood pressure (A)</p> Signup and view all the answers

    What is a common primary site affected by thrombosis in sickle cell patients?

    <p>Spleen (D)</p> Signup and view all the answers

    Flashcards

    Bone Marrow Aspiration

    A procedure to check the quantity and quality of blood cells in the bone marrow, also checking for infection or tumor.

    Bone Marrow Biopsy

    A procedure to remove a small piece of bone marrow tissue for examination.

    Splenectomy

    Surgical removal of the spleen.

    Therapeutic Apheresis

    Separating specific components (like platelets, leukocytes, or plasma) from blood, removing the unwanted substances, and returning the rest to the patient.

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    Hematopoietic Stem Cell Transplant

    Using stem cells from a donor (allogenic) or the patient's own (autologous) to treat blood disorders by replacing damaged stem cells.

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    Hypersplenism

    A condition where the spleen removes too many blood cells, potentially causing anemia or thrombocytopenia.

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    Therapeutic Phlebotomy

    Controlled removal of blood.

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    Autologous transplant

    Use of the patient's own stem cells in a transplant.

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    Leukemia

    A type of cancer that affects blood-forming cells in the bone marrow, leading to an overproduction of abnormal white blood cells that can't function properly.

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    Chronic Leukemia

    A type of leukemia where abnormal white blood cells mature, but they are still not functional, and the disease progresses more slowly, lasting for years.

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    Overt bleeding

    Bleeding that is visible, such as nosebleeds, gum bleeding, rectal bleeding, hematuria (blood in urine), or heavy menstrual flow.

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    Occult bleeding

    Bleeding that is not visible but can be detected by tests, such as in a fecal occult blood test.

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    Symptoms of Anemia

    Fatigue, pallor, shortness of breath during exercise, increased heart rate, dizziness or fainting.

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    Symptoms of Thrombocytopenia

    Bleeding, unusual bruising, prolonged bleeding after injury, heavy menstrual flow.

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    Enlarged lymph nodes, spleen, liver

    Swelling in these areas due to leukemic infiltration, which means abnormal white blood cells are accumulating in these organs.

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    Iron Deficiency Anemia Symptoms

    A condition caused by low iron levels, resulting in symptoms like unusual cravings (ice, clay), weakness, fatigue, brittle nails, and difficulty focusing.

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    Iron Deficiency Anemia Diagnostic Tests

    Tests like blood tests to check Hemoglobin, hematocrit, iron, ferritin, reticulocytes, etc., and a peripheral blood smear to look for small, pale red blood cells.

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    Iron Deficiency Anemia Treatment

    Focuses on increased iron intake through diet, including iron-rich foods, roughage, protein, and fluids; avoiding teas, and coffee which can hinder absorption. Transfusion may be needed.

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    Iron Deficiency Anemia Nursing Diagnoses

    Includes nutritional imbalances (low iron intake), difficulty with physical activity, and impaired blood circulation (due to low oxygen-carrying capacity of the blood).

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    Iron Deficiency Anemia Signs in the Elderly

    In the elderly, iron deficiency anemia can present with unusual cravings (ice, clay), weakness, fatigue, brittle nails, difficulty concentrating and impaired thought processes, and potential depressive symptoms.

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    Iron Deficiency Anemia in Pregnant Women

    Pregnant women may experience unusual cravings (ice, clay), weakness, fatigue, and brittle nails. It's important to identify and treat this condition during pregnancy.

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    Iron Deficiency Anemia Treatments-Medications

    Medication options include iron supplements (like ferrous sulfate), Vitamin B6, Vitamin C, and Vitamin B12.

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    Iron deficiency anemia diagnostic indicator

    A Hemoglobin and hematocrit levels lower than expected, along with decreased iron, ferritin and reticulocyte levels.

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    Microcytic and hypochromic RBCs

    Small, pale red blood cells, indicative of anemia issues.

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    Anemia

    A condition characterized by a reduced number of red blood cells or a decrease in hemoglobin.

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    Sickle Cell Anemia

    A genetic blood disorder where red blood cells are abnormally shaped, leading to blockage of blood vessels, pain, and organ damage.

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    Vaso-occlusive Crisis

    A painful episode in sickle cell anemia when sickle cells block blood vessels, causing tissue hypoxia and necrosis.

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    Aplastic Crisis

    A sudden drop in red blood cell production in sickle cell anemia, caused by infection (usually parvovirus), leading to severe anemia.

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    Sequestration Crisis

    A dangerous complication where sickle cells accumulate in organs, blocking blood flow and potentially causing organ damage.

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    Autosplenectomy

    The functional loss of the spleen in children with sickle cell anemia due to repeated episodes of blood vessel blockage.

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    Hematopoietic Stem Cell Transplant (HSCT)

    A potential cure for sickle cell anemia by replacing damaged stem cells with healthy ones from a donor or the patient's own.

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    What are the three types of sickle cell episodes/crisis in adults?

    Vaso-occlusive crisis, Aplastic crisis, and Sequestration crisis.

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    What causes a vaso-occlusive crisis?

    A painful episode where sickle cells block blood vessels, causing tissue hypoxia and necrosis.

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    What causes an aplastic crisis?

    A sudden drop in red blood cell production caused by infection (usually parvovirus).

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    What causes a sequestration crisis?

    Sickle cells accumulate in organs, blocking blood flow and potentially causing organ damage.

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    Sickle Cell Disease

    A severe hemolytic anemia caused by inheriting the sickle hemoglobin gene, leading to defective hemoglobin molecules.

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    Sickle Cell Trait

    The carrier state for sickle cell disease, characterized by less than 50% of hemoglobin being HbS in each red blood cell.

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    Sickle Hemoglobin (HbS)

    Defective hemoglobin that forms crystals in low oxygen conditions, causing red blood cell deformation.

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    Hemolytic Anemia

    A condition where red blood cells are destroyed faster than they are produced.

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    Sickled Cells

    Deformed, rigid, and sickle-shaped red blood cells caused by HbS.

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    Erythropoietin

    A hormone that stimulates bone marrow to make new red blood cells.

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    Reticulocytes

    Immature red blood cells released prematurely into the circulation, as a bone marrow compensatory response to red blood cell destruction.

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    Bilirubin

    A byproduct of heme breakdown in red blood cells, processed and excreted in bile.

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    Ischemia/Infarction

    Reduced/blocked blood supply to a region, potentially leading to tissue damage.

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    Symptoms of Sickle Cell Disease

    Pain, swelling, fever, and other symptoms resulting from chronic hemolysis and thrombosis.

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    Study Notes

    Management of Patients with Hematologic Disorders

    • Hematologic disorders affect the blood and its production sites, including bone marrow and the reticuloendothelial system (RES).
    • Blood is a specialized fluid organ, distinct from other organs in its liquid state.
    • Blood is composed of plasma (55% of volume) and cells.
    • Plasma contains proteins (albumin, globulin, fibrinogen), electrolytes, waste products, and nutrients.
    • The cellular component of blood includes erythrocytes (red blood cells), leukocytes (white blood cells), and thrombocytes (platelets).
    • These cells generally comprise 40%-45% of blood volume.
    • Hematopoiesis (blood cell formation) primarily occurs in bone marrow.

    Objectives

    • Describe hematopoiesis and hemostasis.
    • Discuss the significance of patient history for hematologic health assessment.
    • Detail techniques for a comprehensive physical assessment of hematologic function.
    • Explain diagnostic tests and related nursing implications used in hematologic function evaluation.
    • Identify blood disorder therapies and nursing implications for blood component administration.

    Hemostasis

    • Hemostasis is the process of preventing blood loss in intact vessels and stopping bleeding from a severed vessel.
    • This process, requiring sufficient functional platelets, involves three phases:
      • Vascular phase (spasm in damaged muscle).
      • Platelet phase (aggregation and adhesion).
      • Coagulation phase (clot formation, retraction, and destruction).

    Assessment

    • Health history includes:
      • Nutritional history.
      • Use of medications (prescription, OTC, herbal).
      • Past medical history (frequent infections, bleeding disorders, and others).
      • Surgical history, recent trauma, and others.
      • Onset, severity, and contributing factors of symptoms.

    Physical Examination

    • Include thorough assessment of skin, oral cavity, lymph nodes, and spleen.
    • Assess signs like:
      • Pallor (anemia).
      • Jaundice (hemolytic anemia).
      • Bruising.
      • Palmar creases (anemia).
      • Tachycardia (anemia).
      • Character of pulse.

    Diagnostic Evaluation

    • Complete blood count (CBC) measures blood cells (leukocytes, erythrocytes, and platelets), hemoglobin, hematocrit (percentage of blood volume consisting of erythrocytes), and RBC indices.
    • Peripheral blood smear examines erythrocytes and platelets, along with the appearance of leukocytes, to identify hematologic conditions.

    Bone Marrow Aspiration and Biopsy

    • Used to assess the quantity and quality of cells produced by the bone marrow.
    • In adults, typically performed from the iliac crest or occasionally the sternum.
    • Nursing interventions primarily center around:
      • Procedure explanation and consent.
      • Comfort measures and relaxation for patient.
      • Post-procedure monitoring with analgesia (if required).

    Therapeutic Approaches to Hematologic Disorders

    • Splenectomy: surgical spleen removal.
    • Therapeutic Apheresis: the removal of specific components (such as platelets or leukocytes or plasma) from a patient's blood, followed by return of the remaining blood to the patient.
    • Hematopoietic Stem Cell Transplant (HSCT): transplantation of stem cells from a donor or the patient to restore healthy blood cell production.
    • Therapeutic Phlebotomy the removal of a certain amount of blood to control conditions.

    Blood Transfusion

    • Procedure details, including transfusion preparation, patient and blood compatibility verification, transfusion start procedures, observation for adverse reactions, and management of potential complications (overload and others).
    • Postprocedure monitoring, including vital signs and assessing for complications.

    Anemia

    Defined as lower-than-normal hemoglobin concentration or fewer-than-normal erythrocytes. It's a symptom, not a diagnosis.

    Iron Deficiency Anemia

    • Characterized by insufficient body iron content that impacts hemoglobin synthesis.
    • Common causes include chronic blood loss (GI bleeding).
    • Findings: pallor, glossitis, headache, irritability, depression, impairment of thought processes, weakness, fatigue, sensitivity to cold.
    • Assessment findings include pica (cravings for non-nutritive substances), pallor, glossitis (inflammation of the tongue), and angular cheilosis (inflammation of the corners of the mouth).
    • Treatment involves iron-rich diet, supplements, and stopping of unnecessary blood loss.

    Megaloblastic Anemias

    • Caused by vitamin B12 or folic acid deficiencies.
    • The erythrocytes produced are abnormally large and termed megaloblasts.
    • Folic acid is present in green vegetables and liver; deficiency, common in those with liver disease, pregnancy, or poor diet.
    • Treatment centers on supplements; patients need to work with a nutritionist to provide a proper diet that enables adequate absorption and intake of folic acid.

    Pernicious Anemia

    • Type of megaloblastic anemia, specifically due to vitamin B12 deficiency.
    • The body needs intrinsic factor—a substance secreted by the stomach—for vitamin B12 absorption from the ileum.
    • Lack or impaired function of intrinsic factor causes vitamin B12 malabsorption, leading to pernicious anemia.
    • Findings include a sore tongue, mild diarrhea, confusion, paresthesias (tingling) and balance issues.
    • Treatment includes supplemental vitamin B12 to achieve normal blood counts.

    Hemolytic Anemias

    • Marked by shortened erythrocyte lifespan and reduced blood cell count.
    • Causes vary, including genetic defects and other factors.
    • Reduced erythrocyte count leads to decreased oxygen transport to tissues; these patients often require transfusions.

    Sickle Cell Disease

    • Severe hemolytic anemia caused by inheritance of the sickle hemoglobin gene.
    • Results in misshapen (sickled) red blood cells.
    • Episodes of sickling can block blood vessels, causing pain and organ damage.

    Aplastic Anemia

    • Rare bone marrow failure characterized by the insufficient production of all blood cell types.
    • Factors causing destruction or damage of bone marrow stem cells range from genetic predisposition to environmental factors.
    • Treatment primarily focuses on supportive care (transfusions) until a stem cell transplant is possible.

    Leukemia

    • A group of malignant hematological disorders.
    • Characterized by abnormal white blood cell production and often immature cells in the bone marrow.
    • Leukemias are classified as acute or chronic, based on the time it takes for symptoms to appear and the type of leukemia cell that starts to increase in the blood.

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    L6-Management of patients with Hematologic disorders PDF

    Description

    Test your knowledge on bone marrow aspiration and biopsy procedures, complications, and related medical conditions. This quiz covers various aspects of hematology including therapies and diagnostic measures for iron deficiency anemia and related disorders.

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