Exam 19 - Disorders Associated with Plts, Clotting, Plasma

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Questions and Answers

Which of the following is a potential cause of decreased platelet production leading to thrombocytopenia?

  • Viral invasion
  • Antibody destruction
  • Aplastic anemia (correct)
  • Platelet sequestration in the spleen

What is the most common cause of thrombocytopenia purpura?

  • Acute form in children
  • Drug-induced
  • Idiopathic (ITP) (correct)
  • Chronic form in women

Which of the following clinical manifestations is specific to platelet disorders?

  • Gingival bleeding
  • Ecchymosis
  • Petechiae (correct)
  • Epistaxis

At what platelet count can spontaneous bleeding occur?

<p>5,000/mm3 (A)</p> Signup and view all the answers

Which of the following diagnostic tests would help identify abnormalities in platelet count and cell lines?

<p>Peripheral blood smear (A)</p> Signup and view all the answers

When monitoring a patient with thrombocytopenia, which assessment finding would indicate a potential complication?

<p>Increased intracranial pressure (A)</p> Signup and view all the answers

What is the therapeutic goal for anticoagulation therapy?

<p>Prevent blood clots (A)</p> Signup and view all the answers

What is the most common symptom associated with heparin therapy?

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

Which of the following is a potential cause of coagulation disorders?

<p>All of the above (D)</p> Signup and view all the answers

What is the initial step in the clotting mechanism?

<p>Formation of a hemostatic plug (C)</p> Signup and view all the answers

Which of the following is a skin and mucous membrane manifestation of coagulation disorders?

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

Which of the following is a potential clinical manifestation of circulatory hypovolemia due to coagulation disorders?

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

What is a potential subjective finding in a patient with a coagulation disorder?

<p>History of bleeding after surgery (D)</p> Signup and view all the answers

Which blood test is used to evaluate the coagulation cascade?

<p>Complete blood count (CBC) (C)</p> Signup and view all the answers

What is a possible medical management option for a patient with a coagulation disorder?

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

What is a key objective finding in a patient with a coagulation disorder?

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

Which of the following is NOT a step in the clotting mechanism?

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

What diagnostic test is used to confirm the diagnosis of Multiple Myeloma?

<p>Bone marrow biopsy (D)</p> Signup and view all the answers

What is a key laboratory marker that can be used to monitor the extent of Multiple Myeloma?

<p>Monoclonal protein (M protein) (D)</p> Signup and view all the answers

Which of the following medications is commonly used to treat Multiple Myeloma?

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

Which of the following is an objective assessment finding that can be observed in a patient with Multiple Myeloma?

<p>Increased body temperature (A)</p> Signup and view all the answers

Which of the following is a nursing intervention related to the management of patients with Multiple Myeloma?

<p>Monitoring vital signs (B)</p> Signup and view all the answers

Which of the following is NOT a factor that is often involved in the etiology of Multiple Myeloma?

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

What is a common clinical manifestation of Disseminated Intravascular Coagulation (DIC)?

<p>Bleeding from unrelated sites (A)</p> Signup and view all the answers

Which of the following is a primary medical management strategy for DIC?

<p>Correction of the underlying cause (B)</p> Signup and view all the answers

Which of the following is a primary nursing intervention in a patient with DIC?

<p>Monitoring for signs of thrombosis and fibrinolysis (A)</p> Signup and view all the answers

What is the purpose of administering Vitamin K in a patient with DIC?

<p>To promote liver synthesis of clotting factors (C)</p> Signup and view all the answers

What is the primary reason for the prolonged partial thromboplastin time (PTT) in patients with a deficiency of factors VIII and/or IX?

<p>Abnormal coagulation process (C)</p> Signup and view all the answers

What is the primary goal of medical management for patients with hemophilia?

<p>Reduce bleeding and pain (D)</p> Signup and view all the answers

Which of these nursing interventions is crucial in managing emergencies related to hemophilia?

<p>Controlling hemorrhage using pressure and cold (D)</p> Signup and view all the answers

What specific guidance should patients with hemophilia receive regarding potential risks?

<p>Understanding of the importance of avoiding injury and aspirin (C)</p> Signup and view all the answers

What is a common characteristic of Von Willebrand's Disease?

<p>Abnormally slow coagulation and spontaneous bleeding (B)</p> Signup and view all the answers

Which of the following treatments is commonly used for mild cases of Von Willebrand's Disease?

<p>Desmopressin (DDAVP) administration (B)</p> Signup and view all the answers

What is the primary underlying cause of Disseminated Intravascular Coagulation (DIC)?

<p>Overstimulation of clotting and anti-clotting processes (B)</p> Signup and view all the answers

Why is DIC considered a serious and potentially life-threatening condition?

<p>It can lead to severe kidney failure and multi-organ dysfunction (B)</p> Signup and view all the answers

Flashcards

Heparin

An anticoagulant used to prevent blood clots.

Thrombocytopenia

A condition with fewer than 150,000 platelets/mm3.

Petechiae

Small red or purple spots on the skin indicative of bleeding disorders.

Ecchymosis

Bruising caused by bleeding underneath the skin.

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Signs of hypovolemia

Vital signs indicating low blood volume or shock.

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Complete Blood Count (CBC)

Test to measure different components of blood, including platelets.

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Bone Marrow Aspiration

A test to check for immature platelets or abnormalities in bone marrow.

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Tapering anticoagulation therapy

Gradually reducing blood-thinning medication under healthcare supervision.

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Clotting Factors Depletion

Reduced levels of proteins necessary for blood clotting, leading to thrombosis and bleeding.

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Microvascular Clotting

Formation of small clots in blood vessels, causing reduced blood flow to organs and potential damage.

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Clinical Manifestations of DIC

Symptoms including bleeding from multiple sites, cold digits, and signs of end-organ damage.

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DIC Diagnostic Tests

Tests indicating DIC include prolonged PT/PTT, positive D-dimer, and decreased fibrinogen.

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Medical Management of DIC

Management includes addressing the underlying cause, controlling bleeding, and replacing lost blood components.

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Coagulation Disorders

Conditions affecting blood clotting mechanisms, leading to abnormal bleeding.

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Causes of Coagulation Disorders

Trauma, vessel damage, liver disease, and disturbances in platelet function.

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Clotting Cascade

A series of reactions involving platelets and clotting factors to form a clot.

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Hemostatic Plug

The initial plug formed by platelets at a site of blood vessel injury.

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Clinical Manifestations

Sign and symptoms that indicate a coagulation disorder, like bleeding and pallor.

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Petechiae and Ecchymosis

Small red or purple spots (petechiae) and larger bruises (ecchymosis) on the skin.

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Hypotension

Lower than normal blood pressure, often seen in circulatory hypovolemia.

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CBC Test

A blood test measuring red blood cells, platelets, and hemoglobin levels.

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Anticoagulation Therapy

Medication used to prevent blood clots by inhibiting clotting factors.

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Liver Disease Effect

Liver impairment that can disrupt production of clotting factors.

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End-organ damage monitoring

Observation of organs affected by disease or treatment processes.

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Monoclonal protein

Immunoglobulin produced by myeloma cells; marker for disease extent.

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Multiple Myeloma

Malignant disease of bone marrow with tumor formation.

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Patient population for Myeloma

Older adults, peaks around 65, affects more men than women.

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Radiographic studies

Imaging tests used to diagnose bone-related diseases.

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Bone marrow biopsy

Test to examine bone marrow for diseases like myeloma.

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Chemotherapy agents

Drugs like Vincristine, Doxorubicin used to treat myeloma.

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Hypercalcemia

High calcium levels in blood, a risk in multiple myeloma.

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Patient assessment data

Includes complaints of pain, temperature, and bleeding potential.

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Deficiency of factors VIII and IX

A condition characterized by the lack of blood clotting factors VIII and/or IX, leading to bleeding disorders.

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Partial Thromboplastin Time (PTT)

A blood test that measures the time it takes for blood to clot; prolonged PTT indicates a coagulation issue.

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Factor VIII administration

Medical management includes transfusions or treatment with Factor VIII to address clotting deficiencies.

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Von Willebrand's Disease

An inherited bleeding disorder caused by a deficiency in factor VIII leading to easy bruising and bleeding.

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Cryoprecipitate

A blood product rich in clotting factors, including factor VIII, used for treating bleeding disorders.

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DIC (Disseminated Intravascular Coagulation)

A serious disorder involving clotting and bleeding due to the overstimulation of coagulation processes.

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Desmopressin (DDAVP)

A medication used to treat mild hemophilia and von Willebrand's disease by increasing factor VIII levels.

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Thrombosis and Fibrinolysis

Thrombosis refers to abnormal blood clot formation, while fibrinolysis is the process of breaking down clots.

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Genetic counseling

A process to help patients and families understand genetic conditions and implications for bleeding disorders.

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Emergency care procedures

Methods like immobilization, applying pressure, and using ice to control bleeding in urgent situations.

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Study Notes

Coagulation Disorders

  • Coagulation disorders are caused by trauma, vessel damage, inadequate vessel function, or irregularities in clotting factor or platelet function. Liver disease can also contribute
  • The clotting cascade involves three distinct reaction chains involving platelets, prothrombin, thrombin, fibrin, tissue factor (Factor III), and factors I-XIII. This process culminates in a hemostatic plug and blood clotting.
  • Vasoconstriction helps limit capillary leakage.
  • Disruptions can be congenital or arise from other diseases or medications

Clinical Manifestations

  • Skin and mucous membrane issues like petechiae, ecchymosis, epistaxis (nosebleeds), and gingival bleeding can occur.
  • Other symptoms include circulatory hypovolemia (hypotension, pallor, cool clammy skin), tachycardia, and gastrointestinal tract bleeding with abdominal pain.
  • Nervous system involvement may include altered responses, malaise, loss of consciousness, and speech changes.

Thrombocytopenia

  • Thrombocytopenia is characterized by a deficiency in circulating platelets or a change in platelet function impacting coagulation.
  • Low platelet counts (less than 150,000/mm³) can be caused by decreased platelet production or survival issues (antibody destruction, infections or viruses).
  • Other potential causes include altered platelet function and sequestration in the spleen.

Von Willebrand Disease

  • This inherited bleeding disorder involves abnormally slow coagulation and spontaneous episodes of bleeding (gastrointestinal, epistaxis, gingival).
  • It's common during pregnancy, menstruation, or after surgery.

Disseminated Intravascular Coagulation (DIC)

  • DIC is a severe coagulopathy resulting from excessive clotting and anti-clotting processes, often due to underlying disorders or injuries.
  • It is associated with significant morbidity and mortality (80-90%).

Multiple Myeloma

  • Multiple myeloma is a malignant plasma cell disease affecting the bone marrow.
  • It involves the rapid build-up of neoplastic plasma cells, which can cause bone destruction and the production of monoclonal proteins (M proteins).
  • Common clinical manifestations include skeletal symptoms, osteolytic lesions, and the spread of tumors to various organs.

Assessment (General)

  • Subjective data includes a comprehensive history of bleeding episodes, exposure to toxins or hazardous materials, medication use, and recent illnesses.
  • Objective data includes physical examination focusing on bleeding tendencies, skin and mucous membrane manifestations, and neurological status.
  • Diagnostic tests like complete blood counts, clotting factor assays, bone marrow biopsies, and imaging studies may aid in assessment and diagnosis.

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