NCM 112 A Hematology PDF Past Paper 2024-2025

NCM 112 A: MEDICAL SURGICAL NURSING HEMATOLOGY PANPACIFIC UNIVERSITY: CARL BALITA INSTITUTE OF HEALTH SCIENCES 1st SEMESTER A.Y. 2024-2025 HEMATOLOGY ○ Lack of folic acid...

NCM 112 A: MEDICAL SURGICAL NURSING HEMATOLOGY PANPACIFIC UNIVERSITY: CARL BALITA INSTITUTE OF HEALTH SCIENCES 1st SEMESTER A.Y. 2024-2025 HEMATOLOGY ○ Lack of folic acid PERNICIOUS RED BLOOD CELL 4 - 6 MILLION - Layman’s Term for DANGEROUS WHITE BLOOD CELL 10,000 - 15,000 CAUSES: PLATELET 150, 000 - 400, 000 1. DIET ○ ↓ B12 - Animal meat ○ common in vegetarian ppl HEMATOLOGY 2. GASTRECTOMY HEMA: Blood ○ Removal of stomach Blood ○ Stomach : contains intrinsic factor o SOLID: ○ Intrinsic factor: vit. B12 will be attached to it ▪ RBCS, WBC, Platelet o LIQUID: B12 + INTRINSIC FACTOR = ABSORBED ▪ Plasma Absorbed in the ILEUM ▪ 99% water 3. ILEOSTOMY ▪ 1% protein ○ Ileum - small intestine ○ Ostomy - surgical opening I. RED BLOOD CELL (RBC) ○ Ileostomy - surgical opening of the ileum ILEUM - Small Intestine 4-6 million Erythrocytes B12 + INTRINSIC FACTOR + ILEUM = ABSORPTION Stimulus: HYPOXIA (↓O2) Any alteration among the 3 of them can Production: ERYTHROPOIESIS cause/lead to pernicious anemia so when Life span: 120 days the ILEUM is perforated (butas) you will have pernicious anemia PROCESSES erythropoiesis: process of RBC Example: X B12 + IF + Ileum = ↓Absorption Hypoxia → stimulates kidneys → kidneys produce B12 + IF + X Ileum = ↓Absorption erythropoietin → bone marrow (stem cells) → B12 + X IF + Ileum = ↓Absorption a. large SIGNS AND SYMPTOMS: b. poorly functioning, ↓ RBC c. immature RBC = immature reticulocytes (it will not ↓ Hgb reach within 120 ○ the oxygen carrying capacity of the blood d. d) : erythrocytes ○ Hemo - color , Globin - protein Fatigue Vitamin B12 and Folic acid: to mature the ○ Gets tired quickly even when not doing reticulocytes anything. Anorexia I. MEGALOBLASTIC ANEMIA Weight loss Mega: big Palor Quick to die ○ These 4 are the general SIgns and ↓ RBC Symptoms Maturation Failure Anemia Paralysis TYPES: ○ Is what makes pernicious dangerous 1. PERNICIOUS ANEMIA ○ Lack of B12 ○ Pernicious : Dangerous ○ Permanent after 6 months Red beefy / Magenta tongue ○ Hallmark sign 🌟 2. FADA Splenomegaly NCM 112 A: MEDICAL SURGICAL NURSING HEMATOLOGY PANPACIFIC UNIVERSITY: CARL BALITA INSTITUTE OF HEALTH SCIENCES 1st SEMESTER A.Y. 2024-2025 - Folic acid DIAGNOSTIC TEST: - Water soluble ( no overdose because it dissolves in water and 1. CBC be readily absorbed in the ○ Decrease hemoglobin gastrointestinal tract ) ○ Decrease hematocrit (% of RBC) 3. PARENTERAL ( INTRAMUSCULAR ) 2. SCHILLING’S TEST ○ Specimen: urine (There should be no B12 in II. IRON DEFICIENCY ANEMIA the urine because it has already been - other name is Hypochromic Microcytic Anemia absorbed by the ileum. ○ B12 (Radioactive) = rejected by the body CAUSES: 1. Trauma MANAGEMENT: 2. Surgery (Major surgery due to blood loss of ↑500cc) 1. ❌ VITAMIN B12 3. Severe Menstruation 4. Excessive intake of milk (common in U.S) 🌟 ✅ ○ ORAL VITAMIN B12 ○ PARENTERAL VITAMIN B12 SIGNS AND SYMPTOMS: (The 4 general S&Sx of anemia) Intramuscular 1. Fatigue For life 2. Anorexia (loss of appetite) Same date each month (e.g. jan 1 3. Weight loss next is feb 1) 4. Palor (paleness) FADA DIAGNOSTIC EXAM: Lack of Green leafy vegetables intake 1. CBC = expected: ↓Hmg; ↓Hct Animal meat eater 2. Peripheral Blood Smear = is the confirmatory test a.) COLOR = normal: normochromic CAUSES: result: hypochromic 1. DIET b.) SIZE = normal: normocytic a. ↓ green leafy vegetables intake result: microcytic 2. MALNUTRITION That’s why Iron Deficiency Anemia is also 3. ALCOHOL INTAKE known as Hypochromic Microcytic Anemia MANAGEMENT: (Step-Ladder approach) 1. DIET: ↑ Fe / iron rich foods example: (organ meat, liver, green leafy vegetables) (dinuguan = chocolate meat) 2. SUPPLEMENT: Ferrous Sulfate (Fe So4) is given in an Empty Stomach - 1 hour before meal - 2 hours after meal stool: BLACK in color (normal) SIGNS AND SYMPTOMS: absorption: vitamin C (if vitamin) cobalt (if mineral) General s/sx ( Fatigue, anorexia, wt. loss, palor) SE: gastric irritation Splenomegaly - liquid preparation = need straw (to prevent teeth staining) MANAGEMENT: (Step ladder approach) 3. PARENTERAL (IM): Method: Z-track technique 1. DIET - Increase intake of green leafy vegetables III. APLASTIC ANEMIA 2. SUPPLEMENT NCM 112 A: MEDICAL SURGICAL NURSING HEMATOLOGY PANPACIFIC UNIVERSITY: CARL BALITA INSTITUTE OF HEALTH SCIENCES 1st SEMESTER A.Y. 2024-2025 4. Sports other name is ○ Non contact - contact sports (e.g. ○ Yellow Marrow Anemia basketball, volleyball) can cause bleeding ○ Fatty Marrow Anemia IV. POLYCYTHEMIA The bone contains: Increased: RBC, WBC, Platelet RED MARROW - Rbc, Wbc, Platelet YELLOW MARROW - Fats I. RBC CAUSES 1. High altitude areas SIGNS AND SYMPTOMS: PATHOPHY: High altitude areas to increase stimulation of blood to ruddy complexion (parang nagblu-blush) 1. Color: ruddy complexion CAUSES: ○ Redness 1. Only GOD Knows (unknown) 2. Thrombus 2. Exposure to pesticide ○ Blood clot CELL OTHER NAME IF ↓ in number RBC erythrocytes Anemia WBC leukocytes Leukopenia Platelet thrombocytes Thrombocytopeni a if all of it is increase in number: - POLYCYTHEMIA 3. Pain if all of it is decrease in number: - PANCYTOPENIA MANAGEMENT: PATHOPHYSIOLOGY: (start w/ the cause) 1. Increase fluid intake (for blood viscosity) exposure to pesticide → destroys the RED marrow → 2. Ambulate pancytopenia → ↑ YELLOW marrow = ↑ FATS ○ Because immobility can cause blood clot 3. Phlebotomy (donate: to decrease blood) SIGNS AND SYMPTOMS: 1. Fatigue II. WHITE BLOOD CELL (WBC) 2. Anorexia (loss of appetite) 3. Weight loss 10,000 - 15, 000 4. Palor (paleness) Soldiers of the body 5. ↓ WBC = risk for infection (platelet : blood clot) ○ Fights infection ↓ Platelet = bleeding TYPES: MANAGEMENT: 1. Granulocytes 2. Agranulocytes 1. Blood transfusion ○ Whole blood GRANULOCYTES 2. Bone marrow transplant Granules 3. Isolate because of risk for infection NCM 112 A: MEDICAL SURGICAL NURSING HEMATOLOGY PANPACIFIC UNIVERSITY: CARL BALITA INSTITUTE OF HEALTH SCIENCES 1st SEMESTER A.Y. 2024-2025 III. PLATELETS B - Basophils I - for Inflammation Blood clot E - Eosinophils A - Allergic reaction 150,000 - 400,000 IDIOPATHIC THROMBOCYTOPENIC PURPURA N - Neutrophils N - Numerous phagocytosis - Cell eating CAUSES: - WBC eat Auto immune microorganisms ○ produces antibody - fight/attack the platelets = Bleeding SIGNS AND SYMPTOMS: AGRANULOCYTES No Granules 1. Epistaxis Monocytes ○ Nose bleeding Increase WBC 2. Petechiae Agranulocytosis : ↓neutrophils /WBC ○ Small blood clot ○ Ex: dengue CAUSES: 3. Ecchymosis - Anti-thyroid medications ○ Slightly larger or Medium size - No infection because the WBC is only for 4. Purpura infections ○ Large size SIGNS AND SYMPTOMS: ○ bleeding → platelet → clumped platelet → bruise 1. Fever MANAGEMENT: 2. Sore throat 3. Dysphagia (difficulty swallowing) 1. Non contact sports only 4. Odynophagia (painful swallowing) 2. Needle - small needle only because large can cause bleeding MANAGEMENT: 3. Razor - electric a. Because mechanical razor can potentially Antibiotic injure the skin ○ Prophylaxis because there is no infection 4. Thermometer - Axilla Isolate a. Rectal thermometer can cause bleeding Hand Washing Mask