Diseases of the Blood and Lymphatic System

1. Fatigue, Dizziness, Pallor, Dyspnea, Chest Pain, in the presence of a low red blood cells and hemoglobin count

Symptomatic anemia, consider blood transfusion if Hgb is less than 8

2. Anemia due to blood loss, stop the bleeding consider treatment with a blood transfusion

Hypovolemic Anemia

3. Anemia caused by absence of an enzyme that aid in the absorption and utilization of B12 in the GI tract

Pernicious anemia

4. Anemia genetic in nature, characterized by crescent shaped RBC's, severe pain commonly in the abdomen, back and joints, jaundice r/t the rapid break down of RBC's, treated with pain control, fluids, O2 and transfusion for symptom management

Sickle cells anemia

5. Teach the patient with ___________anemia to eat eggs, nuts, legumes, dark green vegetables, shellfish, organ meat, red meat, dark meat or take a ferrous sulfate supplement

Iron deficiency anemia

6. A CBC with differential is ordered and resulted revealing an increase of _________. This is referred to as a "shift" and means that an increasing infection is present due to the increased number of immature WBC's

Neutrophils

7. Precautions requiring the nurse to wear a mask when entering a patients room, prevention of the patient receiving fresh fruit/vegetable/flowers and restricting visitors who have any signs or symptoms of infection

Neutropenic Precautions

8. Also referred to as cancer of the blood, characterized by the inability to produce or the production of dysfunctional WBC's, diagnosed by bone marrow biopsy, treated with Chemotherapy and/or bone marrow transplant

Leukemia

9. Prevent blood loss via clot formation they are produced in the bone marrow

Platelets: Thrombocytes

10. S/SX of __________petechiae, ecchymosis, epistaxis, gingival bleeding, hypotension, pallor, internal bleeding, CNS changes. Most common cause is medication induced followed by immune mediated, can also be present in patients with liver failure. Requires that the nurse place the patient on bleeding precautions

Thrombocytopenia

11. Inherited bleeding disorder that leads to a degree of clotting abnormality, prolonged bleeding time that can be managed but requires close observation once bleeding occur

Von Willebrand's Disease

12. Inherited bleeding disorder that primarily effects males, patients are missing a clotting factor, must restore the clotting factor once bleeding starts, a small cut could be fatal, goal is to prevent bleeding, seek emergency care if bleeding starts_________

Hemophylia

13. Wide spread inflammation leads to release and use of all clotting factors causing micro vascular clotting and hemorrhage at the same time

Disseminated Intravascular Coagulation

14. Inflammation of the lymphatic vessels or nodes, most commonly in the axilla and groin, causing a red streak to appear, good prognosis with antibiotic treatment

Lymphangitis

15. Accumulation of Lymph in the soft tissue r/t obstruction or removal of lymph nodes. No Cure Supportive care = strict skin care, massage toward the heart, limit sodium intake, attend regular appointments for wound care/ compression bandage therapy, elevate extremity at rest, avoid restrictive clothing

Lyphedema

16. Neoplasm of lymphatic tissue, usually begins in the cervical lymph nodes, spreads to other lymph nodes, diagnoses by the presence of Reed-sternburg cells, if caught early cure rates are in the 90th percentile

Hodgkins Lymphoma

17. Neoplasm of the lymphatic Tissue, begins in the lymph nodes spreads to the bones, spleen, liver, GI tract. NO Reed-Sternberg cells present, 5 yr. survival rate = 60%

Non Hodgkins Lymphoma

Narrowing (thinning) of the arterial wall that causes the vessel to dilate

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Hallmark symptoms include pulsatile upper abdominal mass and a widening mediastinum on chest xray

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Patients with this arrhythmia are commonly placed on anti coagulation therapy to prevent this well known complication of this disease process. It is most common arrhythmia among adults over the age of 60

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The priority nursing interventnion of defibrillation

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Cardiac arrest, priority nursing interventions include: check the patient for responsiveness and pulse, activate a code blue, initiate and maintain CPR while waiting for an advanced life support care team

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May lead to stenosis of the valves of the heart. Rheumatic heart disease is one type that may be prevented if strep infections are treated. Patients who have a history of this should have a onetime does of antibiotics administered prior to dental or surgical procedures.

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Genetic condition that causes intermittent arterial spasms and arterial occlusion, finger and toes become pale white or blue may be precipitated by exposure to cold or an auto immune exacerbation. Teach patient to avoid extremes in cold and protect the skin of hands and feet

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Pain, redness, swelling, and warmth, commonly occurs in the lower extremity, but may occur in the upper extremity, may be in a superficial or deep portion of the vein.

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S/S include CP (angina), dyspnea, nausea, dizziness, and diaphoresis

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Occurs with activity or emotional distress. Woman tend to have atypical symptoms including nausea in neck, jaw, abdominal upper back pain and shortness of breath. Men tend to have typical pain including tight squeezing substernal pressure that radiates down the left arm

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Relieved with rest and medication

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Un-relieved with rest or medication and is a medical emergency

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Defined by 2 or more separate readings greater than 140 systolic or 90 diastolic

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Defined by 2 or more separate readings greater than 160 systolic and 100 diastolic

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Severe rapid increase in blood pressure that can happen with any rapid increase from the baseline blood pressure, but commonly becomes symptomatic with systolic BP> 200, diastolic BP >120. S/S include blurred vision, epitaxis, CP, SOB, dizziness, numbness in the arms and legs. MEDICAL EMERGENCY

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Things that we have no control over but contribute to cardiovascular disease: family history, age, sex, culture and ethnic considerations

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Lifestyle patterns that a person has the option to change which contribute to cardiovascular disease

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Most common type. SS: Left ventricular hypertrophy and a decreased ejection fraction. As well as fatigue, pulmonary edema, paroxysmal nocturnal dyspnea, crackles, orthopnea, pink tinged frothy sputum

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Usually occurs secondary to left failure, SS include fatigue, JVD, anorexia, nausea, abdominal distention, ascites, peripheral edema/pitting edema

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Provide frequent rest periods, supplemental oxygen, administer diuretics as ordered, monitor intake and output, daily weight, encourage a low sodium diet, maintain fluid restrictions of ordered, elevate the HOB to prevent dyspnea

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Provided supplemental oxygen, start with the bed rest then progress to activity as tolerated, low sodium low fat diet, educate concerning any new cardiac meds., offer emotional support r/t to changes in physical capabilities/role, educate the patient to stop an activity if CP, dizziness, or dyspnea occur. Educate concerning the benefits of cardiac rehab

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Lab studies that indicate cardiac muscle damage is present

Troponin, CK-MB, myoglobin

Only one is cardiac muscle specific and it is the gold standard for diagnosing of an MI

Troponin

A level no greater than 200 is desirable and a level greater than 240 is considered high. A level greater than 240 puts a person at risk for coronary artery disease and will need diet modification and possibly treatment with a HMG-CoA reductase inhibitors medication

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