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MSN 277 EXAM 2 STUDY GUIDE WITH COMPLETE QUESTIONS AND ACCURATE ANSWERS RATED A+
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MSN 277 EXAM 2 STUDY GUIDE WITH COMPLETE QUESTIONS AND ACCURATE ANSWERS RATED A+
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MSN 277 EXAM 2 STUDY GUIDE WITHCOMPLETE QUESTIONS AND ACCURATE
ANSWERS RATED A+
Iron deficiency anemia Correct Answer Most common type of
anemia
Occurs from inadequate intake of iron, increased hemolysis,
malabsorption (pts with their duodenum removed), blood loss,
and CKD
Can cause pallor, glossitis, cheiltis, headache, paresthesia,
burning sensation of tongue
Diagnosed by Hgb, Hct, HGB, CBC, serum iron, TIBC elevated,
ferritin low, stool for occult blood, endoscopy, colonoscopy, bone
marrow biopsy
Tx by increasing dietary source of iron (red meat, green leafy
vegetables, whole grains, ferrous sulfate with vitamin C
Anemia of chronic disease Correct Answer Under production of
anemia and/or decreased survival time
Can come from chronic diseases such as chronic inflammation,
autoimmune disorders, HF, infectious diseases, malignancies
Tx by correcting the underlying disorder, blood transfusion, and
erythropoietin
Aplastic anemia Correct Answer Can be chronic or acute (life-
threatening); rare
,Occurs from peripheral blood pancytopenia (decrease in all cells)
and hypo cellular bone marrow
S/S include anemia (fatigue, dyspnea), neutropenia (infection,
shock, death), thrombocytopenia (bleeding, petechiae)
Dx by labs and biopsy
Tx by supportive care, HSCT, and immunosuppressive therapy in
those >55
Anemia caused by acute blood loss Correct Answer Occurs from
hemorrhage
10% 500ml loss - no symptoms
20% 1000ml loss - no symptoms at rest, tachycardia with
exercise, mild postural hypotension
30% 1500 ml loss - normal BP and pulse at rest, tachycardia and
postural hypotension with exercise
40% 2000 ml loss - BP, CVP, and CO below normal, air hunger,
rapid, thready pulse, cool, clammy skin
50% 2500ml loss - shock, lactic acidosis, possible death
Tx by replacing fluid volume (lactated ringers, albumin), identify
and correct source of blood loss, blood transfusion, replace
platelets, and supplement iron if needed
Blood transfusion reactions Correct Answer S/S include fever,
pain (lower back, flank, chest), itching, hives, flushing,
hypotension, tachypnea, dyspnea, wheezing, bronchospasm,
HTN, pulmonary congestion
2 major dysfunctions in cancer Correct Answer Cellular
proliferation
Cellular differentiation
,Cellular proliferation Correct Answer Normally cell growth and
death are equal
Cancer cells don't necessarily grow fast, but at a constant rate
The rate of growth depends on the type of tissue
Contact inhibition (cells don't respect boundaries so they grow
uncontrollably
Cellular differentiation Correct Answer Cells have a problem going
from immature to mature
Mature cells perform one function, and immature cells become
specialized
Proto-oncogenes and oncogenes Correct Answer Proto-
oncogenes is the normal gene that controls cell growth
The mutation in this gene is called oncogenes, which are tumor
inducing genes
Normally porto-oncogenes control cell growth like a light-switch,
but with oncogenes the light-switch never goes off
Thrombocytopenia Correct Answer Low platelet count
Platelet count below 150,000
Results in abnormal hemostasis (prolonged bleeding from injury
or spontaneous bleeding)
3 types: ITP, TTP, and HIT
S/S include mucosal/cutaneous bleeding (epistaxis, petechiae,
purpura, abnormal bleeding, after venipuncture/IM injections,
internal bleeding
Major complication is hemorrhage
Platelet count
150,000 pt okay
<50,000 prolonged bleeding
, <20,000 spontaneous life-threatening hemorrhages
<10,000 platelet transfusion
Dx by checking PT and aPTT
Tx by treating underlying condition, specific to each type, avoid
anti-platelet drugs
Teach pt to shave with an electric razor, no gardening, good oral
care, avoid tattoos, piercings, eyebrow tweezing
ITP Correct Answer Immune Thrombocytopenia Purpura
Most common
Abnormal destruction of platelets by the spleen
Tx by splenectomy, IVIG, corticosteroids, platelet transfusion
TTP Correct Answer Thrombotic Thrombocytopenia Purpura
Rare
Results in the enhanced aggregation of platelets
Associated with hemolytic uremic syndrome
S/S fever, anemia, neuro changes, renal abnormalities
THIS IS A MEDICAL EMERGENCY
Tx by plasmapheresis and immunosuppressants
HIT Correct Answer Heparin Induced Thrombocytopenia
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