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NUR 405 ( LATEST 2024 / 2025 ) EXAM 3 | GRADED A+ | PASSED | NEW FULL EXAM ACTUAL
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NUR 405 ( LATEST 2024 / 2025 ) EXAM 3 | GRADED A+ | PASSED | NEW FULL EXAM ACTUAL
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NUR 405 EXAM 31. Polycythemia
-Increased RBCs (hyperviscosity) Causes
-JAK-2 mutation (primary)
-Hypoxia (secondary)
-s/s SOB, fatigue, dizziness, HA, pruritis, facial flushing, nosebleeds, gum bleeds, abdominal
fullness (blood clogged in liver/spleen), thrombosis
2. Primary Polycythemia
-Results from JAK-2 mutation
-Increase in RBCs, WBCs, and platelets
3. Secondary Polycythemia
-Hypoxia
-RBCs increased (WBCs and platelets normal)
-Appropriate response
high altitudes, COPD, HF, heavy smoke inhalation
,-Inappropriate response
Answer
excess erythropoietin (kidney disease, tumor)
4. Polycythemia Dx
-CBC (RBCs greater than 6,000), HCT (greater than 48% in F and 52% in M), Hgb (Greater than
16.5 in M and 16 in F), bone marrow bx, genetic tests
5. Polycythemia management
-Main goal
reduce hyperviscosity
-Tx
-Primary
therapeutic phlebotomy, chemo/radiation (bone marrow suppressants), antiplatelets (low dose
aspirin)
,tx cause
6. Therapeutic phlebotomy
-Treatment for polycythemia (removes RBCs, not WBCs or platelets)
-1 unit of blood is removed weekly until HCT is less than 45%
-Provides immediate relief/improvement
-MONITOR IRON (can cause anemia and may need supplements)
7. Polycythemia teaching
•s/s of thromboembolic events (PE, MI, CVA), bleeding precautions (soft toothbrush, electric
razor), exercise, elevate legs, avoid tight cloth- ing, increase fluids (3L/day unless
contraindicated), small, frequent meals
8. Polycythemia complications
-MI, CVA, PE, GI hemorrhage
9. Thrombocytopenia
-Low platelets (less than 150,000)
, -3 types
Answer
ITP, DIC, HIT
-s/s
bruising, petechiae, bleeding from nose and gums, GI bleeding, hematuria
10. Idiopathic Thrombocytopenic Purpura (ITP)
-antiplatelet antibodies
-Causes
infection, cancer, sulfa meds, autoimmune conditions (lupus)
-Decreased bone marrow production or increased destruction
-RF
African, obesity, F (15-40)
11. Disseminated intravascular coagulation
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