Screening 5

Question 1

Leukocyte disorders are recognized as the body’s reaction to

Answer 1

• disease

- foreign invaders

Question 2

What are the two leukocyte disorders we discussed?

Answer 2

• leukocytosis

- leukopenia

Question 3

leukocytosis =

Answer 3

increased neutrophils

Question 4

leukopenia =

Answer 4

too few leukocytes

Question 5

Too few leukocytes (leukopenia) is related to

Answer 5

• bone marrow failure

- never a beneficial condition

Question 6

s/s of leukocytosis

Answer 6

• fever
• sx of localized or systemic infection
• inflammation
• tissue trauma

Question 7

s/s of leukopenia

Answer 7

• sore throat
• cough
• high fever/chills
• ulcerations
• persistent infections
• frequent/painful urination

Question 8

When is leukopenia commonly seen?

Answer 8

• following chemotherapy

- consider nadir

Question 9

What is the nadir?

Answer 9

WBC count is at lowest level as a result of cancer tx

Question 10

Important considerations for a pt at a nadir

Answer 10

If we know they will reach the nadir, must remember that they are more susceptible to infections during this time

Question 11

Leukopenia: When does the nadir generally occur after cancer tx?

Answer 11

Usually between 7-14 days

Question 12

What are the platelet disorders we discussed?

Answer 12

• thrombocytosis

- thrombocytopenia

Question 13

Thrombocytosis is an increase in

Answer 13

platelet count

Question 14

Why/when does thrombocytosis usually occur?

Answer 14

usually compensatory and temporary after surgery

Question 15

What factors can influence platelet count?

Answer 15

• diet
• exercise
• liver disease
• radiation
• chemotherapy

Question 16

What are two nutritional factors that influence platelet count?

Answer 16

• lecithin

- vitamin K

Question 17

Lecithin (prevents/promotes) coagulation

Answer 17

prevents

Question 18

Vitamin K (prevents/promotes) coagulation

Answer 18

promotes

Question 19

How does exercise impact coagulation?

Answer 19

helps destroy clots

Question 20

clinical s/s of thrombocytosis

Answer 20

• easy bruising
• splenomegaly
• thrombosis

Question 21

Why does splenomegaly occur with thrombocytosis?

Answer 21

It becomes enlarged because it has to work much harder

Question 22

What is thrombocytopenia?

Answer 22

decreased platelet count

Question 23

What can thrombocytopenia result from?

Answer 23

decreased or defective platelet production

Question 24

What causes thrombocytopenia?

Answer 24

• bone marrow failure
• leukemia
• medications

Question 25

Which medications can cause thrombocytopenia?

Answer 25

- NSAIDs - methotrexate - gold - coumadin

Question 26

clinical s/s of thrombocytopenia

Answer 26

- bleeding after minor trauma - spontaneous bleeding - gingival bleeding

Question 27

Where might you see idiopathic thrombocytopenia?

Answer 27

children

Question 28

PT must be on alert for obvious sx of thrombocytopenia: Why?

Answer 28

- exercise that involves straining could precipitate a hemorrhage - esp. of eyes or brain

Question 29

undiagnosed clients with sx of thrombocytopenia

Answer 29

need immediate physician referral

Question 30

Why is COX so important for platelets?

Answer 30

COX is an enzyme needed for thromboxane A2 »»» platelet aggregation and arterial smooth muscle constrictor «««

Question 31

These two drugs activate platelet COX

Answer 31

- Aspirin (ASA) | - NSAIDs

Question 32

A single dose of this can suppress normal platelet aggregation for 48 hours up to a week

Answer 32

ASA

Question 33

Why is ASA problematic for platelet aggregation?

Answer 33

- irreversibly inhibits COX | - platelets are inactivated for the rest of their lifespan

Question 34

How long do platelets live?

Answer 34

about 8 days

Question 34

NSAIDs effects on COX are ________

Answer 34

reversible

Question 36

Effects of NSAIDs on platelets

Answer 36

milder than ASA - bruising - skin bleeding

Question 37

platelets and NSAIDs: pre-op implications

Answer 37

safest to d/c NSAIDs preop, even though effects are milder