Acute Care Settings: hematologic disease screening and considerations for PT Flashcards
What to think about with blood work
- solid components
- liquid components
- gas components
- what do each of these do?
- where arre they filtered?
- how are they removed orr excreted
What are the filters of blood
- liver
- kidneys
- spleen
- gall bladder
- lungs
- skin
How can concentration of blood be increased
- increase components
- and or
- decrease fluids
- thicker fluid = increase in BP
How can blood concentration be decreased
- decrease components
- and/or increase fluids
- thinner fluids = decreased BP
Signs and symptoms of hematologic disease: cardiovascular system
- typically hematologic manifestations are 2º to disease not so much the hematological system itself
- cardiovascular
- problems with exertion
- dyspnea
- chest pain
- palpitations
- weakness and fatigue
S&S associated with hematologic diseas: neurologic
- headaches
- drowsiness
- dizziness
- syncope
- polyneuropathy
S&S associated with hematologic disease: integumentary
- skin and fingernail probelms
- cyanosis
- clubbing of fingernails, brittleness, concavity
- pallor of face, hands, fingernail beds: grey and yellowing
Other S&S of hematologic disease
- other
- bruise easily
- bleeding of skin and gums with little to no trauma
- blood in stool
- swelling of joints and muscles
What are hematologic disorders often related to as seen in PT practice
- medications: NSAIDs, Corticosteriods, blood thinner
- complications from radiation and chemotherapy
How can NSAIDs and corticosteriod use affect the hemotolgical system
- chronic use = GI system problems
- gastritis
- peptic ulcer => bleeding
- => iron deficiency anemia
Erythrocytes Disorders
causes
- anemia = blood loss, destruction of RBCs, decrease O2 carrying capacity of blood
- NSAIDs, Corticosteriods = GI peptic ulcers = blood loss
- Chronic disease or inflammatory conditions such as RA or lupus
- infectious diseases: TB, AIDs
- Cancers: leukemia (bone marrow failure)
- complication from chemotherapy
Anemia Associated S&S
- dyspnea on exertion
- chest pain with minimal exertion
- weakness and fatigue
- palpitations
- decrease diastolic pressure
- increase pulse rate
- redistribution of blood to heart, brain therefore may see: skin pallor, yellow tint, cyanosis conjuctiva
Pernicious Anemia
- CNS/Neurological S&S
- Headache
- drowsiness
- dizziness
- syncope
- slow thought process
- apathy, depression
- polyneuopathy
- may need transfusions
more severe/harash on the body
Polycythemia
- increase in RBCs, Increase hemoglobin concetration
- increase blood viscosity/volume
- tendency to clot
- decrease blood to brain, vital tissues
Polycythemia S&S
- fatigue
- SOB
- Headache-fullness of head
- dizziness
- blurred vision
- irritability
- fainting
- decrease mental acuity
- decrease sensation
- cyanosis
- clubbing of fingers
- enlarged spleen
Sickle cell anemia
- abnormal shape of hemoglobin/RBCs
- ability to pass through vessels is decreased
- decreased blood supply
- ischemia tot tissues
Sickle cell anemia S&S
- pain in chest and abdominal areas
- UE, LE joint pain, back pain
- avascular necrosis
- chronic leg ulcers
- CVA
Sickle cell anemia S&S pulmonary
bacterial pneumonia
Sickle cell anemia S&S
neurological
- convulsions
- drowsiness
- coma
- parresthesia
- cranial N problems
- blindness
- nystagmus
Sickle cell anemia S&S
hand and foot syndrome
- painful swelling
Sickle cell anemia S&S
liver and spleen
- enlargement due to trapped erythrocytes
Sickle cell anemia S&S
renal complications
- renal failure
- renal papillay necrosis
- hematuria
- nocturia
- bed wetting
Leukocytosis are S&S of
- increase concenration of WBCs
- fever
- infection
- tissue inflammation/trauma/necrosis
- metabolic intoxicaitons ie uremia, gout
- neoplasms, lung, lymphoma, melanoma
- acute hemorhage
- appendicitis
leukopenia
what is it and causes
- bone marrow failure
- chemotherapy or radiation therapy
- autoimmune disease
- overwhelming infection
- dietary deficiency
reduction in WBCs
leukopenia S&S
- fever, chills, sweats
- persistent infection
- ulcerations of mouth, rectum, vagina
Leukemia
- disease of bone marrow
- uncontrolled growth of immature dysfunction WBC
- grouped with cancers
Platelet Disorders
thrombocytosis
- function in stopping bleeding
- thrombocytosis: assymptomatic until exceeds 1 million/mm
- too much platelet production
Thrombosis S&S
- throbbing
- pain
- warm
- heavy
Splenomegaly S&S
- pressure on left side
- feeling full
thrombocytopenia
potenital causes
- platelets less 150,000/mm
- bone marrow failure
- chemotherapy, radiation treatment
- leukemia
- metastatic CA
- drug induced platelet reduction (coumadin/warfin, asprin)
Thrombocytopenia S&S
- ecchymosis
- hematoma
- excessive menstruation
- joint swelling (single or traveling)
- petechiae (red spots under skin)
- bleeding gums
- nose bleeds (dry air or low platelets)
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With thrombocytopenia what may be contraindicated/precautioned
Contraindication:
- strenuous exercise
- mechanical compression
- STM
Caution:
- using BP cuff
Hemophilia
bleeding longer
not faster
coagulation disorder
S&S of hemophilia
hemarthrosis => joint disease
- joint pain swelling decreased ROM, contracture, atrophy
Muscle hemorrhage
- pain and spams => muscle shortening for comfort => decrease length
- increase blood volum => pressure on nerves => sensory and motor deficits
GI involvment:
- abdominal distension and pain
- blood in stool
- vomiting blood
- fever
Abdominal and groin:
- large intestine vs iliopsoas bleed
