Chapter 24 Flashcards
hematology
the medical specialty concerned with blood disorders
nephrology
the medical specialty concerned with renal/kidney diseases
specific functions of blood that are crucial to survival
- control of bleeding by clotting
- delivery of oxygen to the cells
- removal of carbon dioxide from the cells
- removal and delivery of other waste products to organs that provide filtration and removal like kidney and liver.
solid components of blood
- white blood cells
- red blood cells
- platelets
(suspended in liquid called plasma)
-created in the bone marrow
RBC,LBC, and platelets life span
is not forever. they go through a cycle of usage and removal through filtration and waste
clumping of platelets
-aggregation
- when platelets clump together they begin to form clots
- clots are the body way of stopping bleeding
prevented by aspirin (prevents clumping of platelets)
aspirin prevents_____?
clumping (clotting) of platelets
coagulopathy
loss of normal ability to form a clot with internal or external bleeding
where are clotting factors produced?
in the liver
poor clotting causes
- disease (cirrhosis)
- genetic disorders (hemophiliac)
- von willebrands disease (most common inherited blood disorder) 1 in 1000
von whiles disease
most common inherited blood disorder
- 1 in 1000
- sufficient amount of platelets, but they are ineffective
- upon injury, patients bleed excessively
blood thinners
warfin dabigatran apixaban rivaroxaban enoxaparin
-these drugs prevent clotting factors
platelet inhibitor
placid, and aspirin
inhibit platelet aggression
acute anemia
may be the result of trauma or of sudden massive bleeding from the gastrointestinal tract
-these patients may exhibit signs and symptoms of shock. (tachycardia, diaphoretic, hypotension
chronic anemia
occurs over time, makes patients more pale than normal
- often shortness of breath, and fatigue
- one of the best ways to examine the color of the eyelids (junctiva on lower eyelid)
sickle cell anemia (SCA)
inherited disease, creates an abnormal red blood cells
-most common in african american
(also occurs in middle eastern, and indian)
- defective hemogloin
- severe pain in arms, legs, chest or abdomen
1 in 12 african americans are effected by SCA
Spleen blockages
often caused by SCA
jaundice
when liver becomes overwhelmed by the breakdown in RBC, resulting a yellowish pigmentation of body tissues
kidneys
in charge of filtering blood and the removal of certain waste products, excessive salts, and excessive fluid.
urinary tract infection
can be deadly in the older crowd, if bacteria spread into the blood stream
- most common disease that afflicts the renal and urinary system.
- left un checked it can move up to the kidney causing pyelonephritis
pyelonephritis
infection of the kidney that was caused by an un attended UTI. if left unchecked it can enter the blood stream and cause death.
renal failure
loss of kidneys ability to filter blood and remove toxins from the body
- this is the most serious kidney disease.
- acute renal failure
- chronic renal failure
acute renal failure
can occur because of shock, toxic ingestion, and other causes
-if this is caught early, normal kidney functions could be returned to normal
chronic renal failure
can include inherited diseases like polycystic kidney disease
end stage renal disease (ERSD)
when the renal system can no longer filtrate, and balance fluid to sustain life, they are then called ESRD
roughly 900,000 americans are treated for ESRD
400,000 are chronic dialysis with 3 treatments per week
-require dialysis
more than 90% get hemodialysis at outpatient centers, rather than peritoneal dialysis
-only 8% of ERSD patients treat themselves at home
dialysis 2 types
-hemodialysis (HD) blood is ran through a machine that filters and removes toxins from blood.
-peritoneal dialysis (PD) usually done in patients own home, and is normally a lengthy process which require multiple treatments.
(also the most common form of dialysis in the world outside of the USA and canada)
peritoneal dialysis
2 forms
- continuous ambulatory peritoneal dialysis (CAPD)
- continuous cycler-assisted peritoneal dialysis (CCPD)
CAPD dialysis
the most common form of PD
-fluid is left in the peritoneal cavity for 4-6 hours. the catheter is clamped and then exchanged several times a day
-using gravity to feed the fluids to exchange
CCPD dialysis
- uses the same type of catheter as CAPD, but rather than gravity exchange. a machine is used to cycle the fluids 3 to five times during the night. (while patient is sleeping)
- in the morning, the last exchange occurs and it will last the patient all day.
most serious complications of ESRD
-when patients fail to get their treatments.
(bad weather, illness, and poor compliance are common reasons for missing treatment)
-without the ability to rid the body of excess fluid, patients who miss their treatment can show signs similar to CHF congestive heart failure. (swelling and shortness of breath due to fluid in the lungs)
- can experience dysrhythmia
- cannot balance electrolytes and toxins
complications of dialysis
- bleeding from the A-V fistula
- clotting and loss of function of the A-V fistula
- bacterial infection of the blood due to contamination of the A-V fistula.
(most common complication is acute peritonitis)
acute peritonitis
a bacterial infection within the peritoneal cavity
kidney transplant
kidneys are the most transplanted organs. patients with endstage renal disease may be candidates for transplant
- roughly 16,000 kidney transplants in US per year.
- patients with kidney transplants spend the rest of their life on immune depressant (preventing organ rejection medications)
how many americans are on dialysis?
400,000
