Haematopoietic System Disease Flashcards
What treatment can be done for clotting disorders?
- Blood or plasma transfusion
- Treat signs of anaemia if present (eg. O2)
- Recognition and treatment of underlying disease (eg. vitamin K/calcium, lungworm treatment, cause of DIC/heat stroke
What nursing care can be done for a patient with a clotting disorder?
- Monitor vital signs
- Quiet and gentle handling
- Monitoring during treatment procedures
- Blood sample from peripheral vein
- Avoid IM injections (risk of bleeding into muscle)
Leukopenia
White blood cells abnormally low
What investigations may be done for a suspected clotting disorder?
- Obtain clinical history
- Physical examination
- Faecal and urine analysis
- Haematological investigations (eg. Full haematology and biochemistry, smear for platelet count and aggregation, clotting profile for secondary disorders, buccal mucosal bleeding time (BMBT) for primary disorders)
- Imaging
(If normal platelet count but prolonged BMBT may suggest secondary clotting disorder, eg liver disease, von willebrand disease)
What clinical signs may be seen with primary Haemostatic disorders?
-Small (petechiae) and large bruises
-Often multiple sites
-Prolonged bleeding from cuts
-Epistaxis
-Venepuncture bleeding common
Surface bleeding common (often MMs and skin)
What clinical signs may be seen with secondary haemostatic disorders?
- Haematomas common
- Often localised site of bleed
- Rebleeding from cuts
- Venepuncture usually uncomplicated
- Deep and cavity bleeds common (eg. joints and abdominal or thoracic cavity)
Identify some clinical signs of anaemia
- Collapse, lethargy and exercise intolerance
- Pale MMs (may see jaundice in severe cases)
- Dyspnoea/tachypnoea
- Tachycardia
- Widespread lymphadenopathy and splenomegaly
- Pica (eat things not food)
- Other things related to cause
- Cold extremeties
Identify the difference between regenerative and non-regenerative anaemia
Regenerative = Bone marrow healthy and responds to the best of its abilities to correct the anaemia. Immature RBC’s (reticulocytes) may be seen on blood smear
Non-regenerative = Bone marrow fails to respond adequately to the anaemia and does not produce adequate new RBS’s
What are the causes of non-regenerative anaemia?
- Disorders of the bone marrow
- Suppression of bone marrow due to other disease
What are the causes of regenerative anaemia?
- Blood loss (haemorrhage) -> trauma or coagulopathies
- Blood cells burst (haemolytic) -> Primary or secondary IMHA, infection, toxins, neonatal isoerythrolysis
What are the types of anaemia?
Non-regenerative and regenerative
Haemopoiesis
Process by which blood cells are produced from bone marrow (in long bones, pelvis, sternum and skin)
What may be the reason for secondary haemostatic defects?
Usually acquired
- Genetic disorders (eg haemophilia)
- Lack of vitamin K or calcium (diet, rat poison)
- Liver disease
- Toxicity (rat poison)
- Lactating bitch
- Hypothyroidism
- Mal absorption disorder
What is disseminated intravascular coagulation and what is it associated with?
Rare but serious condition that causes abnormal blood clotting throughout the body’s blood vessels
- Some viral infections
- Neoplasia
- Heat stroke
- Liver disease
- IMHA
- Lungworm
What may clotting disorders be classed/grouped as?
- Primary haemostatic disorders (congenital)
- Secondary haemostatic disorders (acquired)
What may be the reason for primary haemostatic defects?
- Vessel wall defects
- Von Willebrands disease (common in Dobermans)
- Quantitative or qualitative disorders of platelets
What may be the reason for congenital platelet disorders?
- Disorders of the bone marrow
- Feto-maternal alloimmune thrombocytopenia (FMAIT)
- Primary immune mediated thrombocytopenia (IMTP)
What may be the reason for acquired platelet disorders?
- Secondary IMTP (vaccinations, viruses)
- Bone marrow tumour
- Suppression of the bone marrow due to other disease
- Haemorrhage
- Drugs (eg. aspirin - anti platelet)
What treatment can be done for an anaemic patient?
- Blood transfusion
- Oxygen therapy
- Recognition and treatment of underlying disease (eg. chemo, erythropoietin therapy and bone marrow stimulation)
What nursing care is needed for an anaemic patient?
- Monitoring vital signs
- Restricted exercise and excitement/stress
- Monitoring during treatment procedures
- Blood sampling
What investigations may be done for a patient with suspected anaemia?
- Confirm with PCV
- Blood smear
- Full haematology and biochemistry -Saline agglutination test
- Imaging (X-ray/USS to identify haemorrhaging)
- Bone marrow biopsy
What nursing care can be done for a patient wit a blood blood cell disorder?
- Monitor vital signs
- Administering chemotherapy under VS direction
- Practice safe handling of chemotherapeutic drugs and excreted waste and fluids from patient
- Offer palatable foods
- Fresh water provision
- Keeping patient clean and comfortable
What investigation may be done for a patient with a suspected white blood cell disorder?
- Clinical history
- Clinical examination
- Haematological investigation
- Cytology (FNA/Biopsy)
- Imaging
What treatment can be done for a patient with a white blood cell disorder?
- Recognition and treatment of underlying disease (eg. chemotherapy)
- Fluid therapy
- Treatment of secondary infections (if present)
What are the possible causes for white blood cell orders?
- Genetic
- Autoimmune disease
- Viruses (eg. FIV)
- Cancer (eg. leukaemia or lymphoma)
What clinical signs may be seen for a patient with a white blood cell disorder?
- Frequent infections
- Weight loss
- Anorexia/inappetence
- Vomiting and diarrhoea
- Enlarged lymph nodes and splenomegaly
- Clotting disorders
- Clinical signs associated with other organs affected
Leukocytosis
White blood cells abnormally high
