Hematologic disorder 2 Flashcards
Disk-shaped red blood cells become sickle shaped
Misshapen cells more fragile than normal red blood cells; as a result, the sickled cells easily rupture as they pass through small capillaries, resulting in a chronic anemia
Cells become stuck in the small capillaries, obstructing blood flow
Sickle Cell Anemia
how do you get sickle cell anemia
Genetic disease: almost exclusively in African Americans
Carried on a recessive gene; a person must inherit the gene from both the mother and the father to actually have the disease
Sickle cell crisis is where
the sickled cells become stuck in larger blood vessels of the body; obstruct blood flow and cause severe pain
Various stressors can trigger a sickle cell crisis what are they
Dehydration, infection, overexertion, cold weather changes, excessive alcohol consumption, smoking
s/s of sickle cell anemia
Symptoms vary: depend on where circulation is blocked by the sickled red blood cells
Circulation to the chest, abdomen, bones, joints, bone marrow, brain, or penis may be compromised
Tissue hypoxia occurs, causing severe pain
Medical diagnosis of sickle cell disease
Physicians use clinical judgment
Radiographs and scans of the painful area to evaluate for bleeding
Medical treatment of sickle cell crisis
There is no cure; treatment is symptomatic
Intravenous fluids and pain medication
Red blood cell transfusions correct the anemia and help the body oxygenate tissues
Oxygen therapy
Hydroxyurea
Assessment of sickle cell anemia
Complete description of the pain
Document location, intensity, duration, and precipitating events; vital signs every 4 hours
Assess for fever
Any symptoms of an infection, such as sore throat, cough, abnormal breath sounds, dysuria, or diarrhea
Monitor for signs and symptoms of dehydration
Interventions of sickle cell anemia
Acute Pain
Anxiety
Risk for Injury
Ineffective Therapeutic Regimen Management
Too few platelets circulating in the blood
Not enough platelets being made in bone marrow or too many platelets are being destroyed in circulation
thrombocytopenia:
Major cause:thrombocytopenia:
treatment with chemotherapy or radiation therapy
Examples of too many platelets being either destroyed or consumed are
idiopathic thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP
s/s thrombocytopenia:
Symptoms: petechiae and purpura, gingival bleeding, epistaxis (nosebleeds), or any other unusual or prolonged bleeding
Treatment for thrombocytopenia:
treat or stop the causative factor
A hypercoagulable state
Overstimulation of normal coagulation cascade: simultaneous thrombosis and hemorrhage
Coagulation
Always secondary to another pathologic process of
overwhelming sepsis, shock, major trauma, crush injuries, burns, cancer, acute tumor lysis syndrome, or obstetric complications
Coagulation occurs at so many sites that eventually
all available platelets and clotting factors are depleted and uncontrolled hemorrhage results
Blood tests that help diagnose DIC includes
prothrombin time, partial thromboplastin time, fibrinogen, thrombin time, fibrin split products level, and D-dimer
treatment Coagulation
Blood component replacement therapy
Heparin to interrupt the DIC cycle and allow the body to replenish platelets and clotting factors
Genetic disease: affected person lacks some blood clotting factors normally found in plasma
Hemophilia
Signs and symptoms Hemophilia
Uncontrollable bleeding is the hallmark of hemophilia
Occurs after trauma; however, also spontaneously for no clear reason
Commonly, bleeding occurs into the joints, causing swelling and severe pain
Also can occur into the skin; from the mouth, gums, and lips; and from the gastrointestinal tract
Medical diagnosis Hemophilia
Measuring factors VIII and IX in the blood
Partial thromboplastin time
Medical treatment Hemophilia
No cure; treatment is symptomatic
Physician prescribes transfusions of fresh frozen plasma or
cryoprecipitate, or both
Red blood cell transfusions
Intravenous morphine
Physicians try quickly to transition from IV opioids to oral opioids to nonopioid pain relievers as crisis resolves
Assessment Hemophilia
For bleeding and pain; note what measures have stopped the bleeding and relieved pain in the past
Monitor vital signs and urine output
Interventions Hemophilia
Risk for Injury
Acute Pain
Ineffective Therapeutic Regimen Management
