Hematologic Disorders Flashcards
- where RBC & platelets made
•Bone marrow
• – removes old red blood cells from circulation
Spleen
•Blood –
Contains RBCs, WBCs, clotting factors, protein, plasma, platelets, electrolytes, enzymes, and hormones.
›Transports oxygen, nutrients, cellular waste
›Regulates body temperature, pH, fluid balance
›4-6 L, 52-62% is plasma, 38-48% are cells
›Produced by red bone marrow
›Acts as a transportation medium
•Red blood cells (erythrocytes
) – transports O2 and CO2
›Biconcave, without nuclei, carry O2 bonded to the iron in Hgb
›Need sufficient protein and iron in diet to synthesize Hgb, folic acid, Vit B12
›Live for about 120 days
›Heme portion of Hgb is converted to bilirubin when RBCs become fragile and are phagocytized, if bilirubin isn’t excreted properly jaundice occurs
Type A blood
A and O blood
Tybe B blood
b and o blood
Type o blood
Can only receive type o
Universal donar
Type AB blood
aB, a, b, o
Universal recipient
RH+
rH + and -
RH-
RH- only
Age related changes
- Bone marrow becomes less productive
- Hematologic function not affected unless a person is unusually stressed with trauma, a chronic illness, or treatment for cancer
- In conditions necessitating a higher production of blood cells, bone marrow usually responds to the increased demand, given time
Nursing asses.
- Inquire about bruising easily, bleeding for an unusually long time, or chronic fatigue
- May be the symptoms of an underlying hematologic disorder
Family hx
- Sickle cell disease or hemophilia
* Death of a family member at a young age for reasons other than trauma may indicate a genetic hematologic disorder
: using the patient’s own blood
›Patient donates blood several times before procedure
›Blood is stored by the blood bank and reinfused into the patient if needed intraoperatively or postoperatively
•Autologous transfusion
›When platelet count falls
•Platelet transfusion
›Plasma separated from whole blood by centrifugation and quickly frozen
›Contains all the clotting factors as well as the plasma proteins
›Cryoprecipitate contains only fibrinogen and factor VIII; can be further separated out from plasma and administered alone
•Fresh frozen plasma transfusions
Immune system attacks red blood cells of the donor
Reaction of blood transfusion
Hemolytic
Immune system attacks white blood cells of the blood
Reaction of blood transfusion
Febrile
Allergic reaction hives and itching
Reaction of blood transfusion
Anaphylactic
Person revives to much blood overload of heart
Reaction of blood transfusion
Circulatory overload
S/s blood transfusion reaction
•Back or chest pain, fever, chills, decreased blood pressure, urticaria, wheezing, dyspnea, or coughing during the transfusion
Blood transfusion reactions intervention
- Stop transfusion immediately; keep intravenous line open with normal saline
- Immediately notify physician, nursing supervisor, blood bank
- Be prepared to administer oxygen, epinephrine, Solu-Cortef, furosemide (Lasix), antipyretics as prescribed by physician
- Save the unused portion of the blood bag for the blood bank
- Stimulates bone marrow to produce more red blood cells
- Effects on the hematocrit not apparent for several days; not an option for patients immediately needing to elevate their red blood cell counts
›Erythropoietin (Epogen)
•Too many red blood cells are produced
•Increased cells make blood more viscous (thicker); doesn’t circulate freely throughout body
Can turn face red
Polycythemia Vera
Symptoms polycythemia Vera
: headache, dizziness, ringing in the ears, and blurred vision. Patients with this disorder may have a ruddy (reddish) complexion
Treatment of polycythemia Vera
•Treatment is to have a unit of blood phlebotomized, or taken off, to keep the hematocrit normal
- Complete failure of the bone marrow
- Extremely low red blood cell count, white blood cell counts, and platelet counts because bone marrow is not making any of these cells
Aplastic anemia
Cause of aplastic anemia
- Certain drugs (e.g., streptomycin and chloramphenicol) and exposure to toxic chemicals/radiation cause bone marrow failure
- In many cases, cause of bone marrow failure is never identified
S/s aplastic anemia
•Signs and symptoms: pallor, extreme fatigue, tachycardia, shortness of breath, hypotension, unusually prolonged or spontaneous bleeding, and frequent infections that do not resolve
Treatment of aplastic anemia
Transfusion replace red blood and platelets
Antibiotic to prevent or treat infections ; corticortsteriods also may be given
Transplant may be given considering if donor can be found
Bone marrow makes enough blood cells, but they are destroyed once released into circulation
Autoimmune Hemolytic Anemia
cause Autoimmune Hemolytic Anemia
Causes: certain infections, drug reactions, and certain cancers
Hemolytic anemia of the newborn can occur
Hemolytic anemia of the newborn can occur after delivery if the mother has Rh-negative blood and the baby has Rh-positive blood
Transfusions can cause a hemolytic anemia if
Transfusions can cause a hemolytic anemia if lymphocytes in the transfused blood make antibodies against the recipient
Signs and symptoms: Autoimmune Hemolytic Anemia
pallor, extreme fatigue, tachycardia, shortness of breath, and hypotension
Patients may appear jaundiced because of release of billi
High bilirubin levels from all the RBC cells lysed (broken down)
Patients have a positive Coombs’ antiglobulin blood test
medical treatment Autoimmune Hemolytic Anemia
Medical treatment: identifying and treating the cause
Blood transfusions may be needed to replace red blood cells
Corticosteroids may be administered to the patient
Patient usually recovers in a few days to weeks
•- manufactures clotting factors; filters out old or damaged RBCs
Liver
