Hematologic Disorders

Question 1

• where RBC & platelets made

Answer 1

•Bone marrow

Question 2

• – removes old red blood cells from circulation

Answer 2

Spleen

Question 3

•Blood –

Answer 3

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

Question 4

•Red blood cells (erythrocytes

Answer 4

) – 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

Question 5

Type A blood

Answer 5

A and O blood

Question 6

Tybe B blood

Answer 6

b and o blood

Question 7

Type o blood

Answer 7

Can only receive type o

Universal donar

Question 8

Type AB blood

Answer 8

aB, a, b, o

Universal recipient

Question 9

RH+

Answer 9

rH + and -

Question 10

RH-

Answer 10

RH- only

Question 11

Age related changes

Answer 11

• 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

Question 12

Nursing asses.

Answer 12

• Inquire about bruising easily, bleeding for an unusually long time, or chronic fatigue
• May be the symptoms of an underlying hematologic disorder

Question 13

Family hx

Answer 13

• 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

Question 14

: 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

Answer 14

•Autologous transfusion

Question 15

›When platelet count falls

Answer 15

•Platelet transfusion

Question 16

›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

Answer 16

•Fresh frozen plasma transfusions

Question 17

Immune system attacks red blood cells of the donor

Answer 17

Reaction of blood transfusion

Hemolytic

Question 18

Immune system attacks white blood cells of the blood

Answer 18

Reaction of blood transfusion

Febrile

Question 19

Allergic reaction hives and itching

Answer 19

Reaction of blood transfusion

Anaphylactic

Question 20

Person revives to much blood overload of heart

Answer 20

Reaction of blood transfusion

Circulatory overload

Question 21

S/s blood transfusion reaction

Answer 21

•Back or chest pain, fever, chills, decreased blood pressure, urticaria, wheezing, dyspnea, or coughing during the transfusion

Question 22

Blood transfusion reactions intervention

Answer 22

• 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

Question 23

• 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

Answer 23

›Erythropoietin (Epogen)

Question 24

•Too many red blood cells are produced
•Increased cells make blood more viscous (thicker); doesn’t circulate freely throughout body
Can turn face red

Answer 24

Polycythemia Vera

Question 25

Symptoms polycythemia Vera

Answer 25

: headache, dizziness, ringing in the ears, and blurred vision. Patients with this disorder may have a ruddy (reddish) complexion

Question 26

Treatment of polycythemia Vera

Answer 26

•Treatment is to have a unit of blood phlebotomized, or taken off, to keep the hematocrit normal

Question 27

* 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

Answer 27

Aplastic anemia

Question 28

Cause of aplastic anemia

Answer 28

* 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

Question 29

S/s aplastic anemia

Answer 29

•Signs and symptoms: pallor, extreme fatigue, tachycardia, shortness of breath, hypotension, unusually prolonged or spontaneous bleeding, and frequent infections that do not resolve

Question 30

Treatment of aplastic anemia

Answer 30

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

Question 31

Bone marrow makes enough blood cells, but they are destroyed once released into circulation

Answer 31

Autoimmune Hemolytic Anemia

Question 32

cause Autoimmune Hemolytic Anemia

Answer 32

Causes: certain infections, drug reactions, and certain cancers

Question 33

Hemolytic anemia of the newborn can occur

Answer 33

Hemolytic anemia of the newborn can occur after delivery if the mother has Rh-negative blood and the baby has Rh-positive blood

Question 34

Transfusions can cause a hemolytic anemia if

Answer 34

Transfusions can cause a hemolytic anemia if lymphocytes in the transfused blood make antibodies against the recipient

Question 35

Signs and symptoms: Autoimmune Hemolytic Anemia

Answer 35

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

Question 36

medical treatment Autoimmune Hemolytic Anemia

Answer 36

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

Question 37

•- manufactures clotting factors; filters out old or damaged RBCs

Answer 37

Liver