Screening 6 Flashcards
What are the coagulation disorders we discussed?
- hemophilia
- disseminated intravascular coagulation (DIC)
hemophilia is a bleeding disorder cause by a deficiency in
one of two blood clotting factors (proteins)
- factor VIII
- factor IX
What is the root cause of hemophilia?
several different gene abnormalities can cause the disorder
What is the main problem for people with hemophilia?
- people bleed unexpectedly or after minor injuries
- bleed longer, but not faster than normals
What is the most common clinical manifestation of s/s for hemophiliacs?
acute hemarthroses
What is the 2nd most common location of bleeds for hemophiliacs?
muscle bleeds
Where are muscle bleeds often seen?
flexor groups
With muscle bleeds, which are very important to distinguish between?
- iliopsoas bleed
- hip bleed
trunk flexion: iliopsoas bleed
causes severe pain
trunk flexion: hip bleed
causes mild pain
hip rotation: iliopsoas bleed
causes mild pain
hip rotation: hip bleed
causes severe pain
For hemophiliacs, what will repeated muscle bleeds cause over time?
- fibrotic tissue
- contractures
- possibility of peripheral nerve lesions from compression
Treatments for hemophilia
transfusions given to replace missing clotting factors
Hemophilia tx: transfusions will have greater concentrations of:
The factor they’re deficient in
Hemophilia: Why must you watch for an acute hemarthrosis?
Pseudotumor or bone erosion can occur
What are the two forms of hemophilia?
- Hemophilia A
- Hemophilia B
Which is the most common form of hemophilia?
- Hemophilia A
- accounts for 80% of all cases
Hemophilia A is a deficiency of
clotting factor VIII
Hemophilia B is a deficiency of
clotting factor IX
Bleeding patterns and overall consequences: hemophilia A/B
both have similar bleeding patterns and overall consequences
DIC =
disseminated intravascular coagulation
What is DIC?
overactivation of clotting cascade with simultaneous and paradoxical
- clotting
- hemorrhaging
With DIC, get widespread deposition of ____. Where does this happen?
- fibrin
- in circulation and in major organs
Disseminated intravascular coagulation (DIC) is common after:
- shock
- sepsis
- OB/GYN complications
- cancer
- trauma
What should you always take into account with a pt who has DIC?
- NO PT during bleeding episodes
- monitor lab values carefully to see when it’s safe to mobilize
Blood disorders overall: Guidelines for immediate medical attention
- Excessive or spontaneous bleeding
- Severe bruising previously seen or unreported
Blood disorders overall: Guidelines for physician referral
- May be warranted with exercise prescription for client with known anemia
- New episodes of joint or muscle pain in client with hemophilia
Blood disorders overall: Clues when screening for hematologic disease
- previous hx of chemo/radiotherapy
- chronic NSAID use
- spontaneous bleeding of any kind
- recent major surgery
- rapid onset of dyspnea
- chest pain
- weakness
- fatigue with palpitations associated with recent change in altitude
- observed changes in hands and nail beds
