Week 4 Chapter 46 Flashcards
Transport nutrients and oxygen to the body tissues
Transport waste products from the tissues
RBCs
Clotting
Thrombocytes and platelets
WBCs
Fight infection
Production of RBCs in the embryo begin by how many weeks?
8 weeks
Bloods cells in the embryo form in the liver
Where is EPO primarily derived from
Liver in the Fetus and after birth the kidneys take over
In absence of congenital defect the hematological system is..
Intact and functional at birth
Amount of fetal hemoglobin declines beginning at birth and as the child matures
3 Types of Normal Hemoglobin
Hgb A- Predominant type after 6 months
Hgb F or fetal- Has shorter cell life
- Present in higher quantities putting the infant at risk for anemia
- Leads to problems in oxygen carrying capacity of blood
Hgb A2
Actual number of counted RBCs in a certain volume of blood
RBC count
Measure of the protein made up heme (Iron) and globin ( transports nutrients and oxygen)
Hgb
Indirect measure of RBCs ( number and volume)
Hematocrit
Cell diameter, Hgb/ RBC
RBC indices
MCV
Average size of RBC
Calculated value of the oxygen carrying capacity of the Hgb in RBCs
MCH
A calculated value that reflects the concentration of Hgb inside the RBC
MCHC
Calculated value that is measured of the width of RBCs
Red Cell distribution width
Health history Related to Hematologic Functioning
Birth and Maternal History
- Low Birth Weight
Gestational Diabetes
- Vitamin K after birth for clotting?
Recent illnesses related to blood cell distribution
Sleep and wake patterns
Bowel elimination patterns
Family history for inherited disorders
Typical diet for deficits
Risk for lead exposure
Common Laboratory and Diagnostic Tests
Complete blood count
Reticulocyte count
Hg electrophoresis
Blood type and cross match
Clotting Studies
Coagulating Factor concentration
Iron and lead levels
Serum Ferritin
Nursing diagnoses for a child with Hematological Disorder
Fatigue
Pain
Impaired physical mobility
Ineffective health maintenance
Anxiety
Ineffective family coping
Common Medications for Hemat Disorders
Iron Supplements and folic acid
Deferasirox/ deferoxamine- Binds with iron, removed in feces
Factor replacement VIII or IX- Replaces deficient clotting factors
Antibiotics
Hydroxyurea- Stimulates the development of Hgb (Sickle cell anemia)
Biotherapy (monoclonal antibodies)- stimulates production of RBCs
IVIG- Provides antibodies
ITP Common Hemat Med
Condition in which levels of RBCs and Hgb are lower than normal
Remember significant anemia result in hypoxia
Anemia
Types of Anemia are
Nutritional Anemia
- Iron deficiency, folic acid, pernicious anemia
Toxin Exposure
- Lead poisoning
Aplastic Anemia
- Acquired as an adverse reaction to medication
- Rare congenital bone marrow failure ( Fanconi Anemia)
Hemolytic Anemia
- Sickle cell anemia, thalassemias
Occurs when body does not have enough iron to produce Hgb
Peak prevalence in 12-24 month old children
- Cows milk consumption ( poor iron availability)
- Adolescence
Iron deficiency Anemia
S/S of Iron Deficiency Anemia
Weakness, fatigue, headache, dizziness, SOB, and pallor
Therapeutic management-
Formula fortified with iron
Iron supplements( ferrous sulfate, ferrous fumarate)
Severe cases- PRBC transfusion
