Week 6 - Hematology Flashcards
Signs of platelet diseases
- pallor
- bruises
- bleeding
Signs of progressive tumor or complication of sickle cell
- tachypnea
Disorders of blood cell amount/volume
- Iron-deficiency anemia
- Aplastic anemia
Iron Deficiency Anemia definition
Bone marrow produces small RBCs that are LOW in Iron
Iron Deficiency Anemia patho
- diet insufficient in iron
- vegetarian
- “white food”
- shift from formula to cow’s milk
Is Iron Deficiency Anemia a disorder of malnutrition?
NO
Is Iron Deficiency Anemia preventable and reversible?
Yes
S/s Iron Deficiency Anemia
- Pallor (white sclera)
- Decreased CBC
Iron Deficiency Anemia prevention and teaching
- breastfeed and formula until 6 months
- iron fortified food at 6 months
- limit cow’s milk
- vary diet
- supplementation with Vitamin C
What can supplementation cause?
- constipation
- stained teeth
Aplastic Anemia definition
Abnormality of bone marrow causes pancytopenia
- low RBC
- low WBC
- low platelets
S/s of Aplastic Anemia
Depends on which type of blood is lowest:
- Anemia (weakness, fatigue, pallor)
- Leukopenia (fever, frequent infections)
- Thrombocytopenia (abnormal bleeding)
Aplastic Anemia interventions (4)
- Prevent exposure to the cause
- Keep infections away (wash hands, immunization)
- Immunosupression meds
- Bone marrow transfusion (severe cases)
Coagulation Abnormality Disorders (3)
- Immune thrombocytopenia
- Hemophilia
- Von Willebrand’s Disease
Immune thrombocytopenia definition
Decreased platelets as a result of a immune-mediated response
S/s Immune thrombocytopenia
- Petechiae (small bruises)
- Purpura (large bruises)
Hemophilia definition
Issue of the clotting cascade
Hemophilia types
- Hemophilia A: missing factor VIII
- Hemophilia B: missing factor IX
S/s Hemophilia
- bleeding in the join that can occur without trauma
- might not be diagnosed until later in life
Von Willebrand’s Disease definition
Genetic disorder missing or abnormal Von Willebrand factor (a clotting protein)
Signs of decreased clotting
- heavy menses
- epitaxis (nose bleeds)
- increased abnormal bleeding
- gingival bleeding
- bruising from minor/spontaneous
- joint pain and damage from swelling
Decreased clotting teaching
- prevent injury
- medical alert bracelet
- signs of decreased platelets
- sneezing with mouth open to decrease pressure
Decreased clotting treatment
- administer factor VIII and factor IX
- desmopressin (stimulates release of Von Willebrand factor)
Disorders of blood cell function and anatomy (3)
- Thelassemia
- Sickle Cell Disease
- Hereditary Spherocytosis
Thelassemia definition
Anemia due to abnormally found hemoglobin (varying severity)
Major Thelassemia s/s
- Pallor
- Irritability
- Growth retardation
- Hepatospleenomegaly
How can you prevent infection for blood cell function disorders?
- Hand washing
- Penicillin
- Vaccination
Thelassemia treatment
- transfusion q 3-5 weeks with 1-3 units of blood
- splenectomy
- iron chelation r/t frequent transfusions - removes the high levels of iron
Sickle Cell Disease definition
Change in genetic make up causes sickling of RBC
Highest risk ethnicities of Sickle Cell
- African American
- Mediterranean
Sickle Cell Disease genetics
- Autosomal recessive
- 6th amino acid is altered
S/s of Sickle Cell Disease
- Acute Sequestration crisis (blood pooling in spleen, risk for hypovolemic shock)
- Vaso-occlusive crisis (stressors that cause RBC to sickle)
- Aplastic crisis (worsening anemia)
- Spleenomegaly
Vaso-occuluisve crisis (4)
- Clumping (altered peripheral perfusion and tissue hypoxia)
- Severe pain
- Swelling
- Visual disturbance
Sickle Cell teaching (5)
- hydration, keep out of high temps
- know limitations
- prevent infection (wash hands, penicillin, vaccinations)
- folic acid daily supplementation
- Hydroxyuria
Hydroxyuria
- chemo drug that activates the fetal hemoglobin production
- helps replace sickled RBC
Sickle Cell treatment
- Splenectomy
- Transfusion
- Treat the vaso-oclusive crisis (PCA, IV fluids, infection tx, O2)
Hereditary Spherocytosis
Sphered shape RBC
S/s Hereditary Spherocytosis
- anemia
- jaundice (when RBC are broken apart bilirubin is released)
- splenomegaly
Hereditary Spherocytosis teaching
Prevent infection!
- wash hands
- penicillin
- vaccinations
Hereditary Spherocytosis treatment
- splenectomy
- transfusion in severe cases
