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Spring- Blood
Blood Disorders
| Question | Answer |
|---|---|
| Sickle Cell Anemia | Have BOTH defective gene **if you only get one you are a carrier |
| Abnormal Hbg molecule= Hgb S= causes cells to sickle | |
| complication of sickle cell anemia | cells cannot move through the blod vessls- they get stuck bc of shape |
| caused by | dehydration, stress, poor nutrition, vessels become clogged or blocked= tissue hypoxia |
| death usually occurs from tissue damage to major organs | |
| S/S | pain in bones/organs, fever, anemia, clots in lungs or spleen/spleenomegaly, edema, leukocytosis, chest/abdominal pain, D. ulcers |
| Positive screening of Hgb | get immunized, stay rested= reduce the amount of o2 demand for body, rest, eat well, regular check ups |
| PRIORITY for sickle cell anemia patients | PAIN CONTROL-- while in hospital- give Pain med and IV fluids-- may be "fequent fliers"- give apin meds promptly - pain will be over whelming |
| unique manefestation on Sickle cell anemia | Acute chest syndrom |
| constantly check for HF R or L | |
| coughing, wheezing, techypnea, chest pain Jaundice - due to increase rate of RBC destruction Gallstones - from increase bilirubin | |
| risk for infection compromises growth Priapism-- increased time for an erection | |
| when blood flow is reduced the patient will experience | localized ischemia, severe pain, tissue infarction, fever, pain, swelling |
| treatment is surrpotive rather than curative regular blood transfusion Narcotics Oxygen Hydration | |
| Hemolytic Anemia | chronic premature destruction of RBCs (erythrocytes) iron and Hgb are released |
| caused by | autoimmune reaction radiation blood transfusion (maily if you get the wrong blood) arsenic & lead poisoning medication |
| S/S - may go unnoticed or a sudden, severe reaction may occur | mild fatigue, pallor, jaundice, palpitations, hypotension, dyspnea, back & joint pain-- wrong blood |
| Treatment and Interventions | Find and fix UNDERLYING cause Blood transfusion Erythrocytoapheresis- procedure that removes abnormal RBC and replaces them with healthy RBCS Splenectomy- surgical removal of spleen Corticosteroids- decrease autoimmune response |
| folic acid- increases production of RBCs | |
| Pancytopenia | Numbers of ALL marrow-produced blood cells are reduced |
| Aplastic Anmeia | inadequate stem cell production in bone marrow possible autoimmune DEATH RATE IS HIGH |
| Assessment finding | infections (low WBC) coagulation abnormalities (low WBC) small skin hemorrhages (low platlets) enlarged spleem |
| Nursing Managmetn | watch for s/s of infection, assess temp, vitals, monitor for bleeding HISTORY |
| Pernicious Anemia | VIT B 12 deficieny- injections daily for 2 weeks then one per month for rest of life No cure but treatments are available for pt to have normal life span |
| Caused by | partial or complete removal of the fundus of the stomach (gastrectomies) |
| source of the intrinsic factor which is necessary for absorption of B12 | fundus |
| Necessary element in the production of RBC and NS function | VIT B 12 |
| immature RBCs | large and die quickly |
| labwork will show | low RBC Hgb low High Bili- jaundice |
| Cardinal sign | tounge in sore and beefy red- toung is very vascular |
| the more Neurological problems | the worst the Anemia is (tingling of hands & feet, loss of body position, memory loss, confusion, depression, if NOT treated- partial or total paraylsis |
| Diet | high in protein, vitamins, minerals |
| B12 has no side effects & cannot overdose | |
| Folic Acid Def | low folic acid levels -- Treatment-- VIT C- helps with maturity of RBC and absoption |
| Foods with Folate: | breads, cereals, green leafy vegies, orange juice, dried peas and beans |
| Polycythemia Vera (Erythrocytosis) | abnormal production of RBCS, WBCS, PLTS RBC count may range from 7-10 mill-- (norm is 3.6-5.4) |
| oxygen content of blood is diminished due to short life span of RBCS Blood flow rate is slowed due to increased thickness-- increased risk for clots | |
| HTN- bc H blood vol- thick blood CVA- clotting factors H CHF- too much blood hemorrhage- at risk bc amount H amount of Blood | |
| S/S | Angina(most common), HA, fatigue, Night sweats, Puritis, Dyspnea, enlarged spleen/liver, skin bruising, bleeding mucous membranes |
| Treatment- Objective- Supress bone marrown, decrease blood cell mass, reduce # of RBCS, WBCS, PLTS | chemo to suppress bone marrow phlebotomy- reduce excess volume (sv x wk) high risk for developing Leukemia |
| high fluid intake- help prevent clots restriction of blood flow- no tight cloths' encourage isometric exercise if angina - educate patient to REST | |
| Position to put pt in with enlarged spleen | sitting position |
| Lymphatic System | a network of vessls that transport lymph (watery fluid from plasma that exits the walls of capillariers and enters interstitial space) |
| ALWAYS | check tonsils for size & enlargement |
| lymphocytes & macrophages | trap destroy remove (why our lymph nodes are swollen) |
| Primary lymphemdema | congenitally acquired/ Affects women more that men (mastectomy) |
| Secondary Lymphedema | develops from complications of other disorders, removal of mult lymph nodes |
| Parasitic worm-- Most common cause of Lymphedema -- always ask about forgien travel (secondary) | |
| when the volume of lymph exceeds the capicity of the vessels- lymph enters interstitial space w/in soft tissues | trapped fluid eventually causes non-pitting edema |
| RESULTS FROM IMPAIRED LYMPH CIRCULATION | |
| nursing management for Lymphedema | assess affected area, elevate extremity, encourage movement, support, teach about garments and mechanical devices |
| Treatment | symptomatic |
| Lymphangitis, Lymphadenitis | Strepococcal microorganisms |
| red streaks-fever-tender-enlarged lymph nodes Visual inspection and Palpation | |
| PAIN managment | note the respose to antibiotic therapy- decrease redness, swellilng, elevate extremity, apply warm soaks to area |
| BROAD SPECTRUM ANTIBIOTICS | |
| Infectious Mononucleosis | Epstein-Barr Virus Direct contact secretions |
| Fatigue, Fever, sore throat, cervical lymph enlargement, oozing tonsils, pharyngeal swelling | |
| Epstein-Barr virus can cause lyphoma bc | of the way it attacks the body |
| AViod blood donation for | 6 months |
| Hodgkins Disease | Reed Sternberg cells onset 15-40 and then older than 55 orderly growth more curable |
| Non-Hodgkins | NON-reed sternberg cells Genetic - Aggressive peaks after 50 30 subtypes B&T cell origins Mets common Less curable |
| Leukocytosis | increase in WBC sign of infection more indicate leukemia usually accompany fever |
| common s/s of leukemia | anemia, weakness, fatigue |
| definite cause is unknown- toxic chemicals, radiation, viruses, certain drugs, genetics | |
| ALL | occurs primarily in children |
| AML | Affects all age ranges |
| CLL AND CML | CLL- commonly affects those older than 40- MOST COMMON in adults CML- found in those older that 20- incidence increases with age- 95% genetic link |
| in ALL leukemias- there is risk of infection | |
| ecchymosis | bruising |
| petichia | tiny red dots |
| purupa | redish/ purple small skin hemorrhages |
| most of the pt discomfort results from treatment than the disease | chemo/radiation |
| normal platlet count | 150,000-350,000 |
| WBC | 5,000-10,000 |
| if you have cancer and you are anemic | you will recieve a blood transfusion |
| treatment of choice if remission occrs | Bone Marrow Transplant |
| Multiple Myeloma | Cause is unkown CANCER OF THE plasma cells - results in abnormal production of immunoglobulins Abnormal plasma cells cannot protect the pt |
| PLASMA CELLS | destroy bone & lymph nodes, liver, spleen and kidneys |
| symptoms occur when kidneys are damaged or infection sets in Pathological FX RENAL CALCULI | |
| HOW MUCH FLUID | 3-4 L unless contraindicated |
| Agranulocytosis Caused by adverse reaction to... | Butazolidine, Choloromycetin, Penicillin & its derivatives, Dilantin, Onocovin, Diuretics, Thorazine, Sulfa CELEBREX |
| Neoplastic disease- cancer causing | |
| chemotherapy, radiation, bacterial and viral infections | |
| RESULTS IN | bone marrow suppresion- thus reducing WBC pro # of granulocytes are severly reduced |
| s/s | HA, fever, chills(BAD-chills cause body heat=fever)Fatigue Mucous membrane ulceration of the... |
| nose, mouth, pharynx, vagina, rectum | |
| MAIN GOAL | remove cause of bone marrow supression prevent or treat infection |
| blood transfusion- provide mature wbc to wk system | |
| protective isolation | due to low WBC- reverse or neutropenic |
| diet | soft, bland, high in calories, protein, vitamins |
| Aplastic Anmeia | bone marrow shuts down completely severe life threatening very poor DX |
| ppl on chemo have blood drwn | everyday for labs |
| 1st sign of organ rejection | FEVER |
| thrombocytopenia | decrease inPLT count related to |
| aplastic anemia, tumors, leukemia, chemo | |
| platelet survival rate is also lowered due to | infection or viral illness |
Created by:
sweaver
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