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Blood Dyscrasias
Anemia, Neutropenia, Thrombocytopenia, Hemophilia
| Term | Definition |
|---|---|
| Anemia | Not enough RBC which leads to not enough oxygen carrying capacity. |
| Causes of Anemia | Body just does not make enough Bleeding/Hemorrhage Body destroys the RBCs |
| Types of Anemia | Aplastic Anemia Iron Deficiency Anemia Sickle Cell Anemia Thalassemia Vitamin Deficiency Anemia |
| Risk Factor of Anemia | Diet, Hereditary, pregnancy, menstruations, GI disorders, Ageing |
| Symptoms of Anemia | Fatigue, Weakness, Pallor, Jaundice, Palpitations/Tachycardia, Propensity to feeling cold, Headaches/Chest Pain, Dizziness, SOB |
| Nurse's Role for Anemia | Assess cause & History Provide Teaching and Supplementation therapies Assess Symptoms Encourage routine doctor visits for lab monitoring Teach Pt when to seek help Blood or Iron Transfusions Oxygen Therapy Pain Control Perfusion Support |
| Labs for Anemia | CBC, RBC, Hg, Hct, Iron Level, B12 level and Folate Level |
| Meds/Treatments for Anemia | Epoetin Alpha Epogen, Ferrous Sulfate with vitamin C, Folate, B12. S |
| Treatment for Sickle Cell Anemia | Pain management, Transfusions, Hydration |
| Epoetin Alpha- Epogen | Helps your body make RBCs- Epo is a natural substance in the body made primarily by the kidneys but is in other places in the body, live, bone marrow and brain. |
| Neutropenia | Insufficient WBC |
| Patho of Neutropenia | Made in bone marrow, lack of neutrophils increases risk of pt getting infection |
| Risk Factors of Neutropenia | Those taking Chemotherapy, having Radiation, having decreased immunity, HIV, Cancer, Older age >70, Organ transplantation, bone cancers |
| Symptoms of Neutropenia | Fever, Illness/Virus/Bacteria Signs/Symptoms, UTI or GI or GU symptoms, Wound infection symptoms |
| Nurse's Role for Neutropenia | Reverse Isolation- Neutropenic Precautions, Dedicated equipment, no fresh flowers or fruits, Assess, Monitor and Intervene |
| Labs for Neutropenia | WBC count, Neutrophil Count (2500-7000) |
| Meds/Treatments for Neutropenia | Filgrastim- increases Neutrophils Viral/Bacterial Treatments Isolation Hydration |
| Thrombocytopenia | Low platelets which makes pt high risk for bleeding (platelets are made in the bone marrow) |
| Risk Factors for Thrombocytopenia | Having leukemia, anemia, hepatitis C or HIV, Chemotherapy, Heavy alcohol consumption, medications, bone cancers |
| Symptoms/Presentation of Thrombocytopenia | Bleeding somewhere, Low Platelet count, Easy Bruising, Blood in urine, Heavy Menstruations, Enlarged Spleen, Jaundice (from hemolysis- excessive destruction of red blood cells- overproduction of bilirubin) Fatigue |
| Nurse's Role for Thrombocytopenia | Monitor for blood in stool, emesis Avoid IVs and Injections Hold pressure prolonged time Encourage electric razor and use Soft toothbrush Don't blow nose vigorously Avoid NSAIDs and ASA Avoid falling when possible Safety Precautions |
| Labs for Thrombocytopenia | Platelet Count (Normal 150000-400000) PTT/PT can be normal, depends on severity of disease INR- used to check clotting for pt on Warfarin, also makes sure that PT results are normal between one lab and another (0.9-1.2, higher on coumadin 2-3) |
| Med/Treatments for Thrombocytopenia | Transfusion Steroids- for some it increases platelet production & activation of platelets Dietary- Vitamin K rich foods, spinach, kale, blueberries, figs TPO-RA a type of protein thrombopoietin peptide which increases platelets |
| TPO- RA | Names; Romiplostim, Eltrombopae, Avatrombopae, Lusutrombopoae |
| Hemophilia | a rare, inherited bleeding disorder that prevents blood from clotting properly |
| Symptoms/Presentation of Hemophilia | Bleeding Somewhere; Nose Bleed, Head Bleed Bleed after puncture- IV, IM, Vaccine Head bleed after labor Blood in urine or stool Bleeding gums or with tooth loss Ecchymosis, Hematoma Hematoma into a joint- knees/elbows |
| Nurse's Role for Hemophilia | Assess bleeding and History of type, typical amount of bleed and treatment Respond Quickly Put pressure over bleeding area Replace factor needed quickly For joint bleeding; RICE (Rest, Ice, Compression, Elevation) Seek Immediate Treatment |
| Labs for Hemophilia | Clotting factors- Blood Test PTT- usually prolonged PT/INR- usually normal CBC/Platelet (not necessarily disturbed) CT if head or join involvement |
| Meds/Treatments for Hemophilia | Replace missing clotting Factor Avoid Injuries Put pressure/compression to bleeding site Teaching Blood transfusions for severe losses Fluids |
| Clotting Factor for Hemophilia | These meds constrict blood vessels, cause a formation of platelet plug, activate clotting cascade and help with fibrin clot, Rebinyn is usually given IV over 1-4 min. after proper dosage calculation. There is a SQ injection for some of these home use. |
| Patient Education for Neutropenia | Take temp daily, Avoid Crowds, Avoid Yard work/gardening, Don't change Cats litter box, wash dishes in dishwasher, Wash toothbrush daily in dishwasher |
| Patient Education for Anemia | Rest, Diet, Supplements (Diet high in Iron, Folate, B12) |
| Patient Education for Thrombocytopenia | Avoid straight razor- use an electric razor Use soft toothbrush Avoid Blowing your nose vigorously Avoid Falls Avoid NSAIDs and ASA |
| Patient Education for Hemophilia | Avoid Injury, Know your treatment, Seek help immediately, Put pressure over wound |
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