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Comprehensive lecture notes on hematology, covering blood components, functions, and various disorders. it details the structure and function of erythrocytes, leukocytes, and platelets, explores different types of anemia (iron deficiency, vitamin b12 deficiency, folic acid deficiency, and sickle cell disease), and discusses polycythemia and leukemia. the notes also include diagnostic tests and nursing care considerations for each condition, making it a valuable resource for students studying hematology.
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Function of Blood correct answer: -Transports oxygen from the lungs. -Brings nutrients from GI tract to the cells -Protects the body from dangerous micro-organisms -Promotes hemostasis/Blood clotting -Regulates body temp Blood Forming Organs correct answer: Bone marrow Thymus Spleen Liver Lymph nodes Hematopoiesis correct answer: Process of blood cell production. Takes place primarily in the bone marrow (flat bones and end of long bones in adults)
Blood Components correct answer: Plasma Red Blood Cells White Blood Cells Platelets Plasma correct answer: 55% of blood Composed mostly of water Contains proteins, electrolytes, gases, nutrients Plasma Proteins correct answer: Albumin Globulins (3 types) Fibrinogen Prothrombin Blood Cells correct answer: 45% of blood Formed from stem cells (undifferentiated) Three types: Erythrocytes (red blood cells) Leukocytes (white blood cells)
Each normal RBC contains hundreds of thousands of Hgb molecules Each molecule of Hgb needs one molecule of iron to transport up to four molecules of oxygen. Leukocytes structure and function correct answer: Appear white when separated from blood Two categories: Granulocytes, Agranulocytes 5 types of WBC, various functions Platelets structure and function correct answer: Smallest of blood cells Perform most of their functions through aggregation Develop in the bone marrow Growth factor thrombopoietin involved in development Hemostasis: The process of blood clotting correct answer: Vascular spasm Plug formation Development of fibrin clot Lysis of clot
Coagulation Modifiers (pharma) correct answer: Heparins Coumadin Direct Thrombin inhibitors Selective factor Xa inhibitor Aggregation inhibitors Hematologic Assessment - Testing correct answer: Complete Blood Count Reticulocyte Count Peripheral Blood Smear Coomb's Test Coagulation Screening Tests Bone Marrow Aspiration and Biopsy Complete Blood Count (CBC) correct answer: Reticulocyte Count correct answer: Used to determine the responsiveness of the bone marrow to the depletion of circulating RBCs.
Responsible for tissue oxygenation RBC disorders include problems in production, function, and destruction. Anemia correct answer: Decreased production of RBCs, Hgb, or hematocrit (HCT) Polycythemia correct answer: Excess production of RBCs Anemia symptoms correct answer: Integumentary: Pallor, jaundice, pruritis Cardiopulmonary: increased HR, tachypnea, orthopnea, dyspnea at rest, orthostatic hypotension, decreased oxygen saturation. GI: anorexia, sore mouth, splenomegaly, hepatomegaly General: sensitivity to cold, lethargy Nutritional Deficit Anemias correct answer: Iron Deficient Anemia Vitamin B12 Anemia Folic Acid deficient anemia
Iron Deficiency Anemia correct answer: A c microcytic anemia due to inadequate absorption of iron. Most common anemia worldwide Often affects the very young, menstuating women, vegetarians, and people with very poor diets Symptoms - Iron deficiency anemia correct answer: Often asymptomatic Headache, dyspnea, dizziness, cold sensitivity, pallor Brittleness of hair, dry spoon shaped nails Nursing Care - Iron deficiency anemia correct answer: Monitor for signs of bleeding Encourage pt to rest to conserve energy Encourage iron rich diet, consult dietary Medicate as odered Pt. education Vitamin B12 Deficiency Anemia correct answer: A macrocytic anemia Results from poor intake of vitamin B12 rich foods
Folic Acid or Folate Deficiency Anemia correct answer: A macrocytic anemia Manifestations are similar to B12 deficiency Nervous system function remains normal Disease develops slowly Folic Acid or Folate Deficiency Anemia - Causes correct answer: Poor nutrition (most common) Malabsorption syndromes such as Crohn's disease Chronic alcohol abuse with malnutrition. Sickle Cell Disease (Anemia) correct answer: -Genetic disease -Results in chronic anemia, pain, disability, organ damage, increased risk for infection, early death -Caused by an autosomal recessive inheritance of two defective gene alleles for hemoglobin synthesis. -Red blood cells assume abnormal, rigid, sickle shape. -Causes decreased blood flow Sickle Cell Disease - Physical Assessment correct answer: Pain is most common symptom of SCD crisis
Cardiovascular changes Skin changes Kidney and urinary changes Musculoskeletal changes Conditions that cause sickling correct answer: Hypoxia Dehydration Pregnancy - due to vascular strain Alcohol consumption Cold weather, cold water consumption, swimming Strenuous exercise Emotional stress High altitudes Sickle Cell Disease - Medical Management correct answer: Children born with SCD require close observation Folic Acid 1 mg. daily for life Children from birth - 5 take PCN (penicillin) daily due to immature immune system Painful crises are treated symptomatically
Pts. with severe, untreated aplastic anemia have a rapid fatal outcome All patients should be referred to a hematologist. Aplastic Anemia - Assessment correct answer: Weakness and fatigue Pallor Purpura and Petechiae Frequent bacterial and fungal infections Mucosal and skin bleeding Aplastic Anemia - Treatment correct answer: -Blood transfusions are used when anemia causes disability or the bleeding is life threatening -Stem cell transplant is the most effective treatment -Splenectomy may be necessary for patients with enlarged spleen that is either destroying normal RBCs or suppressing their development. -Mild cases may be treated with supportive care and use of growth factors such as Epogen. -Antibiotics often administered due to leukopenia
Polycythemia correct answer: Overproduction of erythrocytes Blood is hyperviscous Underlying cause is unknown Polycythemia Vera (PV) correct answer: Most common variety of Polycythemia Fatal if untreated Is a cancer of the blood Polycythemia Vera - Assessment correct answer: Increased RBC, Hgb, HCT Facial skin and mucous membranes are dark, flushed Pruritis (itchy skin) Hypertension Prone to clot formation Headache, dizziness PV - Management and Care correct answer: Pheresis (removal of RBCs and whole blood to reduce viscosity)
-They eventually crowd out normal blood cells. -Low level of normal cells can decrease oxygenation to tissues, affect clotting, and affect body's ability to fight infection. Leukemia Signs and Symptoms correct answer: Frequent infections Fatigue/Weakness Bleeding - most often nose bleeds Bruising Fever/Chills Anorexia, weight loss Swollen or tender lymph nodes Bone or joint pain Leukemia - Most Common correct answer: Acute myeloid leukemia (AML) Acute lymphoblastic leukemia (ALL) Chronic myeloid leukemia (CML) Chronic lymphocytic leukemia (CLL)
Leukemias are named based on whether they are acute or chronic, and by the type of white blood cell that is affected. Leukemia Treatments correct answer: Watchful waiting with chronic leukemias Immediate treating with acute leukemias Leukemia Treatment Options correct answer: Chemotherapy Radiation therapy Stem cell transplant Hematopoietic Stem Cell Transplant (HSCT) correct answer: - Standard treatment for leukemia and other hematopoietic cancers -3 types: Allogeneic, Autologous, and Synergetic -Cells transplanted may be obtained by marrow harvest, peripheral blood stem cell harvesting, or umbilical cord blood harvesting. Leukemia - Nursing Care correct answer: -Treat side effects related to chemotherapy or radiation therapy
One of the most treatable cancers Diagnosed by the specific cancer cell discovered during the examination of the biopsy of the lymph node Specific staging criteria Hodgkin's Lymphoma - Nursing Care correct answer: Focuses on treating the side effects related to chemotherapy and radiation Side Effects of Chemotherapy and Radiation correct answer: Pancytopenia nausea and vomiting Constipation or diarrhea Impaired liver function Skin problems from radiation Sterility in men Non-Hodgkin's Lymphoma correct answer: -Includes all lymphoid lymphomas that do not have Reed-Sternberg cells -Represent a very diverse set of diseases -Exact cause unknown
-Staging is more complicated than Hodgkin's -More common in men and older adults -Treatments include chemo, localized radiation, and hematopoietic stem cell transplantation. Non-Hodgkin's Lymphoma - Physical Assessment correct answer: Pts. with indolent lymphoma usually have painless lymph node swelling Pts. with more aggressive lymphomas may have large abdominal or mediastinal masses that rapidly become symptomatic after diagnosis constitutional symptoms occur in 1/3 of pts. Multiple Myeloma correct answer: -WBC cancer involving a mature lymphocyte known as the plasma cell which secrete antibodies. -When the myeloma cells are overproduced, few functional RBCs, WBCs, and Platelets are produced. -Multiple Myeloma cells also produce cytokines that increase the cancer cell growth rates and destroy bone. -Without treatment the disease causes progressive bone destruction, kidney failure, bleeding problems, and death.
