MED SURG - DISORDERS OF THE HEMATOLOGIC SYSTEM STUDY GUIDE LATEST UPDATE.
RED BLOOD CELL DISORDERS
ANEMIA - a disorder in which you
lack of red blood
... [Show More] cells and results in
decrease of oxygen transported to
the tissues
Causes
1. Blood loss
2. Too few RBC in
circulation
3. Increase destruction of
RBC
S/Sx - pale, fatigue, weak, cold,
tachycardia, tachypnea,
hypotension, dyspnea
Diagnosis - CBC (low RBC, low
Hct, low hemoglobin)
Treatment - blood transfusion, rest
in between activities, oxygen
therapy, apply more blankets,
elevate the head of the bed
POLYCYTHEMIA VERA - too
much RBC produced; increased
blood volume, severe blood
congestion of all tissues and organs
that lead to infarction to vital organs
(thrombus); viscous
S/Sx - Headache and dizziness
(decrease blood flow to the brain),
ringing in the ears (tinnitus; lack
of blood to nerves), blurred vision,
ruddy (reddish) complexion
(plethora), hypertension, heart
failure (increase workload
ultimately leads to failure; shortness
of breath, orthopnea), gout
(accumulation of proteins - uric acid
crystals), enlargement of liver and
spleen (responsible for removal of
RBC), severe pruritus, extremity
pain (gout), intermittent
claudication (pain in the legs when
walking)
Management - phlebotomy (250-
500 ml) (remove excess
blood/RBCs)
Interventions - hydration, monitor
intake and output, monitor for s/sx
of thromboembolism, avoid high
altitudes, administer analgesic and
allopurinol (prevent uric acid build
up), mobility to prevent thrombus
formation, TED hose, no crossing
legs (hinders circulation), avoid
foods containing iron (increase
RBC production), monitor LOC
APLASTIC ANEMIA - failure of
bone marrow, decrease production
of RBC, WBC, and platelets
RBC → decreased oxygenation
WBC → increase infection
Platelets → bleeding, petechiae,
purpura, ecchymosis
Causes - antibiotics: streptomycin,
chloramphenicol, exposure to toxic
chemicals, radiation or
chemotherapy
S/Sx - pallor, extreme fatigue and
malaise, headache, tachycardia,
tachypnea, hypertension,
palpitations, SOB, unusually
prolonged or spontaneous
bleeding, frequent infections that
don’t resolve
Treatment - identify and treat the
cause; blood transfusions,
antibiotics to prevent infection,
corticosteroids (stimulate bone
marrow), bone marrow transplant,
splenectomy for hypersplenism
(reduce destruction of RBC, retain
more RBC in the body)
Interventions - strict aseptic
technique, meticulous care to skin
(avoid injury/bleeding), avoid IM
injections, no rectal
thermometers/meds, electrical
razors, good oral care (soft-bristle
toothbrush), monitor for signs of
bleeding, egg crate mattress,
monitor for signs of bleeding, look
for occult or gross bleeding in stool
or urine, rest, limit visitors,
protective isolation, AVOID
ASPIRIN/NSAIDS.
AUTOIMMUNE HEMOLYTIC
ANEMIA - body identifies own
blood cells as foreigners and
destroys them once released into
circulation.
Causes - infections, drug reactions,
certain cancers, Rh-mother and has
Rh+baby, blood transfusion if
lymphocytes are transfused into the
blood makes antibodies against the
IRON DEFICIENCY ANEMIA
(iron normal level 60-180 ug/dl)
Causes - diet low in iron,
malabsorption of iron in the
duodenum, excessive iron loss
caused by chronic bleeding from the
intestine, uterine and gastric,
menstruation and pregnancy
S/Sx - fatigue, restlessness, pallor,
orthostatic changes in heart rate
PERNICIOUS ANEMIA - vitamin
B12 (growth and maturity of body
cells, nerve myelination) anemia;
slow progression
Causes - lack intrinsic factor
(substance made by parietal cells in
the stomach that is essential for vit.
B12 absorption); gastrectomy,
gastritis
S/Sx - fatigue, pallor, weakness. [Show Less]