Description
In this collection we will go over the hematologic system, Components of blood, Structures of the Hematologic System, Oncologic Disorders and anemias
This collection is useful for all medical students
Study Set Content:
Diagnostic Studies
of the Hematologic System
Radiologic Studies
CT/MRI of lymph tissues
Biopsies
Bone Marrow examination
Lymph node biopsies
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Common Laboratory Tests for Hematologic and Lymphatic Disorders
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Common Laboratory Tests for Hematologic and Lymphatic Disorders
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Anemia
Anemia is a reduction in the number of
RBCs, the quantity of hemoglobin, or
the volume of RBCs
Because the main function of RBCs is
oxygenation, anemia results in varying
degrees of hypoxia
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Anemia
Prevalent conditions
Blood loss
Decreased production of erythrocytes
Increased destruction of erythrocytes
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Anemia (cont
’
d)
Clinical Manifestations:
1. Pallor.
2. Fatigue, weakness.
3. Dyspnea.
4. Palpitations, tachycardia.
5. Headache, dizziness, and restlessness.
6. Slowing of thought.
7. Paresthesia.
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Anemia (cont
’
d)
Nursing Management:
1. Direct general management toward addressing the
cause of anemia and replacing blood loss as needed
to sustain adequate oxygenation.
2. Promote optimal activity and protect from injury.
3. Reduce activities and stimuli that cause tachycardia
and increase cardiac output.
4. Provide nutritional needs.
5. Administer any prescribed nutritional supplements.
6. Patient and family education
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Nursing Actions for a Patient who is
Anemic or Suffered Blood Loss
Administer oxygen as prescribed
Administer blood products as prescribed
Administer erythropoietin as prescribed
Allow for rest between periods of activity
Elevate the pt’s head on pillows during
episodes of shortness of breath
Provide extra blankets if the pt feels cool
Teach the pt/family about underlying
pathophysiology and how to manage the
symptoms of anemia
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Anemia Caused by Decreased Erythrocyte
Production
Iron Deficiency Anemia
Thalassemia
Megablastic Anemia
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Iron-Deficiency Anemia
Etiology
1.
Inadequate dietary intake
Found in 30% of the
world’s population
2.
Malabsorption
Absorbed in duodenum
GI surgery
3.
Blood loss
2 mls blood contain 1mg iron
GI, GU losses
4.
Hemolysis
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Iron-Deficiency Anemia
Clinical Manifestations
Most common: pallor
Second most common: inflammation of the tongue
(glossistis)
Cheilitis=inflammation/fissures of lips
Sensitivity to cold
Weakness and fatigue
Diagnostic Studies
CBC
Iron studies Diagnostics:
Iron levels: Total iron-binding capacity (TIBC), Serum
Ferritin.
Endoscopy/Colonscopy
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Iron-Deficiency Anemia
Collaborative Care
Treatment of underlying disease/problem
Replacing iron
Diet
Drug Therapy
Iron replacement
Oral iron
Feosol, DexFerrum, etc
Absorbed best in acidic environemtn
GI effects
Parenteral iron
IM or IV
Less desirable than PO
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Iron-Deficiency Anemia
Nursing Management
Assess cardiovascular & respiratory status
Monitor vital signs
Recognizing s/s bleeding
Monitor stool, urine and emesis for occult blood
Diet teaching—foods rich in iron
Provide periods of rest
Supplemental iron
Discuss diagnostic studies
Emphasize compliance
Iron therapy for 2-3 months after the
hemoglobin levels return to normal
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Thalassemia
Etiology
Autosomal recessive genetic disorder of
inadequate production of normal hemoglobin
Found in Mediterranean ethnic groups
Clinical Manifestations
Asymptomatic
major retardation
life
threatening
Splenomegaly, hepatomegaly
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Thalassemia
Collaborative Care
No specific drug or diet are effective in
treating thalassemia
Thalassemia minor
Body adapts to
↓
Hgb
Thalassemia major
Blood transfusions with IV deferoxamine
from the body)
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Megaloblastic Anemias
Characterized by large
RBCs which are fragile
and easily destroyed
Common forms of
megaloblastic anemia
1.
Cobalamin deficiency
2.
Folic acid deficiency
This picture shows large, dense,
oversized, red blood cells (RBCs)
that are seen in megaloblastic
anemia.
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Cobalamin (Vitamin B
12
) Deficiency
Cobalamin Deficiency--formerly known as
pernicious anemia
Vitamin B
12
(cobalamin) is an important water-
soluble vitamin.
Intrinsic factor
(IF) is required for cobalamin
absorption
Causes of cobalamin deficiency
Gastric mucosa not secreting IF
GI surgery
loss of IF-secreting gastric mucosal cells
Long-term use of H
2
-histamine receptor blockers cause
a
trophy or loss of gastric mucosa.
Nutritional deficiency
Hereditary defects of cobalamine utilization
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