Podcast
Questions and Answers
What is the primary function of albumin in blood plasma?
What is the primary function of albumin in blood plasma?
Which of the following components of blood is responsible for transporting substances, regulating body temperature and pH, and transporting protective cells?
Which of the following components of blood is responsible for transporting substances, regulating body temperature and pH, and transporting protective cells?
Where does the maturation and differentiation of T-lymphocytes primarily take place?
Where does the maturation and differentiation of T-lymphocytes primarily take place?
Which of the following blood components makes up approximately 45% of blood volume?
Which of the following blood components makes up approximately 45% of blood volume?
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What is indicated by a decreased reticulocyte count?
What is indicated by a decreased reticulocyte count?
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Which organ plays a key role in synthesizing plasma proteins, including clotting factors?
Which organ plays a key role in synthesizing plasma proteins, including clotting factors?
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What are gamma globulins and what role do they serve?
What are gamma globulins and what role do they serve?
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A patient presents with a hematocrit of 55%. What condition is this finding most likely associated with?
A patient presents with a hematocrit of 55%. What condition is this finding most likely associated with?
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What occupational history is important to consider for potential hematologic disorders?
What occupational history is important to consider for potential hematologic disorders?
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Why is a family's health history significant in assessing hematologic disorders?
Why is a family's health history significant in assessing hematologic disorders?
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Which symptom is commonly associated with anemia?
Which symptom is commonly associated with anemia?
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What are possible hematologic causes for cyanosis as noted in physical examination?
What are possible hematologic causes for cyanosis as noted in physical examination?
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Which of the following diagnostic tests is commonly used to assess coagulation issues?
Which of the following diagnostic tests is commonly used to assess coagulation issues?
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What is the role of an INR test in patients undergoing warfarin therapy?
What is the role of an INR test in patients undergoing warfarin therapy?
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What is a potential effect of alcohol on the hematologic system?
What is a potential effect of alcohol on the hematologic system?
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Which finding in a physical exam may indicate a bleeding disorder?
Which finding in a physical exam may indicate a bleeding disorder?
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Which question should be asked to assess for possible dietary deficiencies?
Which question should be asked to assess for possible dietary deficiencies?
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What signs may indicate poor immune function in the objective data collection?
What signs may indicate poor immune function in the objective data collection?
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Which symptom might a patient with anemia experience related to the respiratory system?
Which symptom might a patient with anemia experience related to the respiratory system?
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Which laboratory study is routinely done for hematologic disorders?
Which laboratory study is routinely done for hematologic disorders?
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Why is a social history critical in assessing hematologic disorders?
Why is a social history critical in assessing hematologic disorders?
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What skin condition might indicate a liver involvement or hemolysis?
What skin condition might indicate a liver involvement or hemolysis?
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What stimulates the kidneys to secrete erythropoietin?
What stimulates the kidneys to secrete erythropoietin?
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Which of the following symptoms might suggest a problem with the lymphatic system?
Which of the following symptoms might suggest a problem with the lymphatic system?
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Which of the following is NOT a function of plasma?
Which of the following is NOT a function of plasma?
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Which vitamin is necessary for DNA synthesis in red bone marrow stem cells?
Which vitamin is necessary for DNA synthesis in red bone marrow stem cells?
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What is the approximate lifespan of a red blood cell?
What is the approximate lifespan of a red blood cell?
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What condition can cause an accelerated destruction of red blood cells (hemolysis)?
What condition can cause an accelerated destruction of red blood cells (hemolysis)?
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What causes the yellowish orange hue of the skin and mucous membranes in jaundice?
What causes the yellowish orange hue of the skin and mucous membranes in jaundice?
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Which white blood cell type is most numerous?
Which white blood cell type is most numerous?
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Which white blood cell combats the effects of histamine?
Which white blood cell combats the effects of histamine?
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What is the role of plasma cells?
What is the role of plasma cells?
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What initiates the extrinsic pathway of coagulation?
What initiates the extrinsic pathway of coagulation?
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Which of the following is NOT a function of the lymphatic system?
Which of the following is NOT a function of the lymphatic system?
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Where do T lymphocytes complete their development?
Where do T lymphocytes complete their development?
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What is the term for small purplish hemorrhagic spots under the skin?
What is the term for small purplish hemorrhagic spots under the skin?
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What are platelets involved in?
What are platelets involved in?
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What is the normal range for platelets?
What is the normal range for platelets?
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Where are lymph nodes concentrated?
Where are lymph nodes concentrated?
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What is the primary function of lymph nodules?
What is the primary function of lymph nodules?
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What is thrombocytopenia?
What is thrombocytopenia?
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Which organ stores up to one-third of the body's platelets?
Which organ stores up to one-third of the body's platelets?
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Which WBC type is increased in allergic responses?
Which WBC type is increased in allergic responses?
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What does the thymus primarily produce?
What does the thymus primarily produce?
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What is intrinsic factor necessary for?
What is intrinsic factor necessary for?
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What substance inhibits the clotting mechanism?
What substance inhibits the clotting mechanism?
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What is the role of antithrombin in the clotting process?
What is the role of antithrombin in the clotting process?
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What role do valves play in lymph vessels?
What role do valves play in lymph vessels?
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Where is bilirubin sent after the spleen breaks down red blood cells?
Where is bilirubin sent after the spleen breaks down red blood cells?
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Which blood type has both anti-A and anti-B antibodies?
Which blood type has both anti-A and anti-B antibodies?
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Which vein does lymph from areas below the diaphragm enter?
Which vein does lymph from areas below the diaphragm enter?
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What is the term for the breakdown of red blood cells?
What is the term for the breakdown of red blood cells?
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What is a recommended practice to prevent energy expenditure by a patient with anemia?
What is a recommended practice to prevent energy expenditure by a patient with anemia?
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Which of these is NOT mentioned as a symptom related to hematologic disorders?
Which of these is NOT mentioned as a symptom related to hematologic disorders?
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Which nutrient is specifically recommended for patients with pernicious anemia?
Which nutrient is specifically recommended for patients with pernicious anemia?
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Why should iron supplements be taken with vitamin C-rich foods or fluids?
Why should iron supplements be taken with vitamin C-rich foods or fluids?
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What is a proper method for administering oral iron supplements to avoid teeth staining?
What is a proper method for administering oral iron supplements to avoid teeth staining?
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What should patients with folic acid deficiency include in their diet?
What should patients with folic acid deficiency include in their diet?
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What should a patient do if they experience side effects from iron supplements?
What should a patient do if they experience side effects from iron supplements?
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What is an oral care recommendation to maintain oral mucous membrane integrity for anemic patients?
What is an oral care recommendation to maintain oral mucous membrane integrity for anemic patients?
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What is the purpose of administering intramuscular iron injections using the Z-track method?
What is the purpose of administering intramuscular iron injections using the Z-track method?
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How should oral iron supplements be timed around meals to enhance absorption?
How should oral iron supplements be timed around meals to enhance absorption?
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What dietary modification can aid anemic patients if they have a deficiency in their diet?
What dietary modification can aid anemic patients if they have a deficiency in their diet?
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What does an increase in immature bands indicate in a WBC differential count?
What does an increase in immature bands indicate in a WBC differential count?
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In which part of the body can a bone marrow biopsy be safely performed?
In which part of the body can a bone marrow biopsy be safely performed?
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What changes in lymphocytes are observed during a viral infection?
What changes in lymphocytes are observed during a viral infection?
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Which procedure involves injecting dye into a lymphatic vessel?
Which procedure involves injecting dye into a lymphatic vessel?
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What implication does a high INR have for a patient on anticoagulant therapy?
What implication does a high INR have for a patient on anticoagulant therapy?
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Which of these WBC patterns indicates an acute bacterial infection?
Which of these WBC patterns indicates an acute bacterial infection?
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Which factor is NOT evaluated by activated partial thromboplastin time (aPTT)?
Which factor is NOT evaluated by activated partial thromboplastin time (aPTT)?
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What is a main role of segmented neutrophils in the body’s immune response?
What is a main role of segmented neutrophils in the body’s immune response?
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What should be done to prevent infection during a bone marrow biopsy?
What should be done to prevent infection during a bone marrow biopsy?
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What does prolonged bleeding time indicate in coagulation studies?
What does prolonged bleeding time indicate in coagulation studies?
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Which site is NOT typically used for adult bone marrow biopsy?
Which site is NOT typically used for adult bone marrow biopsy?
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Which factor may be affected by prothrombin time (PT) values?
Which factor may be affected by prothrombin time (PT) values?
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When would lymph nodes be biopsied?
When would lymph nodes be biopsied?
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Which test measures capillary resistance against rupture?
Which test measures capillary resistance against rupture?
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What role does the nurse play in a bone marrow biopsy?
What role does the nurse play in a bone marrow biopsy?
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What is the primary reason for using washed or leukocyte-depleted blood in transfusions?
What is the primary reason for using washed or leukocyte-depleted blood in transfusions?
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What is the main goal of using filters in blood administration tubing?
What is the main goal of using filters in blood administration tubing?
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Which blood product is specifically used for severe anemia?
Which blood product is specifically used for severe anemia?
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Which reaction is most common during blood transfusions?
Which reaction is most common during blood transfusions?
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What type of solution should be used to flush IV lines before and after transfusions?
What type of solution should be used to flush IV lines before and after transfusions?
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Which procedure helps reduce the risk of complications by allowing patients to receive their own blood?
Which procedure helps reduce the risk of complications by allowing patients to receive their own blood?
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How long should a unit of packed cells be transfused to prevent deterioration and bacterial growth?
How long should a unit of packed cells be transfused to prevent deterioration and bacterial growth?
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Which blood product is used to provide clotting factors for bleeding disorders?
Which blood product is used to provide clotting factors for bleeding disorders?
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What symptom is a cardinal sign of an urticarial (hive) reaction?
What symptom is a cardinal sign of an urticarial (hive) reaction?
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Why might a blood warmer be used during rapid transfusions?
Why might a blood warmer be used during rapid transfusions?
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What should be done if a febrile reaction is suspected during a blood transfusion?
What should be done if a febrile reaction is suspected during a blood transfusion?
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What is the role of albumin in transfusions?
What is the role of albumin in transfusions?
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Why is monitoring vital signs crucial during a blood transfusion?
Why is monitoring vital signs crucial during a blood transfusion?
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Which component is necessary with blood transfusion tubing to ensure safety during administration?
Which component is necessary with blood transfusion tubing to ensure safety during administration?
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Which statement about storing autologous blood for transfusion is correct?
Which statement about storing autologous blood for transfusion is correct?
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Which foods are rich in vitamin C?
Which foods are rich in vitamin C?
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What is the primary cause of macrocytic anemia?
What is the primary cause of macrocytic anemia?
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What role does vitamin B12 play in the body?
What role does vitamin B12 play in the body?
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Which medication can interfere with B12 absorption?
Which medication can interfere with B12 absorption?
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Folate is primarily necessary for:
Folate is primarily necessary for:
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What symptom is associated specifically with pernicious anemia?
What symptom is associated specifically with pernicious anemia?
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Which test is performed to assess if anemia is due to iron deficiency?
Which test is performed to assess if anemia is due to iron deficiency?
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A deficiency of which nutrient can lead to neural tube defects?
A deficiency of which nutrient can lead to neural tube defects?
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What is recommended for women of childbearing age to prevent neural tube defects?
What is recommended for women of childbearing age to prevent neural tube defects?
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What simple nursing intervention can help manage decreased activity tolerance in anemic patients?
What simple nursing intervention can help manage decreased activity tolerance in anemic patients?
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What does a peripheral blood smear reveal in a patient with macrocytic anemia?
What does a peripheral blood smear reveal in a patient with macrocytic anemia?
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What is an early sign of iron deficiency anemia?
What is an early sign of iron deficiency anemia?
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Which food source is NOT rich in folate?
Which food source is NOT rich in folate?
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Which condition can lead to vitamin B12 deficiency?
Which condition can lead to vitamin B12 deficiency?
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Why should iron supplements be taken with vitamin C-rich foods?
Why should iron supplements be taken with vitamin C-rich foods?
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What is the first step you should take when you suspect an acute hemolytic reaction during a blood transfusion?
What is the first step you should take when you suspect an acute hemolytic reaction during a blood transfusion?
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Which symptom is NOT typically associated with an anaphylactic reaction from a blood transfusion?
Which symptom is NOT typically associated with an anaphylactic reaction from a blood transfusion?
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Which condition increases the risk of TRALI in patients receiving blood transfusions?
Which condition increases the risk of TRALI in patients receiving blood transfusions?
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What is one of the main differences in symptoms between TRALI and TACO during a transfusion?
What is one of the main differences in symptoms between TRALI and TACO during a transfusion?
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In the context of blood transfusions, what is the primary physiological cause of a hemolytic reaction?
In the context of blood transfusions, what is the primary physiological cause of a hemolytic reaction?
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Why might a patient who has experienced an anaphylactic reaction need future transfusions from frozen, deglycerolized blood cells?
Why might a patient who has experienced an anaphylactic reaction need future transfusions from frozen, deglycerolized blood cells?
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Within what timeframe is TRALI most likely to develop after a blood transfusion?
Within what timeframe is TRALI most likely to develop after a blood transfusion?
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Which laboratory finding can indicate TRALI?
Which laboratory finding can indicate TRALI?
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What is a common intervention if a patient exhibits TACO symptoms during a transfusion?
What is a common intervention if a patient exhibits TACO symptoms during a transfusion?
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In older adults receiving blood transfusions, which sign should be reported immediately?
In older adults receiving blood transfusions, which sign should be reported immediately?
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How should the vein be managed after stopping a blood transfusion due to an acute hemolytic reaction?
How should the vein be managed after stopping a blood transfusion due to an acute hemolytic reaction?
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What preventive measure is suggested for avoiding TRALI with blood transfusions?
What preventive measure is suggested for avoiding TRALI with blood transfusions?
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Which symptom is a late sign of an acute hemolytic reaction?
Which symptom is a late sign of an acute hemolytic reaction?
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Which of the following symptoms might suggest a patient is experiencing a blood transfusion-related anaphylactic reaction?
Which of the following symptoms might suggest a patient is experiencing a blood transfusion-related anaphylactic reaction?
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What is a common vital sign abnormality seen in TRALI that requires immediate attention?
What is a common vital sign abnormality seen in TRALI that requires immediate attention?
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For which patient population is the risk of transfusion-associated circulatory overload (TACO) particularly high?
For which patient population is the risk of transfusion-associated circulatory overload (TACO) particularly high?
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What primary function does the spleen serve in the lymphatic system?
What primary function does the spleen serve in the lymphatic system?
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Which pathway is initiated when a blood vessel or surrounding tissues are damaged?
Which pathway is initiated when a blood vessel or surrounding tissues are damaged?
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What is a common symptom for patients with disorders affecting red blood cells?
What is a common symptom for patients with disorders affecting red blood cells?
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Which factor is necessary for the absorption of vitamin B12?
Which factor is necessary for the absorption of vitamin B12?
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What role do lymph nodes play in the lymphatic system?
What role do lymph nodes play in the lymphatic system?
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What is a hallmark feature of G6PD deficiency in Mediterranean populations?
What is a hallmark feature of G6PD deficiency in Mediterranean populations?
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What essential nutrients are required for healthy RBC production?
What essential nutrients are required for healthy RBC production?
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In which area is the thymus located?
In which area is the thymus located?
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Which of the following could be a symptom of anemia?
Which of the following could be a symptom of anemia?
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What is the primary role of platelets in the blood?
What is the primary role of platelets in the blood?
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Which condition results from chronic or massive blood loss leading to fewer RBCs?
Which condition results from chronic or massive blood loss leading to fewer RBCs?
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Which of the following describes the condition of anemia on a cellular level?
Which of the following describes the condition of anemia on a cellular level?
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What action should be taken during the first 15 minutes of a blood transfusion?
What action should be taken during the first 15 minutes of a blood transfusion?
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How do lymphatic vessels prevent backflow?
How do lymphatic vessels prevent backflow?
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Flashcards
Hematologic System
Hematologic System
The network that includes bone marrow, blood, and its components.
Functions of Blood
Functions of Blood
Transport of substances, regulation of temperature, pH, fluid balance, and immune cell transport.
Plasma Composition
Plasma Composition
Plasma is about 91% water and contains proteins like albumin and globulins for transport and clotting.
Red Blood Cells (RBCs)
Red Blood Cells (RBCs)
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Hematocrit (Hct)
Hematocrit (Hct)
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Hemoglobin (Hgb)
Hemoglobin (Hgb)
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White Blood Cells (WBCs)
White Blood Cells (WBCs)
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Plasma Proteins
Plasma Proteins
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WBC normal count
WBC normal count
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Neutrophils function
Neutrophils function
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Eosinophils role
Eosinophils role
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Basophils purpose
Basophils purpose
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Lymphocytes
Lymphocytes
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Monocytes function
Monocytes function
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Platelet ranges
Platelet ranges
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Thrombocytosis
Thrombocytosis
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Thrombocytopenia
Thrombocytopenia
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Hemoglobin
Hemoglobin
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Erythropoietin
Erythropoietin
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Intrinsic factor
Intrinsic factor
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Blood types
Blood types
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Jaundice
Jaundice
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WHAT’S UP? Format
WHAT’S UP? Format
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Family History
Family History
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Diet History
Diet History
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Alcohol Intake
Alcohol Intake
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Occupational History
Occupational History
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Fatigue
Fatigue
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Bleeding Tendency
Bleeding Tendency
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Shortness of Breath
Shortness of Breath
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Lymphadenopathy
Lymphadenopathy
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Vital Signs
Vital Signs
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Coagulation Tests
Coagulation Tests
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International Normalized Ratio (INR)
International Normalized Ratio (INR)
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Neutrophils
Neutrophils
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Signs of Hematologic Disorders
Signs of Hematologic Disorders
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Objective Data Collection
Objective Data Collection
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Extrinsic Pathway
Extrinsic Pathway
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Intrinsic Pathway
Intrinsic Pathway
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Fibrin Clot
Fibrin Clot
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Role of Endothelium
Role of Endothelium
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Heparin
Heparin
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Antithrombin
Antithrombin
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Lymph
Lymph
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Thoracic Duct
Thoracic Duct
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Lymph Nodes
Lymph Nodes
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Spleen Functions
Spleen Functions
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Thymus
Thymus
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Aging Effects
Aging Effects
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Hemolysis
Hemolysis
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Lymphatic Nodules
Lymphatic Nodules
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Bilirubin
Bilirubin
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Blood Administration
Blood Administration
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Autologous Transfusion
Autologous Transfusion
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Blood Component Storage
Blood Component Storage
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Transfusion Consent Form
Transfusion Consent Form
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Normal Saline Compatibility
Normal Saline Compatibility
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Transfusion Timing
Transfusion Timing
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Blood Filtering
Blood Filtering
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Washed Red Blood Cells
Washed Red Blood Cells
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Warmed Blood Transfusion
Warmed Blood Transfusion
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Monitoring During Transfusion
Monitoring During Transfusion
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Febrile Reaction
Febrile Reaction
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Urticarial Reaction
Urticarial Reaction
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Volume Replacement
Volume Replacement
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Packed Red Blood Cells
Packed Red Blood Cells
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Monitoring Complications
Monitoring Complications
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Bands
Bands
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Segmented Neutrophils
Segmented Neutrophils
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WBC Differential Count
WBC Differential Count
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Acute Bacterial Infection Pattern
Acute Bacterial Infection Pattern
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Viral Infection Pattern
Viral Infection Pattern
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Bone Marrow Biopsy
Bone Marrow Biopsy
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Coagulation Studies
Coagulation Studies
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Prothrombin Time (PT)
Prothrombin Time (PT)
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Activated Partial Thromboplastin Time (aPTT)
Activated Partial Thromboplastin Time (aPTT)
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Bleeding Time
Bleeding Time
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Capillary Fragility Test
Capillary Fragility Test
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Lymphangiography
Lymphangiography
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Lymph Node Biopsy
Lymph Node Biopsy
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Formed Elements
Formed Elements
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Anemia
Anemia
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Microcytic Anemia
Microcytic Anemia
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G6PD Deficiency
G6PD Deficiency
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Pernicious Anemia
Pernicious Anemia
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Iron Deficiency
Iron Deficiency
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Symptoms of Anemia
Symptoms of Anemia
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Clotting Factors
Clotting Factors
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Pathophysiology of Anemia
Pathophysiology of Anemia
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Hemolytic Reaction
Hemolytic Reaction
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Signs of Hemolytic Reaction
Signs of Hemolytic Reaction
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Immediate Action for Hemolytic Reaction
Immediate Action for Hemolytic Reaction
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Anaphylactic Reaction
Anaphylactic Reaction
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Symptoms of Anaphylactic Reaction
Symptoms of Anaphylactic Reaction
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TRALI
TRALI
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Signs of TRALI
Signs of TRALI
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Transfusion-Associated Circulatory Overload (TACO)
Transfusion-Associated Circulatory Overload (TACO)
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Signs of TACO
Signs of TACO
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Emergency Procedures for Transfusion Reactions
Emergency Procedures for Transfusion Reactions
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Role of Antihistamines in Reactions
Role of Antihistamines in Reactions
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Management of Shock in Reactions
Management of Shock in Reactions
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Special Precautions for Older Adults
Special Precautions for Older Adults
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Post-Transfusion Monitoring
Post-Transfusion Monitoring
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Energy Conservation
Energy Conservation
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ADLs
ADLs
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Dyspnea Relief
Dyspnea Relief
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Iron Deficiency Management
Iron Deficiency Management
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Vitamin B12 Administration
Vitamin B12 Administration
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High-Iron Food Examples
High-Iron Food Examples
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Folic Acid Deficiency
Folic Acid Deficiency
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Signs of Anemia
Signs of Anemia
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Glossitis
Glossitis
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Oral Hygiene Importance
Oral Hygiene Importance
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Vitamin C Sources
Vitamin C Sources
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Iron Supplements Timing
Iron Supplements Timing
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Intrinsic Factor Function
Intrinsic Factor Function
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Vitamin B12 Sources
Vitamin B12 Sources
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Folate's Role
Folate's Role
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Folate Sources
Folate Sources
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Pernicious Anemia Symptoms
Pernicious Anemia Symptoms
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Complete Blood Count (CBC)
Complete Blood Count (CBC)
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Treating Anemia
Treating Anemia
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Iron Deficiency Symptoms
Iron Deficiency Symptoms
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Vitamin B12 Deficiency Risks
Vitamin B12 Deficiency Risks
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Daily Folate Requirement
Daily Folate Requirement
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Monitoring Anemia
Monitoring Anemia
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Study Notes
Hematologic and Lymphatic Systems
- The hematologic system includes bone marrow, blood, and blood components.
- The lymphatic system includes lymph nodes, lymphatic nodules (filtering pathogens), and lymph vessels (returning lymph to blood).
Blood
- Blood volume: 4-6 liters
- Formed elements (RBCs, WBCs, platelets): ~45% of blood volume
- Plasma (~91% water): transports substances, regulates temperature, pH, and fluid balance, and transports protective cells.
- Formed elements are produced from stem cells in red bone marrow (hematopoietic tissue) of flat, irregular, and long bones.
- T-lymphocyte maturation/differentiation happens in the thymus.
Plasma
- Primarily water (~91%)
- Plasma proteins (synthesized in liver):
- Clotting factors (prothrombin, fibrinogen): activate for clotting
- Albumin: maintains blood volume/pressure by pulling tissue fluid into capillaries
- Globulins (alpha/beta): carriers for substances like fats
- Globulins (gamma): antibodies produced by lymphocytes.
Blood Cell Counts (Table 27.1)
- Red Blood Cells (RBCs):
- Increased (polycythemia): seen in chronic hypoxia
- Decreased (anemia): seen in anemia or blood loss
- Normal values differ by sex
- Hematocrit (Hct):
- Increased: dehydration or chronic hypoxia
- Decreased: anemia or blood loss
- Normal values differ by sex
- Hemoglobin (Hgb):
- Increased: chronic hypoxia
- Decreased: blood loss or anemia
- Normal values differ by sex
- Reticulocytes:
- Increased: hypoxia or anemia
- Decreased: RBC maturation defect
- White Blood Cells (WBCs):
- Increased (leukocytosis): infection
- Decreased (leukopenia): possible infection
- Normal values range (count): 4,500-11,000/mm3
- Specific WBC types (neutrophils, eosinophils, basophils, lymphocytes, monocytes) and counts are detailed in Table 27.1. Specific increases/decreases indicate a potential cause, i.e. infection.
- Platelets:
- Increased (thrombocytosis): trauma
- Decreased (thrombocytopenia): blood disorders
Blood pH
- Normal range: 7.35-7.45
- Buffer systems maintain homeostasis.
Red Blood Cells (RBCs)
- Biconcave disks, no nuclei
- Carry oxygen bound to iron in hemoglobin.
- Oxyhemoglobin forms in pulmonary capillaries with oxygen binding.
- Reduced hemoglobin results when oxygen is released.
- Factors determining oxygen-carrying capacity: Hgb amount, iron content, and # of RBCs.
- Decreased capacity (anemia): shortness of breath, fatigue.
- Hypoxia stimulates kidneys to produce erythropoietin, increasing RBC production.
- Immature reticulocytes mature by ejecting nuclei, forming biconcave disc.
- Presence of many reticulocytes signifies the body needs more mature RBCs.
- Dietary protein and iron are needed for Hgb synthesis.
- Folic acid and vitamin B12 needed for DNA synthesis in red marrow stem cells (mitosis).
- Vitamin B12 (extrinsic factor) comes from diet.
- Intrinsic factor produced by stomach lining helps absorb B12 in small intestine.
- RBC lifespan: ~120 days
- Phagocytized by macrophages in liver, spleen, and red bone marrow.
- Conditions (malaria, sickle cell) cause accelerated RBC destruction (hemolysis), potentially causing jaundice (bilirubin buildup).
Blood Types
- Determined by antigens on RBCs.
- ABO group and Rh factor are critical.
- ABO type indicates antigens present.
- Plasma contains antibodies for missing antigens.
- Rh-positive has D antigen, Rh-negative does not.
- Rh-negative people can produce antibodies to Rh-positive blood upon exposure.
White Blood Cells (WBCs)
- Larger than RBCs, have nuclei
- Granular (neutrophils, eosinophils, basophils) and agranular (lymphocytes, monocytes)
- Produced in red bone marrow; T lymphocytes mature in thymus
- Activated/differentiated in lymph nodes, spleen, and lymphatic nodules
- All involved in immune/inflammatory response to injury
- Varying lifespans; most circulate a few days, some live years.
Monocytes/Macrophages
- Become macrophages in tissues.
- Phagocytize pathogens and infected cells.
Neutrophils
- Numerous; phagocytize foreign matter.
Eosinophils
- Combat histamine effects. Detoxify foreign proteins. Respond to parasitic infections.
Basophils
- Release heparin and histamine during inflammatory reactions.
Lymphocytes
- Two groups: T cells and B cells
- T cells (helper, suppressor, killer, memory).
- B cells (memory cells and plasma cells): produce antibodies against foreign antigens.
Platelets
- Fragments of megakaryocytes produced in red marrow.
- Involved in hemostasis (vascular spasm, platelet plugs, chemical clotting).
- Lifespan: ~10 days.
- Coagulation:
- Extrinsic pathway: Initiated by damaged blood vessels/surrounding tissues.
- Intrinsic pathway: Initiated when platelets adhere to damaged endothelium and release clotting factors.
- Both pathways lead to a fibrin clot.
- Prevention of excessive clotting:
- Smooth endothelial lining repels platelets.
- Heparin inhibits clotting.
- Antithrombin inactivates excess thrombin.
Lymphatic System
- Consists of lymph, lymph vessels, lymph nodes/nodules, spleen, red bone marrow, and thymus.
- Function: returns tissue fluid, defends against pathogens.
- Lymph capillaries collect tissue fluid (lymph) returning it to blood.
- Lymph nodes house lymphocytes and macrophages.
- Lymph nodes concentrated in cervical, axillary, and inguinal regions.
- Lymphatic nodules are found in mucous membranes; phagocytize pathogens.
- Tonsils are examples of lymphatic nodules.
- Spleen in abdominal cavity;
- Functions: immunity (B cells & T cells), phagocytosis of pathogens/damaged cells, stores platelets.
- Not vital; other organs compensate for spleen removal.
- Thymus: location in mediastinum; T lymphocytes mature here; atrophies in adults.
Aging and the Hematologic/Lymphatic Systems
- Changes occur in older adults (detailed in 27.6).
Patient Data Collection (Hematologic/Lymphatic)
- Health History (Table 27.3): collects info on bleeding, fatigue, etc.
- Family History: identifies hereditary predisposition to disorders.
- Diet History: detects nutrient deficiencies.
- Medical/Supplement History: screens for potential interactions with blood or immune function.
- Environmental Exposure History: identifies substances linked to bone marrow or blood cancer.
Physical Examination (Hematologic/Lymphatic)
- Examination of various body systems (detailed in 27.4) for signs of anemia, bleeding, etc, is fundamental.
Diagnostic Tests
- Blood tests (CBC, Hgb, Hct, platelets)
- Coagulation studies (PT, INR, aPTT, bleeding time, capillary fragility test)
- Bone marrow biopsy
- Lymphangiography
- Lymph node biopsy
Blood Administration
- Safety measures:
- Proper identification.
- Transfusion consent form.
- Fluid compatibility (using normal saline).
- Timing (start within 30 minutes, infuse over 2 hours).
- Filtering (using filters appropriate for blood type).
- Washed/leukocyte-reduced blood (for reduced risk of febrile reactions).
- Warming blood (for severe bleeding/multiple transfusions, to prevent hypothermia).
- Monitoring: vital signs (especially temperature) before and throughout transfusion.
Complications (Blood Transfusions)
- Febrile reaction: common, fever, chills
- Urticarial (hive) reaction: mild allergic reaction, rash
- Hemolytic reaction: incompatible blood, hemolysis of RBCs, dangerous
- Anaphylactic reaction: rare, life-threatening allergic reaction.
- Transfusion-related acute lung injury (TRALI): serious
- Transfusion-associated circulatory overload (TACO): fluid overload risk from rapid transfusion.
Anemia
- Condition of low RBCs, Hgb, or both.
- Reduced oxygen delivery to tissues.
- Symptoms: lightheadedness, weakness, shortness of breath.
- Causes:
- Impaired production (aplastic anemia, nutritional deficiencies)
- Increased destruction (hemolytic anemia, sickle cell)
- Blood loss
- Types:
- Microcytic anemia: smaller RBCs (often iron deficiency)
- Macrocytic anemia: larger RBCs (often vitamin B12 or folate deficiency)
- Cultural considerations: G6PD deficiency linked to certain cultural heritage and foods causing crisis.
- Dietary considerations for treatment
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Test your knowledge on the functions and components of blood plasma. This quiz will explore various aspects including protein synthesis, blood volume composition, and the roles of different blood cells. Perfect for students in biology or medical courses.