Emergency Nursing and Blood Disorders

Emergency Nursing and Blood Disorders

• Upon admission of a patient with acute blood loss, the nurse should conduct rapid head-to-toe assessments, stop bleeding, access large gauge/central lines, and obtain relevant labs such as blood type/match, CBC, and electrolytes.
• Transfusions should be considered only if improvement in RBC count cannot be achieved through nutrition, drug therapy, or treating the underlying disease, and blood should only be administered based on appropriate indications.
• Different types of blood component therapies include whole blood, packed red blood cells (PRBC), platelets, blood clotting factors, plasma, antibodies, and blood substitutes.
• PRBCs are prepared by removing 200-250mL of plasma from whole blood and are advantageous due to decreased volume delivery and risk of circulatory overload.
• Fresh frozen plasma (FFP) is used for active bleeding with coagulation factor deficiencies, warfarin reversal, DIC, and massive transfusions in trauma, while platelets are administered for thrombocytopenia.
• The administration of blood transfusions should follow institutional policy/procedures, with frequent vital signs and assessments as dictated by policy.
• In the event of a transfusion reaction, the nurse should first stop the transfusion and then follow institutional policy/procedures for further action.
• Aplastic anemia can be congenital or acquired, with symptoms related to deficiencies in red blood cells, white blood cells, and platelets, and can be diagnosed through blood analysis, serum iron and iron binding, and bone marrow biopsy.
• Polycythemia, particularly polycythemia vera, involves chronic overproduction of RBCs, WBCs, and platelets, resulting in increased blood viscosity and volume, and is commonly accompanied by splenomegaly and depletion of iron stores.
• The interprofessional management of polycythemia involves phlebotomy, hydration therapy, drug therapy (e.g., hydroxyurea, aspirin), and addressing potential nursing diagnoses such as activity intolerance.
• Hemophilia, caused by inadequate clotting factors, presents with signs and symptoms such as prolonged bleeding, hemorrhage with minor cuts, hemarthrosis, and intracranial bleeding, and is managed through the administration of factor VIII, RICE, and PT after bleeding for control of muscle and joint strengthening.
• Aging affects the hematologic system by slowing down the replacement of erythrocytes, increasing platelet adhesiveness, and decreasing lymphocyte and T-cell function.