Nursing Management Blood Disorders

Nursing Management of Patients With Blood Disorders

• The presentation is about the nursing management of patients with blood disorders.
• Learning objectives include recalling bone marrow components and function, identifying the nursing role in blood transfusions, listing causes of hemophilia, identifying sources of stem cells, and listing different stem cell transplantation methods. Additionally, differentiating between anemia types, prioritizing nursing care for various types of anemia and hemophilia, and providing comprehensive nursing care during stem cell transplantation.

Bone Marrow

• Bone marrow is the spongy or viscous tissue filling the inside of bones.
• Two types: red bone marrow produces blood cells; yellow bone marrow stores fat.

Blood Components

• Blood is a specialized body fluid with four main components: plasma, red blood cells, white blood cells, and platelets.
• Blood has many functions, including transporting oxygen and nutrients, forming clots, carrying infection-fighting cells and antibodies, and removing waste products.

Plasma

• The liquid part of blood, a mixture of water, sugar, fat, protein, and salts.
• Plasma's function is to transport blood cells, nutrients, waste products, antibodies, clotting proteins, hormones, and proteins that maintain fluid balance.

Red Blood Cells (Erythrocytes/RBCs)

• The most abundant blood cell type, accounting for 40-45% of blood volume.
• Shaped like biconcave discs with a flattened center.
• Produced by erythropoietin.
• Lack a nucleus, allowing for easy shape changes.

White Blood Cells (Leukocytes)

• Protect the body from infection.
• Neutrophils have a lifespan of less than a day, requiring constant production by bone marrow to maintain infection protection.

Platelets (Thrombocytes)

• Crucial for blood clotting (coagulation).
• Gather at injury sites, adhering to injured vessel linings, forming a platform for coagulation.
• Low counts lead to extensive bleeding.

Complete Blood Count (CBC)

• Diagnoses conditions like anemia, infection, and other disorders.
• Platelet count and plasma clotting tests (prothrombin time, partial thromboplastin time, thrombin time) assess bleeding and clotting disorders.
• White blood cell counts indicate immune function.

Blood Function

• Transports oxygen and nutrients to tissues and lungs.
• Forms blood clots to prevent blood loss.
• Carries infection-fighting cells and antibodies.
• Transports waste products to the kidneys and liver for filtration and blood cleanup.
• Regulates body temperature.

Blood Transfusion

• Transfused as whole blood (containing all parts) or individually, depending on patient needs.
• Red blood cells are the most common part transfused; they transport oxygen.
• Platelets and clotting factors stop bleeding, including internal bleeding (illnesses may affect production).
• Plasma, the liquid part of blood, is mostly water and contains proteins, clotting factors, hormones, vitamins, cholesterol, sugar, and salts.

Nursing Role Before Blood Transfusion

• Ensuring blood compatibility (cross-matching and typing).
• Verifying doctor's order.
• Informing the patient about the procedure.
• Obtaining and recording baseline vital signs.
• Practicing strict asepsis.
• Checking blood transfusion labels (serial number, blood component, blood type, Rh factor, expiration date).
• Performing screening tests to prevent transmitting blood-borne diseases.
• Warming blood to room temperature to avoid chills.

Nursing Role During Blood Transfusion

• Using appropriate needle gauge (18-19).
• Monitoring vital signs (temperature, respiratory rate).
• Avoiding mixing medications with blood transfusions.
• Not using blood transfusion lines for IV medication push.
• Maintaining blood drop rate (no more than 15 drops/minute for first 15 minutes).
• Monitoring for adverse reactions (during first 15-20 minutes).
• Observing patients for the rest of the procedure (1-4 hours, depending on physician's orders and patient condition).
• Closely observing for reactions such as mild fever/pyrexia , itching and rash.
• Stopping the transfusion/keeping IV line open with normal saline if adverse reactions are observed
• Keeping blood pack to send it to the lab for investigation

Nursing Role After Blood Transfusion

• Checking vital signs (temperature, pulse, blood pressure).
• Monitoring the blood tests' impact on blood counts.
• Nursing care depends on the management of the chronic illness.

Blood Disorders: Anemia

• Dozens of diseases can affect blood, including red blood cells, white blood cells, and platelets.

Anemia Definition

• Condition of having fewer red blood cells or hemoglobin than normal.
• Lowers blood's capacity for oxygen transport.
• Symptoms may include tiredness, fatigue, pallor, palpitations, and shortness of breath.

Different Types of Anemia

• Iron deficiency anemia
• Anemia of chronic disease
• Pernicious anemia (B12 deficiency)
• Aplastic anemia
• Autoimmune hemolytic anemia
• Thalassemia
• Sickle cell anemia
• Polycythemia vera

Hemophilia

• Inherited bleeding disorder due to deficiencies in clotting factors.
• Primarily affects males; females serve as carriers.
• Types include hemophilia A (factor VIII deficiency) and hemophilia B (factor IX deficiency).

Hemophilia Severity

• Severity ranges from mild (5-40% normal clotting factors), moderate (1-5%), to severe (less than 1%).

Hemophilia Symptoms

• Spontaneous bleeding (elbows, knees, ankles, hips, and shoulders).
• Pain and swelling in joints, limiting movement.
• Anemia.
• Blue patches under the skin.

Hemophilia Diagnosis

• Family history.
• Physical examination.
• Blood tests (factor assays) for clotting ability and factor levels.

Hemophilia Treatment

• Replacement therapy (clotting factors) from human blood or synthetic sources (prophylactic or on demand).
• Fresh blood transfusions.
• Plasma therapy.
• Cryoprecipitate (a frozen blood product from plasma).
• Symptomatic treatment.

Stem Cells

• Master cells with remarkable development potential in early life and growth.
• Serve as internal repair systems.
• Replenish cells constantly for a person's lifespan.

Stem Cell Sources

• Embryonic stem cells (from fertilized eggs in vivo or in vitro).
• Umbilical cord stem cells (from newborns' umbilical cords).
• Adult/somatic stem cells (from adults, children, and infants).

Stem Cell Types (Adult/Somatic)

• Undifferentiated cells found among differentiated cells in tissues or organs. Can renew themselves and differentiate into specialized cell types.
• Hematopoietic stem cells primarily in bone marrow/peripheral blood; generate all blood cell types.

Stem Cell Therapy

• A set of techniques aiming to replace diseased cells with healthy functioning cells.

Stem Cell Transplantation Methods

• Autologous: donor and recipient are the same person.
• Syngeneic: stems cells from identical twins.
• Allogeneic: stems cells from another source.

Nursing Care for Patients Undergoing Stem Cell Transplantation

• Before transplantation: patient preparation/biopsychosocial assessment, complete physical exam, donor prep, care during chemotherapy, and starting discharge plan.
• During transplantation: close observation, and psychological support.
• Post-transplantation: closed patient observation, patient isolation, support, and medication administration.
• Post-discharge: planning for patient's discharge, dietary advice, activates support, isolation support, medication reminders, visits from family and friends, and emergency planning

This quiz focuses on the nursing management of patients with blood disorders. It covers topics such as bone marrow function, roles in blood transfusions, and types of anemia and hemophilia, along with stem cell transplantation methods and prioritizing nursing care. Enhance your understanding of these critical nursing responsibilities and components of blood.