NURS 3510 Module 5 Hematology

abnormal hemostasis that presents as prolonged bleeding from minor trauma or spontaneous bleeding without injury

Cancers, aplastic anemia, leukemia, lymphoma, myeloma, myelodysplastic disorders, marrow metastases, drugs, immune thrombocytopenia, infections, nutrition deficiencies, and radiation

accelerated platelet destruction caused by antibodies

an acquired immune disorder where there is abnormal platelet destruction

Artificial surfaces, disseminated intravascular coagulation, heparin-induced thrombocytopenia, pregnancy-related, thrombotic microangiopathy, and atypical hemolytic uremic syndromes

dilution

Wiskott-Aldrich syndrome

drugs

It is a needed health history assessment to diagnose thrombocytopenia.

Haptoglobin, Hgb, indirect bilirubin, LDH, reticulocytes, and schistocytes.

That the patient will have no bleeding.

It is a laboratory study used to diagnose or monitor coagulopathy in thrombocytopenia.

To diagnose or monitor thrombocytopenia.

It helps diagnose thrombocytopenia by examining the bone marrow.

It can cause organ shutdown or failure.

To prevent bleeding and organ failure.

Heparin-Induced Thrombocytopenia (HIT)

PF4-heparin complex

Specific assays such as ITP antigen-specific assay, platelet activation/function assay, or PF4-heparin complex for HIT

If they do not respond to treatment

Thrombocytopenia and platelet-fibrin thrombi

They sequester and destroy platelets

Bone marrow examination

They can be normal even in severe thrombocytopenia

Bleeding

Removal of the spleen increases the number of platelets in circulation

peripheral blood pancytopenia and hypocellular bone marrow

hypovolemic shock and reduced RBCs available to carry O2

Under 50,000/μL (50 × 109/L)

depleted iron stores

Spontaneous, life-threatening bleeding (e.g., intracranial bleeding) can occur

abnormal form of Hgb in the RBC

Weakness, fainting, dizziness, tachycardia, abdominal pain, and hypotension

Prolonged bleeding after routine procedures, such as venipuncture or IM injection

identifying and stopping the bleeding source

Because some antibody synthesis occurs in the spleen

2 new cases per million people per year

Bleeding

increasing plasma volume to maintain circulating fluid volume

bleeding and sepsis

Megaloblastic anemia is caused by impaired DNA synthesis, resulting in defective RBC maturation. Common causes include cobalamin (vitamin B12) and folic acid deficiencies, congenital disorders, suppression of DNA synthesis by drugs, inborn errors of cobalamin and folic acid metabolism, and erythroleukemia.

Pernicious anemia is caused by an absence of intrinsic factor (IF). It occurs most often in persons of Northern European descent (especially Scandinavians) and Blacks, with the most common age of diagnosis being around 60 years.

The manifestations of folic acid deficiency are similar to cobalamin deficiency, and include symptoms such as stomatitis, cheilosis, dysphagia, flatulence, and diarrhea. It is diagnosed with a low serum folate level (normal is 5 to 25 ng/mL or 11 to 57 nmol/L) and a normal serum cobalamin level.

The nursing measures for a patient with folic acid deficiency anemia are the same as those for the patient with anemia, as outlined in Nursing Care Plan 34.1.

The usual dosage of folic acid replacement therapy is 1 to 5 mg/day by mouth.

The normal serum folate level is 5 to 25 ng/mL (11 to 57 nmol/L).

Thiamine deficiency, which is often present with folate deficiency, can cause neurologic symptoms.

Erythroleukemia is a malignant blood disorder characterized by a proliferation of erythropoietic cells in bone marrow, which can cause megaloblastic anemia.

Iron deficiency anemia, and the most susceptible individuals are the very young, those on poor diets, and women in their reproductive years.

1 mg of iron daily in urine, bile, sweat, sloughing of epithelial cells from the skin and intestinal mucosa, and minor bleeding.

A deficiency in the number of erythrocytes, the quantity or quality of hemoglobin, and/or volume of packed RBCs. Common causes include blood loss, impaired RBC production, or increased RBC destruction.

An absent or reduced globulin protein, which leads to inadequate production of normal Hgb, decreasing RBC production.

Megaloblastic anemia is characterized by abnormally large (macrocytic) RBCs, which are easily destroyed because they have fragile cell membranes.

Morphologic classification is based on RBC size and color, while etiologic classification is based on the clinical condition causing the anemia.

Defective DNA synthesis in RBCs can lead to megaloblastic anemias.

The normal life span of an RBC is 120 days. The balance between RBC production (erythropoiesis) and RBC destruction and loss ensures an adequate number of RBCs.

Aplastic anemia is characterized by diminished availability of RBC precursors.

Types of anemia caused by decreased RBC production include anemia caused by decreased RBC production. Causes include impaired erythropoiesis, inadequate iron intake, and bone marrow disorders.

The causes of anemia, such as blood loss, impaired RBC production, or increased RBC destruction, affect the classification and diagnosis of the condition.

Decreased RBC production.

These laboratory tests help diagnose anemia by providing information on RBC count, hemoglobin level, and RBC morphology.

Decreased Hgb synthesis, defective DNA synthesis, and diminished availability of RBC precursors.

Morphologic classification provides an accurate classification of anemia, while etiologic classification helps identify the underlying cause and inform patient care.

Understanding the causes of anemia is crucial for developing effective treatment and management strategies tailored to the specific type and severity of anemia.

Hypovolemic shock

Iron deficiency anemia

Abnormal form of hemoglobin in the RBCs

Peripheral blood pancytopenia and hypocellular bone marrow

Identifying and stopping the bleeding source

2 new cases per million people per year

Prolonged bleeding from trauma or injury

Increases plasma volume to maintain blood volume

Needed for RBC production and DNA synthesis.

Triggers the bone marrow to produce more RBCs.

Improved hemoglobin and hematocrit levels, decrease of anemia symptoms, adequate nutritional intake, adherence to plan of care, improved energy and activity, absence of anemic complications.

Thrombocytopenia is a reduction of platelets to less than 150,000/μL (150 × 10^9/L).

Medication adherence, dietary deficiencies, and the importance of including leafy green vegetables, fortified cereals, fruits, and meat, dairy products, and eggs in their diet.

Triggers the bone marrow to produce more RBCs.

To monitor hemoglobin levels and prevent complications.

Improved hemoglobin and hematocrit levels, decrease of anemia symptoms, adequate nutritional intake, adherence to plan of care, improved energy and activity, absence of anemic complications.

Megaloblastic anemia is caused by impaired DNA synthesis, which results in defective RBC maturation. Common causes include cobalamin (vitamin B12) and folic acid deficiencies, congenital disorders, suppression of DNA synthesis by drugs, inborn errors of cobalamin and folic acid metabolism, and erythroleukemia.

Pernicious anemia is a disease caused by an absence of intrinsic factor. It usually occurs in middle age or later, with 60 years being the most common age at diagnosis.

The manifestations of folic acid deficiency are similar to cobalamin deficiency and include GI problems such as stomatitis, cheilosis, dysphagia, flatulence, and diarrhea. It is diagnosed by a low serum folate level (normal is 5 to 25 ng/mL [11 to 57 nmol/L]) with a normal serum cobalamin level.

The usual dosage of folic acid replacement therapy is 1 to 5 mg/day by mouth.

Erythroleukemia is a malignant blood disorder characterized by a proliferation of erythropoietic cells in bone marrow, which can cause megaloblastic anemia.

The nursing measures for a patient with folic acid deficiency anemia are similar to those for the patient with anemia, as discussed in eNursing Care Plan 34.1.

Thiamine deficiency, which is often present with folate deficiency, can cause neurologic symptoms.

The normal serum folate level is 5 to 25 ng/mL (11 to 57 nmol/L).

Iron deficiency anemia; the very young, those on poor diets, and women in their reproductive years.

1 mg of iron daily in urine, bile, sweat, sloughing of epithelial cells from the skin and intestinal mucosa, and minor bleeding.

Megaloblastic anemia

Thalassemia is a group of diseases involving inadequate production of normal Hgb, which decreases RBC production.

Abnormally large (macrocytic) RBCs.

Diminished availability of RBC precursors.

Near the Mediterranean Sea and equatorial or near-equatorial regions of Southeastern Asia, the Middle East, India, Pakistan, China, Southern Russia, and Africa.

Destruction of RBCs by macrophages in the spleen.

The primary cause of anemia is a deficiency in the number of erythrocytes (red blood cells), the quantity or quality of hemoglobin, or the volume of packed RBCs. The three main categories of its causes are: blood loss, impaired RBC production, or increased RBC destruction.

The normal life span of an RBC is 120 days. The balance of RBC production and destruction is maintained through a process called erythropoiesis, where RBC production is in equilibrium with RBC destruction and loss.

Morphologic classification is based on RBC size and color, while etiologic classification is based on the clinical condition causing the anemia. Morphologic classification is more accurate, but etiologic classification is more practical for patient care.

The primary cause of iron deficiency anemia is inadequate iron intake, increased iron demand, or chronic blood loss. The common manifestations of this condition include fatigue, pale skin, and shortness of breath.

Thalassemia is a genetic disorder that affects the production of hemoglobin, leading to anemia. The common manifestations of this condition include severe anemia, fatigue, and jaundice.

Megaloblastic anemia is a type of anemia characterized by the production of large, immature RBCs. The common causes of this condition include vitamin B12 deficiency, folic acid deficiency, and certain medications.

Anemia of chronic disease is a type of anemia that occurs in individuals with chronic inflammatory conditions, such as rheumatoid arthritis or cancer. The common causes of this condition include chronic inflammation, which leads to the suppression of erythropoiesis.

Erythropoiesis is the process of RBC production, and it plays a critical role in maintaining a healthy RBC count. Various diseases, such as chronic inflammatory conditions, can affect erythropoiesis, leading to anemia.

A significant decrease in the number of RBCs available to carry O2

The body maintains its blood volume by slowly increasing the plasma volume

Identifying the source of bleeding and stopping it, followed by iron supplements if necessary

An abnormal form of Hgb in the RBCs

Depleted iron stores lead to a decrease in RBC production

Hypocellular bone marrow

Hypovolemic shock

2 new cases per million people per year

Epoetin Alfa triggers the bone marrow to produce more RBCs, which increases hemoglobin and hematocrit levels, and decreases anemia symptoms.

Vitamin B12 is necessary for RBC production and DNA synthesis, and its deficiency can lead to anemia, fatigue, and neurological symptoms.

The expected outcomes are improved hemoglobin and hematocrit levels, decreased anemia symptoms, adequate nutritional intake, adherence to the plan of care, and improved energy and activity. These can be achieved through medication adherence, dietary changes, and regular monitoring of hemoglobin levels.

Thrombocytopenia is a reduction of platelets to less than 150,000/μL, which can lead to increased risk of bleeding and bruising.

Folic acid is essential for the production of RBCs, and its deficiency can lead to megaloblastic anemia, characterized by fatigue, weakness, and neurological symptoms.

Iron is essential for the production of hemoglobin, and its deficiency can lead to iron deficiency anemia, characterized by fatigue, weakness, and pale skin.

Anemia of chronic disease is a condition characterized by decreased RBC production due to chronic inflammation, and it differs from other types of anemia in that it is not caused by iron or Vitamin B12 deficiency.

Thalassemia is a genetic disorder that affects the production of hemoglobin, leading to abnormal RBC production and anemia.