NSG 2060 Spring 2025 Hematologic Disorder Lecture Notes PDF

Hematologic Disorder Part #2 NSG 2060 Spring 2025 Professor Hong Class Announcements Dosage Calculation Quiz is due today (2/5/25) at 7pm. No extensions allowed. Prep-U Chapter 20 is posted Learning Objectives 1. Accurately interpret coagulation laboratory values to identify deviations from no...

Hematologic Disorder Part #2 NSG 2060 Spring 2025 Professor Hong Class Announcements Dosage Calculation Quiz is due today (2/5/25) at 7pm. No extensions allowed. Prep-U Chapter 20 is posted Learning Objectives 1. Accurately interpret coagulation laboratory values to identify deviations from normal ranges and relate abnormal results to potential clinical implications and patient care needs. 2. Formulate a comprehensive nursing care plan for a patient with thrombocytopenia, considering individualized needs and potential complications 3. Prioritize interventions to prevent bleeding, including patient education on activity restrictions and recognizing signs of bleeding 4. Outline nursing interventions to support patients diagnosed with ITP, emphasizing teaching about the chronic nature of ITP and the importance of adherence to treatment plans 5. Understand the implications of aspirin and NSAID therapy, emphasizing the importance of balance between anti platelet effects and potential bleeding risks 6. Address the unique challenges and complications associated with platelet disorders, including pharmacological and non-pharmacological interventions Test AD Learning Objectives 1. Explain the clinical indications for blood component therapy and recognize contraindications and potential risks associated with blood transfusions. 2. Summarize the nurse’s role in administering blood components, including accurate identification, calculation of infusion rates, and monitoring for signs of adverse reactions 3. Demonstrate the ability to perform through pre-transfusion assessments, monitor vital signs during transfusions, recognize signs of transfusion reactions, and intervene appropriately 4. Describe the significance of accurate blood typing in preventing transfusion reactions 5. Providing information to patients and families about blood component therapy Hemostatic Process Labs to know: Test PT (Prothrombin Time): Measures how long it takes for your blood to clot. It checks the clotting ability of certain blood proteins. What it checks: Measures the time it takes for your blood to clot, specifically focusing on the "extrinsic" and "common" clotting pathways (clotting factors like I, II, V, VII, and X). When it's used: Often used to check for bleeding disorders or to monitor patients on blood thinners like warfarin. INR (International Normalized Ratio): A standardized number that helps doctors compare blood clotting times across different labs. It’s mainly used for people on blood thinners (like warfarin) to make sure their clotting is at the right level. What it checks: It’s a calculation based on PT. It standardizes PT results so they can be compared across different labs, which helps doctors adjust blood thinner doses like warfarin. When it's used: Specifically used to monitor people on blood thinners to make sure their clotting time is in a safe range. aPTT (Activated Partial Thromboplastin Time): Measures how long it takes for your blood to clot, focusing on different clotting factors than PT. It’s often used to monitor blood thinning treatments. What it checks: Measures the time it takes for your blood to clot, but it focuses on the "intrinsic" and "common" pathways (clotting factors like I, II, V, VIII, IX, X, XI, and XII). When it's used: Commonly used to monitor patients on heparin therapy or to diagnose clotting issues. Key difference: PT/INR are related and used together because they focus on the extrinsic and common pathways and are useful for monitoring treatments like warfarin. aPTT is assessed separately because it evaluates the intrinsic and common pathways and is useful for monitoring treatments like heparin or diagnosing certain clotting disorders.  can Thrombocytopenia Thrombocytopenias: Condition characterized by a low number of platelets in the blood 1.Impaired platelet production (Cancers, infections, nutritional deficiencies) 2.Increased platelet destruction (Acquired disorders) 3.Increased consumption of platelet sequestration ÉTAPEE Causes for thrombocytopenia: malignancy, infection, medications, alcohol use, sequestration, genetic etc. Clinical Manifestations: Many clients with thrombocytopenia are asymptomatic. Most common symptom is bleeding. Below 150,000 platelets per microliter: Thrombocytopenia Below 50,000 platelets per microliter: Prolonged bleeding Knot Below 20,000 platelets per microliter: petechiae, Spontaneous nasal/gingival bleeding, excessive menstrual bleeding, excessive bleeding after surgery or dental procedure Below 10,000 platelets per microliter: spontaneous, potentially fatal CNS or GI hemorrhage can occur Thrombocytopenia 30 cases of Pseudothrombocytopenia: platelets clump in the presence of EDTA IF SOS BLOOD smear Patient and Caregiver Teaching: Symptoms of bleeding (internal vs external), restrictions to activity, prevention of nosebleeds, do not bend down with head lower than waist, adequate fluids, prevent cuts (shaving, tweezing, skin punctures), review medications (aspirin), soft-bristle toothbrush, track bleeding with menstruation, surgical precautions mted induced_ med WHATS Transusion AB10 er now  Be spleen Thrombocytopenia (Box 19-2) Thrombocytopenia Question: When assessing a patient who has a diagnosis of thrombocytopenia, the nurse should understand that the patient may present with what sign or symptom of disease? A. Petechiae B. Cherry Angiomas C. Alopecia D. Pruritus  autoimmune ITP Immune Thrombocytopenic Purpura (ITP) Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by low platelet counts due to the immune system mistakenly attacking and destroying platelets, leading to an increased risk of bleeding and bruising Pathophysiology: Historically was referred to as “idiopathic”; recent years number of etiologies leading to current understanding of autoimmune process Antiplatelet antibodies destroy platelets and impair production. Inappropriately low thrombopoietin response. Triggers include infections, medications (e.g., sulfa drugs), pregnancy, or autoimmune conditions (e.g., lupus). Types of ITP: Acute ITP: More common in children. Usually follows a viral infection within 1-6 weeks. Self-limited and often resolves spontaneously within 6 months. ACUTE Typically does not require long-term treatment. Chronic ITP: More common in adults, especially women. Persistent and often requires ongoing management. Diagnosed after ruling out other causes of thrombocytopenia. Chronic Relapses are common even after remission.  w man below 20k Asymptomatic until plat Immune Thrombocytopenic Purpura (ITP) Brize Symptoms: Often asymptomatic; incidental low platelet Medical Management: easy Reticine count (