Hematologic System - araneta PDF

Hematologic system - consists of plasma, proteins, cells, and a variety of other substances necessary to maintain homeostasis Functions: Maintenance of pH, maintenance of fluid and electrolyte levels, temperature regulation, clotting process, immunologic protection, transport of oxygen, hormones,...

Hematologic system - consists of plasma, proteins, cells, and a variety of other substances necessary to maintain homeostasis Functions: Maintenance of pH, maintenance of fluid and electrolyte levels, temperature regulation, clotting process, immunologic protection, transport of oxygen, hormones, and glucose; waste removal Liver crucial for producing clotting factors that help regulate the blood clotting process, which is vital for preventing excessive bleeding when injuries occur Bone marrow primary site of hematopoiesis body generates new blood cells, including red blood cells, white blood cells, and platelets development and maturation of immune cells B cells - responsible for producing antibodies Spleen blood filter removing damaged or old red blood cells and other cellular debris from the bloodstream Plasma liquid component of blood and plays a crucial role in the hematologic system makes up about 55% of the total blood volume RBC - 5 million, 120 days, carry oxygen on hemoglobin molecule WBC - 4,500-11,000; life span - varies from hours to many months depending on type of leukocyte, fight infection and allergic response PLATELETS - 150,000-450,000, life span:10 days, clotting process Neutrophils - biggest source of defense against bacteria Eosinophils - respond to allergic reactions to fight inflammatory responses. fight parasitic infections Basophils - release heparin, histamine, and bradykinin. work to remove fat after eating high-fat meal Monocytes - remove debris, bacteria, virus via macrophages, important in chronic infections Lymphocytes - formation of antibodies. immunity production, have both b and t cell lymphocytes. increase with viral illness neutropenic patient with a fever is a medical emergency Normal Female - 12-16 Men - 14-18 Hematocrit Female - 36-44% Men - 41-50% Pernicious anemia - does not absorbs b12  - do not give IM ABO - D Antigen The ABO blood group system classifies blood into four main types (A, B, AB, and O) based on the presence or absence of A and B antigens on red blood cells. The D antigen (Rh factor) is another blood group antigen that can be either present (Rh positive) or absent (Rh negative). The presence of the D antigen is crucial in blood transfusions and pregnancy. Anemia - Hypoxia End Product Anemia is a condition characterized by a deficiency of red blood cells or hemoglobin, leading to reduced oxygen transport in the body. This can result in hypoxia (lack of oxygen) at the tissue level. The body may produce more erythropoietin in response, stimulating the production of red blood cells to compensate for the hypoxia. Schilling Test The Schilling test is a medical test used to determine whether the body is properly absorbing vitamin B12. It helps distinguish between pernicious anemia (due to intrinsic factor deficiency) and other causes of vitamin B12 deficiency. Hypochlorhydria Hypochlorhydria is a condition characterized by low levels of hydrochloric acid in the stomach. This can impair digestion and absorption of nutrients, including vitamin B12, which requires an acidic environment for proper absorption. Positive Romberg Test The Romberg test is a neurological test used to assess balance and proprioception. A positive Romberg test indicates that a person sways or falls when standing with their feet together and eyes closed, suggesting issues with proprioception or vestibular function, often associated with neurological conditions. 4 Quality Prenatal Visits Quality prenatal visits are essential for monitoring the health of both the mother and the fetus during pregnancy. Typically, these visits include assessments of maternal health, fetal growth, screenings for complications, and education on pregnancy and childbirth. Reactive Thrombosis Reactive thrombosis refers to the formation of a blood clot in response to an underlying condition, such as infection, inflammation, or surgery. It’s often a temporary condition and resolves once the underlying issue is addressed. Bone Marrow Failure - Pancytopenia Bone marrow failure occurs when the bone marrow does not produce enough blood cells, leading to pancytopenia, which is a reduction in all three blood cell types: red blood cells, white blood cells, and platelets. This can result in anemia, increased risk of infections, and bleeding issues. Melena Melena refers to black, tarry stools that typically indicate upper gastrointestinal bleeding. The dark color is due to the digestion of blood as it passes through the gastrointestinal tract. Hematochezia Hematochezia is the passage of bright red blood from the rectum, often associated with lower gastrointestinal bleeding. This can indicate conditions such as hemorrhoids, diverticulosis, or colorectal cancer. Pernicious Anemia Pernicious anemia is a type of macrocytic anemia caused by the inability to absorb vitamin B12 due to a lack of intrinsic factor (a protein produced in the stomach). It can lead to nerve damage and neurological symptoms. The mean corpuscular volume (MCV) is increased because the red blood cells produced are larger than normal. Causes: Lack of vitamin 812 in the body due to decreased intake of foods from animals. Clients who have had gastric or ileal surgeries, which lead to malabsorbtion. Age (the older you get, the less vitamin B12 foods you take in). Genetic predisposition Signs and Symptoms: Pallor due to anemia Weakness and fatigue due to anemia Tingling in hands and feet - "stocking-glove paresthesia" Diminished vibratory and position sense Atrophic glossitis-beefy red tongue Dementia appears later in the disease Premature graying of hair Lab & Test Results: Decreased hemoglobin due to decreased production of RBCs. Increased MCV-macrocytic anemia.  Positive Schilling test due to decrease in intrinsic factor. Decreased amount of hydrochloric acid in the stomach (hypochlorhydria). Postitive Romberg test due to ataxia and neurologic changes. Management and Treatment: Lifelong replacement with vitamin B12 will correct the anemia and improve the neurologic changes. Administer vitamin 812 by IM injection. Transfusion of packed RBC if anemia is severe. NURSING INTERVENTIONS: 1. Prevent injuries 2. Explain to the patient: Use soft toothbrush due to oral changes. Avold activities that could lead to injury due to paresthesias or changes In balance. Inspect feet each day for injury due to paresthesia. 3. Bed rest due to hypoxia. Folic Acid Deficiency Anemia A type of megaloblastic anemia caused by a lack of folate (also known as folic acid or vitamin B9), which is essential for DNA synthesis and cell division. The RBCs produced in this condition are megaloblastic and have a very short lifespan. Causes: Decreased dietary intake. Malabsorption (may be due to intestinal disorder or from bowel surgery). Cooking food too much (heat destroys folic acid). Increased need in pregnancy (baby is growing rapidly). Drugs that interfere with folle acid absorption. Signs and Symptoms: Fatigue and weakness Pale skin Shortness of breath Heart palpitations Irritability Loss of appetite and weight loss There are "no neurological symptoms" with this type of anemia as the nerves are not affected. Lab & Test Results: Serum folic acid (folate) levels will be