Hematologic Disorders PDF

Evolve. Adapt. Overcome. CEFI is now ready. HEMATOLOGIC DISORDERS OF ADULTS NCM 112 PREPARED BY: Niña Mae L. Sumilang, RN  COLLEGE OF NURSING Calayan Educational Foundation, Inc. LEARNING O...

Evolve. Adapt. Overcome. CEFI is now ready. HEMATOLOGIC DISORDERS OF ADULTS NCM 112 PREPARED BY: Niña Mae L. Sumilang, RN  COLLEGE OF NURSING Calayan Educational Foundation, Inc. LEARNING OBJECTIVES: At the end of the lesson, the students would be able to: ⮚ Identify different hematologic disorders according to their signs and symptoms ⮚ Identify proper nursing management for clients with hematologic disorders. ⮚ Determine diagnostic tests used in each disorder. COLLEGE OF NURSING Calayan Educational Foundation, Inc. ANATOMY & PHYSIOLOGY RECALLS  COLLEGE OF NURSING Calayan Educational Foundation, Inc. FUNCTIONS OF HEMATOLOGIC SYSTEM 1. Transport medium 2. Defensive function 3. Hemostasis function 4. Homeostatic function COLLEGE OF NURSING Calayan Educational Foundation, Inc.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. BLOOD Composed of red blood cells, white blood cells and platelets. Make up 40-45% of the blood volume. Hematopoiesis – continuous process of forming blood cells to supply the body COLLEGE OF NURSING Calayan Educational Foundation, Inc. GUESS THAT CELL  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Releases histamine and heparin Basophil Inflammatory response for allergy Eosinophils Phagocytizes microorganism Neutrophil Produces antibodies Lymphocytes Phagocytizes dead cells Monocytes Another name for platelet Thrombocytes Another name for RBC Erythrocytes Another name for WC Leukocytes COLLEGE OF NURSING Calayan Educational Foundation, Inc. HOW DOES ERYTHROPOIESIS WORK?  COLLEGE OF NURSING Calayan Educational Foundation, Inc. ERYTHROPOIESIS Decreased oxygen level in the body ↓ Will stimulate the kidney to release a hormone called erythropoietin ↓ It will stimulate the bone marrow to release immature RBC ↓ For the blood RBC to mature, iron, Vitamin B12, Folic Acid, Pyridoxine, protein and others are needed ↓ Mature red blood cell COLLEGE OF NURSING Calayan Educational Foundation, Inc. HOW ABOUT HEMOLYSIS?  COLLEGE OF NURSING Calayan Educational Foundation, Inc. HEMOLYSIS Aged RBC ↓ Removed by the reticuloendothelial cells (liver and spleen) ↓ Hemoglobin ↓ ↓ Heme Globulin ↓ ↓ Bilirubin and secreted as bile Used by new RBC COLLEGE OF NURSING Calayan Educational Foundation, Inc. EXCESSIVE BLEEDING! HOW DOES IT STOP?  COLLEGE OF NURSING Calayan Educational Foundation, Inc. HEMOSTASIS Injury at the site ↓ Vasoconstriction of blood vessel ↓ Formation of platelet plug ↓ Formation of blood clot ↓ Growth of fibrous tissue Evolve. Adapt. Overcome. CEFI is now ready. ANEMIA  COLLEGE OF NURSING Calayan Educational Foundation, Inc. ANEMIA Hemoglobin concentration is lower than normal. It reflects the presence of lower than normal number of RBC. Hypoproliferative Anemia Bleeding Anemia Hemolytic Anemia  COLLEGE OF NURSING Calayan Educational Foundation, Inc. GLOBAL MANIFESTATION OF ANEMIA F Fatigue P Pallor A Anorexia T Thin, dry skin and T Tachycardia hair I Insomnia G Generalized weakness U Unusual irritability E Exertional dyspnea D Dizziness  COLLEGE OF NURSING Calayan Educational Foundation, Inc. IRON DEFICIENCY ANEMIA It is caused by inadequate intake of iron required for hemoglobin synthesis. Most common anemia. CAUSE Bleeding from ulcers, gastritis, IBD, GI tumors, menorrhagia, pregnancy with inadequate iron, aspirin, NSAIDS  COLLEGE OF NURSING Calayan Educational Foundation, Inc. CLINICAL MANIFESTATIONS Smooth red tongue Brittle and ridged nails Angular cheilosis Pallor  COLLEGE OF NURSING Calayan Educational Foundation, Inc. DIAGNOSTIC FINDINGS Bone marrow aspiration – definitive MCV decreases Hct and RBC decreases  COLLEGE OF NURSING Calayan Educational Foundation, Inc. MEDICAL MANAGEMENT Stool specimen should be tested for occult blood. Colonoscopy, endoscopy, or xray exam of the GI tract for people 50 years of age. Oral iron supplementation as primary treatment COLLEGE OF NURSING Calayan Educational Foundation, Inc.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. NURSING MANAGEMENT Instruct patient to eat food sources high in iron (organ meats, beans, leafy greens, raisins, molasses Take iron-rich foods with Vit.C for better absorption. Take iron an hour before meals Nutritional counseling Eat foods high in fiber to minimize bowel problems Instruct that stools will become dark in color. Use straw if in liquid preparation  COLLEGE OF NURSING Calayan Educational Foundation, Inc. APLASTIC ANEMIA Rare disease caused by a damage to marrow stem cells. ETIOLOGY T cells inappropriate attack against the bone marrow CAUSE Viral infection, pregnancy, benzene and benzene derivatives  COLLEGE OF NURSING Calayan Educational Foundation, Inc. CLINICAL MANIFESTATION Complications from the disease may occur before diagnosis Infection Symptoms of anemia (fatigue, pallor, dyspnea) Purpura Repeated throat infections – cervical lymphadenopathy  COLLEGE OF NURSING Calayan Educational Foundation, Inc. DIAGNOSTIC FINDINGS Pancytopenia -Neutrophil