blood disorders
TRANSCRIPT
BLOOD DISORDERS Dhuha F Shamsaldeen
What is blood ?
Blood is a combination of plasma (watery liquid) and cells that float in it. It is a specialized bodily fluid that supplies essentials substances and nutrients, such as sugar, oxygen, and hormones to our cells, and carries waste away from those cells
Types of blood cells
Red blood cells - also known as RBCs or erythrocytes. These are the most abundant cells, and contain hemoglobin (Hb or Hgb). Hemoglobin is a protein which contains iron; it transports oxygen from the lungs to body tissues and cells. 97% of a human's red blood cell's dry content is protein.
White blood cells (leukocytes) - these are the cells of our immune system; they defend the body against infections and foreign materials.
Platelets (thrombocytes) - are involved in the clotting (coagulation) of blood. When we bleed the platelets clump together to help form a clot.
ANEMIA
• Anemia is a condition in which the hemoglobin concentration is lower than the normal; it reflects the presence of fewer than the normal number of erythrocytes within the circulation.
• As a result, the amount of oxygen delivered to the body tissues is also diminished.
• Anemia is not a specific disease state but a sign of an underlying disorder. It is by far the most common hematologic condition.
Classification of anemia
hypoproliferative
Results from defective RBC production
bleeding
Results from RBC loss
hemolytic
Results from RBC destruction
hypoproliferative
Iron deficiency.
Vitamin B12 deficiency (megaloblastic)
Folate deficiency (megaloblastic)
Decreased erythropoitin production
Cancer/ inflammation
Bleeding
Bleeding from GI tract, epistaxis (nosebleed),
trauma, bleeding from genitourinary
tract (menorrhagia)
Hemolytic
Sickle anemia Hypersplenism ( hemolysis)
Drug-induced anemia
Autoimmune anemia
Mechanical heart valve-
related anemia
Stressors
Physiological
• Reduced RBC production.
• Excessive RBC destruction.
sociocultural • Diet habits.
developmental• Age group.• sex
Clinical manifestations:
Special complications of
the condition that produced
anemia
The duration
of anemia
The speed of anemia
IRON DEFICIENCY ANEMIA
• Iron deficiency anemia typically results when the intake of dietary iron is inadequate for hemoglobin synthesis.
• Iron deficiency anemia is the most common type of anemia in all age groups, and it is the most common anemia in the world.
Causes • The most common cause of iron deficiency anemia in
men and women is bleeding from ulcers gastrirtis, inflammatory bowel disease, or GI tumors. The most common causes of IDA in premenopusal woman are menorrhagia ( ie, excessive menstrual bleeding) and pregnancy with inadequate iron supplementation. Other causes include iron malabsorption, as is seen after gastroctomy.
Sings and symptoms
Fatigue Weakness Headache
Dyspnea Palpitations Chest pain
Jaundice Smooth; sore tongue
Diagnostic tests
Serum iron
( female 8.9-30.4 umol/l)
( male 11.6-30.4 umol/l)
SERUM Hb ( normal
13.2-17.5 g/dk)
CBC
Bone marrow
aspiration
Treatment • Correction of the underlying cause, iron supplements
including :
Oral • Ferrous phosphate, ferrous
glucanate
IV or IM
• Administer small dose
Patient education ( taking oral iron supplements ):
• Take iron on an empty stomach ( 1 hr before or 2 hrs after the meal). Iron absorption is reduced with food, especially dairy products.
• To prevent GI distress, the following schedule may work better if more than one tablet a day is prescribed. Start with only one tab/day for a few days, then increase to 2 tab/day, then 3 tab/day. This method permits the body to adjust gradually to the iron.
• Increase the intake of vit C , to enhance iron absorption.• Eat foods high in fiber to minimize problems with
constipation.• Remember that stool will become dark in color.
SICKLE CELL ANEMIA
• Sickle cell anemia is a severe hemolytic anemia results from inheritance of the sickle hemoglobin gene.
• The sickle hemoglobin (HbS) acquires a crystal-like formation when exposed to low oxygen tension.
Clinical manifestations:
Always anemic (Hb= 7-10gm/dl)
Sometimes enlargement of the bones of face and
skull.
Jaundice
Tachycardia
Sings and symptoms:
Pallor
Decrease urinary output,
Dark urine-smoky,brownish
Abdominal or chest pain.
Swelling and pain in the joint
Weakness
Mental depression
Difficulty concentrating
Diagnostic test • CBC• Hgb—men 14-18g/dl, women 12-16g/dl• Platelet count—150,000-350,000/100ml 0f blood.• Haematocrit – packed cell volume (PCV).• Bone marrow puncture
Medical management:
long term RBC transfusion.
hydroxyurea (chemotherapy)
Bone marrow transplant
NURSING DIAGNOSIS AND INTERVENTIONS For all anemic patients
Diagnosis: Activity intolerance related to poor tissue oxygenation.
Give oxygen
Bed rest
Monitor vital signs
Observe urine for signs of blood
Give prescribed
fe medication
Diagnosis: Pain related to joint inflammation
Assess level of
pain
Apply warm packs
Use distraction technique
Give pain medication