presentation ms1 (group 7) thalessemia

8/9/2019 Presentation Ms1 (Group 7) THALESSEMIA

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Thalassemia

MEDICAL SURGICAL NURSING I

HNS 214

Diploma in Nursing, School of Nursing,

Faculty of Health Science


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ThalassemiaDefinitionInherited blood disorder that cause the body to

produce less hemoglobin.

Cause

One of more gene defected that passed from parents.




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Types

Alpha Thalassemia

Missing or damage of one or more Alpha Globins

of chromosome 16.

I. Silent carrier

II. Alpha Thalassemia Minor

III. Hemoglobin H disease

IV. Alpha Thalassemia Major




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Cont

Beta Thalassemia

Missing or damage of one or more Beta

globins gene of chromosome 11.

I. Beta Thalassemia Minor

II. Beta Thalassemia IntramediaIII. Beta Thalassemia Major

Diploma in Nursing, School of Nursing,Faculty of Health Science


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Alpha Thalassemia

Silent carrier

One Alpha-globins gene defected.

Asymptomatic.

No need treatment.

Blood cell more small than normal cell.




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Cont

Alpha Thalassemia Minor

Two Alpha-globins gene defected.

Mild anemia.

No need treatment.




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Cont

Hemoglobin H Disease

Three Alpha-globins gene defected.

Moderate to severe anemia.

Need blood transfusion.




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Cont

Alpha Thalassemia Major

Four Alpha-globins gene defected.

Die shortly after born.




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Beta Thalassemia

Beta Thalassemia Minor

One of Beta-globins gene defected.

Mild anemia.

No need treatment.




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Cont

Beta Thalassemia Intramedia

Two of Beta-globins gene defected.

Moderate anemia.

Need blood transfusion.




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Cont

Beta Thalassemia Major

Two of Beta-globins gene defected.

Severe anemia.

Cant live until adulthood without treatment.

Live with blood transfusion since child. Maybe death due to damage organ such as heart or

liver.




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Clinical Manifestation

Fatigue

Weakness

Light headaceness

Slow growth and delay puberty

Short of breath during exercise




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Diagnosis

Complete Blood Count ( CBC )

Amount of RBC, WBC, Platelet and Plasma.

Gene TestDNA comparison between patient and parents.

Iron Serum Test

Identify the level of iron.




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Cont

Hemoglobin electrophoresis

Detect or identify the abnormal Hb in blood. Quantitative G6PD

Quantity of enzyme and protein in blood.




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Cont

Prenatal testingcan be done before a baby is born to find out if he or she hasthalassemia and determine how severe it may be. Tests used todiagnose thalassemia in unborn babies include:

Chorionic villus sampling. This test is usually done around the11th week of pregnancy and involves removing a tiny piece of the

placenta for evaluation.

Amniocentesis. This test is usually done around the 16th week ofpregnancy and involves taking a sample of the fluid that surrounds

the baby. Fetal blood sampling. This test can be performed after 18 weeks of

gestation and involves taking blood from the fetus or the bloodvessels in the umbilical cord using an ultrasound-guided needle.




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Treatment

Depend on the type and sign and symptom of

Thalassemia.

Mild anemia

No need treatment.




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Cont

Moderate anemia

Folic acid supplement.

Help in build healthy RBC.

Blood transfusion

Supply healthy RBC and normal Hb.




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Cont

Severe anemia

Regular blood transfusion.

Every 2 4 weeks.

Folic acid supplement.




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Complication

Iron overload

Infection Bone Deformities

Enlarged spleen




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Risk for infection

related to invasive procedure

Intervention

Assess the puncture site for any

inflammation.

Assess any sign and symptom of

infection. (V.S)

Rational

Inflammation is a normal

reaction of body for infection.

To detect any abnormality.




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Intervention

Maintain aseptic technique

when do any procedure to

patient.

Cover the puncture site after

procedure.

Administered medication asordered by doctor such as

antibiotic for bacteria infection

and antipyretic for fever.

Rational

To prevent any cross infection

between patient and hospital

staff.

To prevent expose to

microorganism.

To kill bacteria and relief thefever.




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Fatigue related to Disease

ProcessIntervention

Assess patient condition by

seeing physical activity.

Assisting patient by daily

activity example giving bed pan.

Encourage patient rest in bed.

Rational

To know any abnormality for

next intervention.

Easier patient to void and

reduce fatigue to ambulation.

To restore back the energy.




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Intervention

Instruct client how to use call

bell and ask client to press it if

required.

Make sure the client bed is not

to high.

Rational To reach immediate help from

staff nurse.

Easier client to move and

prevent any injuries.




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Low Self Esteem related to

inherited diseaseIntervention

Assess the cause of low self

esteem and acceptance of

patient for the disease.

Establish relationship with

patient and provide and

opportunity for patient to

verbalize feelings.

Rational

To understand patient condition

and guide intervention.

As a therapeutic therapy.




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Intervention

Provide treatment for patients

disease blood transfusion.

Encourage family and peer

support.

Refer patient to supportive

community.

Rational

Treat cause to build patients

self esteem.

To build patients confidence

and feel of acceptance.

Help patient to deal with

embarrassment and learncoping mechanism.




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Thank You



presentation ms1 (group 7) thalessemia

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