Download Hematology/ Fluid Transport

HEMATOLOGY/
FLUID TRANSPORT
2013
OVERVIEW
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Iron Deficiency Anemia
Aplastic Anemia
Sickle cell Anemia
Hemophilia
OBJECTIVES
 Describe function of red blood cells, white blood cells and
platelets
 Discuss the pathophysiology of anemia's
 Discuss the pathophysiology of clotting disorders
 Verbalize the signs and symptoms of hematologic disorders
 Discuss treatment of hematologic disorders
 Describe the nursing care of children with hematologic
disorders
ANATOMY & PHYSIOLOGY OF
PEDIATRIC DIFFERENCES
 Blood Cells
 Red Blood Cells (RBC)
 Erythrocytes
 Carry O2 via hemoglobin (Hgb)
 Release CO2 in lungs – pick up O2
 White Blood Cells (WBC)
 Leukocytes
 Responsible for immune responses
 Phagocytic, inflammation, antigen-producing
 Platelets
 Thrombocytes
 Clotting component
FUNCTION OF WHITE BLOOD CELLS
Type
Function
Neutrophils
Phagocytosis
Eosinophil
Allergic reactions
Basophils
Inflammatory reactions
Monocytes (macrophages)
Phagocytosis, antigen
processing
Lymphocytes
Humoral immunity (B cell),
cellular immunity (T)
IRON DEFICIENCY ANEMIA
 Pathophysiology
 Blood loss
 Poor nutritional intake
 Symptoms
 Pallor
 Fatigue
 Irritability
 Diagnosis
 Low hemoglobin, hemotocrit
 RBC count
 Reticulocytes
 Treatment
 Correct the iron deficiency
IRON DEFICIENCY ANEMIA
 Nursing Care
 Screening
 Educating
 Dietary management
APLASTIC ANEMIA
 Pathophysiology
 Congenital
 Acquired
 Symptoms
 Petechiae, purpura
 Bleeding
 Pallor
 Diagnosis
 Blood studies
 Treatment
 Supportive
 Immunosuppressive drug therapy
APLASTIC ANEMIA
 Nursing Care
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Preventing bleeding
Blood transfusion
Preventing infection
Encouraging mobility
Educating
Emotional support
SICKLE CELL ANEMIA
 Pathophysiology
 Autosomal recessive disorder.
 Crescent (sickle) shaped RBC
 Symptoms
 Headaches
 Joint pain
 Fatigue
 Diagnosis
 Sickledex
 Newborn screening
 Treatment
 Supportive
EFFECTS ON ORGANS
Organs
Effects
Brain
CVA manifested by headache, aphasia, convulsions, visual changes
Eyes
Retinopathy, retinal detachment, diminished vision
Bones
Chronic ischemia of bones , bone degeneration (osteoporosis,
osteomyelitis, spinal deformities
Liver
Impaired blood flow from capillary obstruction causing scarring
Spleen
Splenic infarct leads to fibrosis and increased rates of infection
Kidney
Ischemia to kidney causes enuresis, hematuria, inability to concentrate
urine
Extremities Vaso occlusion and chronic ischemia manifests as peripheral
neuropathy , or weakness
Skin
Decreased peripheral circulation causes ulcerations
SICKLE CELL
 Nursing Care
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Increasing tissue perfusion
Promoting hydration
Controlling pain
Preventing infection
Ensuring adequate nutrition
Preventing complications
Emotional support
HEMOPHILIA
 Pathophysiology
 Genetic
 Males affected
 Females carriers
 Symptoms
 Mild to severe
 Bleeding
 Internal
 Joint bleeds
 bruising
 Diagnosis
 History , physical exam, & labs
HEMOPHILIA
 Treatment
 Control bleeding
 Replace missing clotting factor
 Desmopressin acetate (DDAVP)
 Nursing Care
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Preventing & controlling bleeding
Limiting joint involvement
Managing pain
Provide emotional support