Hematological System and Disorders - Nursing Study Notes

ATLAND Nursing

Hematological System and Disorders

Nursing Study Notes

Overview of Anatomy and Physiology
 The hematologic system is mainly composed of blood and plasma
 The blood is mainly composed of:
a) Red blood cells/Erythrocytes (RBCs)
b) White blood cells/Leukocytes (WBC)
c) Platelets (Thrombocytes)




Total Body Whole Blood Plasma (percentage by
Weight (percentage by weight)
volume)
Blood – 8% Plasma – 55% Proteins – 7%  Albumins – 54%
 Globulins – 38%
 Fibrinogens – 4%
 Prothrombin – 1%
Water – 91%

Other solutes – 2%  Ions

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,  Nutrients
 Waste products
 Gases
 Regulatory
substances
Formed Platelets – 150,000 –
Elements – 45% 400,000
Erythrocytes – 4 – 6.2 million
Leukocytes – 4,500 – Neutrophils – 60 -70%
11,000 Lymphocytes – 20 -25%
Monocytes – 3 – 8%
Eosinophils – 2 – 4 %
Basophils – 0.5 – 1%
Other fluids
and tissues –
92%

 The blood is regenerated in the bone marrow through hematopoiesis
 Complete blood count (CBC)
a) RBC’s = 4 – 6.2 million g/dl
b) HGB = Male adult is 14 – 16.5 g/dl, Female adult is 12 – 15 g/dl
c) HCT = Male adult 42% - 52%, Female adult 35% - 47%


Causes of Changes in Value

Blood Component Causes of High Values Causes of Low Values
Red Blood Cell (RBCs)  Smoking  Anemia (different
 Cancer types)
 Kidney disease  Addison’s disease
 Polycythemia vera  Inflammatory bowel
 Heart disease disease
 Stomach ulcers
 Colon cancer
White Blood Cell (WBC)  Infections  Cushing’s syndrome
 Leukemia  Aplastic anemia
 Kidney failure
 Lupus
 Use of Corticosteroids
Platelets  Iron deficiency  Idiopathic
 Excessive bleeding thrombocytopenic
purpura (ITP)
 Pregnancy




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, Functions of blood
 Transportation of gases, nutrients, and waste products
 Clot formation – clotting proteins help stem blood loss when a blood vessel is injured
 Transportation of processed molecules – substances produced in one part of the body
and transported in the blood to another part.
 Protection against foreign substances – antibodies protect the body from pathogens
 Transport of regulatory molecules – various hormones and enzymes are carried from one
part of the body to another within the blood
 Maintenance of body temperature
 Regulation of PH and osmosis – albumin contributes to the osmotic pressure of blood,
which acts to keep water in the bloodstream


Assessment

History and Physical Clues

 Ask about the ease in which the client perform activities of daily living, to determine if
hypoxia is present
 Inquire about fatigue, shortness of breath, or episodes of breathlessness.
 Inquire about prior radiation therapy, chemotherapy, episodes of bleeding, miscarriages,
diet, and use of herbal supplements

Skin Coloration

 Gray-tan or bronze skin color – indicates hemochromatosis
 Ruddy complexion (on the face, conjunctiva, hands, and feet) – indicates polycythemia
 Ecchymosis (bruises) – indicates thrombocytopenia coagulopathy
 Petechiae – indicates severe thrombocytopenia
 Conjunctival hemorrhage – indicates severe thrombocytopenia, coagulopathy
 Pallor mucous membranes – indicates anemia
 Jaundice in mucous membranes – indicates hemolysis




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