MED SURG - DISORDERS OF THE HEMATOLOGIC SYSTEM STUDY GUIDE LATEST UPDATE.

MED SURG - DISORDERS OF THE HEMATOLOGIC SYSTEM STUDY GUIDE LATEST UPDATE. RED BLOOD CELL DISORDERS ANEMIA - a disorder in which you lack of red blood cells and results in decrease of oxygen transported to the tissues Causes 1. Blood loss 2. Too few RBC in circulation 3. Increase destruction of RBC S/Sx - pale, fatigue, weak, cold, tachycardia, tachypnea, hypotension, dyspnea Diagnosis - CBC (low RBC, low Hct, low hemoglobin) Treatment - blood transfusion, rest in between activities, oxygen therapy, apply more blankets, elevate the head of the bed POLYCYTHEMIA VERA - too much RBC produced; increased blood volume, severe blood congestion of all tissues and organs that lead to infarction to vital organs (thrombus); viscous S/Sx - Headache and dizziness (decrease blood flow to the brain), ringing in the ears (tinnitus; lack of blood to nerves), blurred vision, ruddy (reddish) complexion (plethora), hypertension, heart failure (increase workload ultimately leads to failure; shortness of breath, orthopnea), gout (accumulation of proteins - uric acid crystals), enlargement of liver and spleen (responsible for removal of RBC), severe pruritus, extremity pain (gout), intermittent claudication (pain in the legs when walking) Management - phlebotomy (250- 500 ml) (remove excess blood/RBCs) Interventions - hydration, monitor intake and output, monitor for s/sx of thromboembolism, avoid high altitudes, administer analgesic and allopurinol (prevent uric acid build up), mobility to prevent thrombus formation, TED hose, no crossing legs (hinders circulation), avoid foods containing iron (increase RBC production), monitor LOC APLASTIC ANEMIA - failure of bone marrow, decrease production of RBC, WBC, and platelets RBC → decreased oxygenation WBC → increase infection Platelets → bleeding, petechiae, purpura, ecchymosis Causes - antibiotics: streptomycin, chloramphenicol, exposure to toxic chemicals, radiation or chemotherapy S/Sx - pallor, extreme fatigue and malaise, headache, tachycardia, tachypnea, hypertension, palpitations, SOB, unusually prolonged or spontaneous bleeding, frequent infections that don’t resolve Treatment - identify and treat the cause; blood transfusions, antibiotics to prevent infection, corticosteroids (stimulate bone marrow), bone marrow transplant, splenectomy for hypersplenism (reduce destruction of RBC, retain more RBC in the body) Interventions - strict aseptic technique, meticulous care to skin (avoid injury/bleeding), avoid IM injections, no rectal thermometers/meds, electrical razors, good oral care (soft-bristle toothbrush), monitor for signs of bleeding, egg crate mattress, monitor for signs of bleeding, look for occult or gross bleeding in stool or urine, rest, limit visitors, protective isolation, AVOID ASPIRIN/NSAIDS.