Hematology/ Fluid Transport 2013

Overview 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 Symptoms Diagnosis Treatment Congenital Acquired Symptoms Petechiae, purpura Bleeding Pallor Diagnosis Blood studies Treatment Supportive Immunosuppressive drug therapy

Aplastic Anemia Nursing Care Preventing bleeding Blood transfusion Preventing infection Encouraging mobility Educating Emotional support

Sickle cell anemia Pathophysiology Symptoms Diagnosis Treatment 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 Increasing tissue perfusion Promoting hydration Controlling pain Preventing infection Ensuring adequate nutrition Preventing complications Emotional support

Hemophilia Pathophysiology Symptoms Diagnosis Genetic Mild to severe Males affected Females carriers Symptoms Mild to severe Bleeding Internal Joint bleeds bruising Diagnosis History , physical exam, & labs

Hemophilia Treatment Nursing Care Control bleeding Replace missing clotting factor Desmopressin acetate (DDAVP) Nursing Care Preventing & controlling bleeding Limiting joint involvement Managing pain Provide emotional support