1. Hematology/ Fluid Transport
2013

2. Overview Iron Deficiency Anemia Aplastic Anemia Sickle cell Anemia
Hemophilia

3. 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

4. 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

5. 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)

7. 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 .

8. Iron Deficiency anemia
Nursing Care
Screening
Educating
Dietary management

9. Aplastic Anemia Pathophysiology Symptoms Diagnosis Treatment
Congenital
Acquired
Symptoms
Petechiae, purpura
Bleeding
Pallor
Diagnosis
Blood studies
Treatment
Supportive
Immunosuppressive drug therapy

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

11. 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

12. 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

13. Sickle Cell Nursing Care Increasing tissue perfusion
Promoting hydration
Controlling pain
Preventing infection
Ensuring adequate nutrition
Preventing complications
Emotional support

14. 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

15. 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