Hemolytic anemia
Mediterranean descent, heredity
Thalassemia
make Rbc’s, ESRD
Epoetin Alpha
rbc without plasma
Packed rbc
Low platelets, unknown etiology
ITP priority bleeding risk
Immune globulin, administer platelets
Cancer of wbc, very high # immature cells
Leukemia
S shaped hemoglobin
Sickle cell anemia
Examples of Glucocorticoids
Prednisone , dexamethasone
ADE: high BG, mood swings, moon face , brittle bones, mask infection
55% blood volume, straw colored contains antibodies
Plasma
Not a disease but sign of underlying disorder
DIC, microvascular bleeding and clotting
D dimer most reliable test
AML
Defect in stem cell that differentiates into myeloid cell
fever, weakness and fatigue, older patients
Nsg priority with SCD
pain management , Oxygen, hydrate
Filgrastim, colony stimulating factor
Neupogen, used for cancer patients undergoing chemo etc
Used to stop bleeding help clot
Platelets or thrombocytes
Micro vascular clotting then hemorrhage , seen in obstetrics
DIC
Blood cancer common in kids but good prognosis
ALL
Fatigue and HgB 5-10
Sickle cell disease
Synthetic vasopressin, treat DI
Desmopressin help conserve water, correct underlying cause (tumor etc)
No fresh flowers or fruit, limit visitors
Neutropenic precautions. Veggies and fruit must be cooked. No salad bars
Treat DIC
treat underlying cause ( sepsis, placenta abruptly, trauma)
Multiple myeloma
neoplastic plasma cells infiltrate the bone marrow and destroy bone. Men are affected twice as often as women, and the disease occurs in African Americans twice as often as whites.
The disease usually occurs after age 40 years, with the average age at diagnosis being 65 years.
Back and rib pain initially
Excessive destruction of RBC’s
Hemolytic anemia’s
Fe dextran IV
Give small dose. Wait 30 min monitor orthostatic hypotension
may give full dose after 60 min if no anaphylaxis
Used to replace clotting factors or replace fluid
FFP ( fresh frozen plasma)
Polycythemia Vera
too many blood cells
therapeutic phlebotomy 1-2 times a week (500 ml) then discard
antiplatelet therapy, allopurinol to decrease uric acid level
VTE prophylaxis
Hodgkin's lymphoma
overall survival rates are 85% at 5 years and 80% at 10 years (American Cancer Society, 2015).
Rare malignancy, high cure rate , younger patient
Dx: reed sternburg cells, initiates in one lymph node
lack intrinsic factor
Pernicious anemia B12, gastric bypass, resection after surgery
Oral Fe SO4
fiber for constipation, dark tarry stools, drink with straw can stain teeth
Blood transfusion protocol
Pick up from lab hang within 30 minutes.
Each unit no more than 4 hours, change tubing in between units
Monitor closely for first 15 start at 50 ml/hr then increase to 125/ hr. vitals per protocol
Review blood transfusion reaction
aplastic anemia
Often normal cells, abnormal Pancytopenia
bone marrow damage or failure
multiple infections, excess bleeding
Non Hodgkin's lyphoma
older patients, NHL is less predictable and tends to spread to other body sites much more rapidly.
More lymph node involved