Hemolytic anemia
Mediterranean descent, heredity
Thalassemia
make Rbc’s, ESRD
Epoetin Alpha (Epogen)
rbc without plasma
Packed rbc
Low platelets, unknown etiology
ITP priority bleeding risk
Immune globulin, administer platelets
Cancer of wbc, very high # immature cells (blasts)
Leukemia
S shaped hemoglobin
Sickle cell anemia
Normal wbc
4,500-11,000
55% blood volume, straw colored
Plasma- contains antibodies, clotting factors replace volume
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
platelet count
150,000-400,00
dangerous below 150,000 risk for bleeding
Used to stop bleeding help clot
Platelets or thrombocytes
Micro vascular clotting then hemorrhage , seen in obstetrics
DIC treat underlying cause ( sepsis, placenta abruptlio, trauma)
Blood cancer common in kids but good prognosis
ALL (acute lymphocytic lekemia)
Fatigue and HgB 5-10
Sickle cell disease
Sodium level
135-145
No fresh flowers or fruit, limit visitors
Neutropenic precautions. Veggies and fruit must be cooked. No salad bars
decreased wbc, rbc and platelet production due to meds, radiation and chemicals
aplastic anemia treat underlying cause
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.
monitor for hypercalcemia
Back and rib pain initially
Excessive destruction of RBC’s
Hemolytic anemia’s
Potassium level
3.5-5.0
Used to replace clotting factors or replace fluid
FFP ( fresh frozen plasma)
Polycythemia Vera
too many blood cells
therapeutic phlebotomy weekly or monthly per provider (500 ml) then discard
antiplatelet therapy, allopurinol to decrease uric acid level
VTE prophylaxis
Hemophilia
Lack factor 8 for clotting
Have cryoprecipitate on hand to replace clotting factor if bleeding
hereditary disorder
Hemarthrosis- painful joints full of blood and fluid see etc
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
meds that can cause chloramphenicol, phenytoin
chemicals like benzene, radiation
Hydroxyurea (hydrea)
Hydroxyurea (Hydrea) may decrease frequency of sickling episodes