Blood Disorders

blood is specialized CT with

cells, fiber, matrix, plasma and formed elements

plasma

90% water, 10% solutes: proteins, electrolytes, nutrients, hormones

whole blood minus formed elements

formed elements are

RBC, WBC, platelets

CBC

4 tests: concentrations of WBC, RBC, platelets, and hemoglobin and hematocrit

what is serum

plasma minus fibrinogen

what is hematocrit

% of RBC in total blood volume

plasma/buffy coat (WBC and platelets)/packed RBCs

hematocrit high and low

15 and 60%

what is hemoglobin

oxygen carrying pigment of RBC that gives them red color and delivers oxygen

reduced form in venous blood and oxygenated in arterial blood

hemoglobin criticals

5 and 20

iron deficiency correlation with H and H

normal HCT and decreased Hgb

what is hematopoiesis

blood formation

adults: bone marrow

fetus: liver, spleen, and thymus

ansiocytosis

RBC unequal sizes

poikilocytosis

RBC with abnormal shape

polycythemia

high number of RBC

leukocytosis

higher WBC

leukopenia

below normal WBC

thrombocytosis

more than normal platelets

congestion

accumulation of excessive blood within the blood vessels of an organ or tissue

shock

inability of circulatory system to maintain adequate pressure and perfuse organs

types of shock

hypovolemic: hemorrhage, vomit, diarrhea, dehydration

cardiogenic: arrhythmia, acute valve dysfunction, acute MI, severe CHF

obstructive: massive pulmonary embolism, pulmonary HTN, pneuomothorax

neurogenic: SCI, pain, vasodilator drugs, trauma

s/s of shock

rapid, weak pulse, hypotension, cool, pale, moist skin, mottled extremities with weak or absent periperhal pulse, eventual LOC and CV collapse

s/s of CV collapse

weakness, abdominal pain, tired, dyspnea, tachycardia, pallor, hypotension, medical emergency

move to supine with legs elevated

blood transfusion complications

post-transfusion reaction, disease transmission, iron overload, air embolism, circulatory overload

s/s of acute blood transfusion reaction

local burning, facial flushing, N/V, chills and fever, flank and abdominal pain, HA, dyspnea, hypotension, tachycardia, red urine, allergic reaction

s/s of delayed blood transfusion

dyspnea, anemia, jaundice, hives/rash

5-10 days after transfusion

exercise effects on blood

increase blood volume, plasma and erythocyte (over time)

blood doping

exogenous erythropoeitin

urine test or athlete biological passport

risks can increase blood viscocity and thrombosis

anemia is

a symptom (abnormal quanity or quality of RBC)

common anemic presentations

iron deficiency with chronic GI blood loss due to use of NSAID use, nutritional conditions, chronic diease or inflammatory, neoplasm, infectious diesease

precautions with anemia

tachycardia and palpitations, fatigue, generalized weakness, extertional dyspnea, decreased diastolic during exercise

WBC critical high and low

2,500 and 30,000

platelets critical high and low

under 50,000 and 1 million

dont start exercise is BP

200/110

SBP normal response to exercise

7-10 raise, abnormal if declines 10, if 20 then ventricular ischemia, no increase

DBP response to exercise

no change or slight decrease

abnormal: rise in 10-15 or drop of 10-20

MET

unit to estimate the amount of oxygen used by body for physical activity

HR exercise guidelines

increase 10 bpm per MET

usually 60-100

orthostatic hypotension

drop of BP within 3 minutes systolic over 20 or DBP over 10 with symptoms

when not to start exercise for RR

over 45

35-45 exercise with caution