emt 28

Blood functions

control bleeding via clotting, delivering O2/removing CO2 from cells, removing waste products to organs that filter and expel (kidney + liver)

Blood composition

solid: red/while blood cells and platelets, created in bone marrow (the core of nay bones) and circulate temporarily liquid: plasma, filtered out of circulation via spleen or liver

RBCs

most cells in circulation, contains hemoglobin which binds to O2 and deliveries it to cells, amount of RBCs is determined via hemoglobin count (blood test)

WBCs

respond to infection and mediate immune response, neutrophils = most common WBC, responsible for fighting bacterial infections, eosinophils = react to allergic conditions

Platelets

parts of larger cells, clot (most rapid response to bleeding), may cause plaque in coronary arteries (leading to MI)

Plasma

liquid in blood, dissolves nutrients and carries proteins such as clotting factors

Blood clotting 2 components

2 major components: platelets and clotting factors—a group of proteins from the liver that release into bloodstream in inactive forms (activated to clot) 

Coagulopathies

abnormal clotting when the body clots too fast/slowly leading to uncontrolled bleeding, caused by platelets deficiencies/dysfunction from medication or liver disease

Coagulopathies identification

acknowledging that the patient is at risk of abdominal bleeding based on past med history and current meds atrial fib dysrhythmia patients are often on blood thinners

Acute anemia

trauma or sudden massive GI tract bleeding, may show signs of shock

Chronic anemia

over time from heavy menstrual periods, slow GI bleeding, or diseases w bone marrow/the structure of hemoglobin itself, examine color of patient's conjunctiva on the lower eyelid 

Sickle cell disease (SCD)

genetic defect in hemoglobin leading to abnormal RBC structure, common in AAs leads to sickle cell anemia

Sickle cell anemia complications

• destruction of the spleen

• pain crisis

• acute chest syndrome (short breath, chest pain, hypoxia),

• priapism (painful erection in males bc RBCs stop normal blood drainage from erect penis)

• stroke, jaundice, short life spain

Sickle cell disease care

 supplemental O2, bag-valve vent if needed, transport

Renal system composition

kidneys, ureters (carry urine kidney to bladder), and urethra (expels urine from bladder)

Urinary tract infections (UTIs)

bacterial infection causing pain and frequent urination, if left untreated, can lead to pyelonephritis 

Pyelonephritis

UTIs going up the ureter into the kidneys causing unilateral flank pain and bacteria in the bloodstream

Kidney stones

made of calcium, no symptoms, severe unilateral flank pain that radiates to groin area when the stone descends from kidney and becomes lodged in the ureter

Who has urinary catheters

patients unable to urinate normally due to obstruction of outflow from bladder (tumor or enlarged prostate) or a neurological disorder, placed in the urethra

Renal failure

most serious kidney disease, when kidneys loose the ability to filter blood/remove toxins and excess fluid 

End-stage renal disease

irreversible renal failure, kidneys can no longer filter and balance fluid, requires dialysis

Dialysis

when an external med system used to remove toxins and excess fluids from the body

Hemodialysis

most common form of dialysis

• blood is pumped through filters to remove toxins/fluids via 2 large catheters, one flows blood in, the other flows blood out creating a circuit

Thrill

vibration felt when palpating an AV fistula

Peritoneal dialysis (PD)

at home dialysis, slower process, multiple treatments a day

Exchange

a cycle of filling and draining the peritoneal cavity in peritoneal dialysis

2 types of peritoneal dialysis

continuous ambulatory peritoneal dialysis (CAPD) and continuous cycler assisted peritoneal dialysis  (CCPD) 

Continuous ambulatory peritoneal dialysis (CAPD)

most common type of PD, puts fluid in the left peritoneal cavity by clamping a catheter for 4-6 hours several times a day, bag is elevated above abdominal catheter to let fluid in and then lowered to drain fluid

Continuous cycler assisted peritoneal dialysis (CCPD)

uses a machine to fill and empty the abdominal cavity w fluid 3-5 times a night. when they wake up, the last fill of fluid will stay in the stomach for the rest of the day

ESRD worst complication

missing dialysis, symptoms similar to CHF (short breath, (pulmonary edema) and dysrhythmia from electrolyte imbalances

ESRD hemodialysis complications

• bleeding from the AV fist when dia needles are removed

• clotting/lost function of the AV fist

• bacterial infection of blood due to AV fist or dialysis contamination

• acute peritonitis 

Acute peritonitis

bacterial infection within the peritoneal cavity, cased w abdominal pain, fever, and cloudy dialysis fluid