723 Hematologic System Red Flags

hematologic systems

blood, blood vessels, organs that produce blood (e.g., bone marrow)

function of the hematologic system

produce blood cells, circulate blood cells and nutrients, clot blood appropriately, contribute to immune function

leukopenia

decreased WBC

leukocytosis

increased WBC

thrombocytopenia

decreased platelets

hemoglobin

oxygen carrying component of RBCs

hematocrit

refers to the percentage of RBCs in the blood

anemia

too few RBCs

leukocytosis causes

• infection

• inflammation

• bone marrow disease

• immune system disorder

• severe stress/pain

leukocytosis symptoms

• fever

• fatigue

• bleeding

• bruising

• frequent infections

leukopenia causes

• chemotherapy

• radiation

• marrow infiltrative diseases

• infections

• diet deficiency

• autoimmune disease

thrombocytosis & thrombocythemia causes

• cancer

• splenectomy

• acute/chronic inflammation

• strenuous exercise

• iron deficiency anemia

thrombocytosis & thrombocythemia symptoms

• headache

• dizziness

• weakness

• chest pain

• tingling in hands and feet

thrombocytopenia causes

• hemorrhage/blood loss

• damage to developing blood cells, diseases, chemotherapy

• various diseases lead to reduced platelet count

thrombocytopenia symptoms

• petechiae

• ecchymosis

• oral bleeding

• hematuria

• epistaxis

erythrocytosis causes

• high altitude

• dehydration

• pulmonary fibrosis

• thalassemia triat

• severe COPD

• polycythemia vera

• medications

• congenital heart disease

erythrocytosis symptoms

• weakness

• fatigue

• headache

• lightheadedness

• dyspnea

anemia causes

• hemorrhage

• bone marrow suppression

• oncologic conditions

• hemoglobinopathy

• renal disease

• pregnancy

• diet deficiency

• prosthetic valves

• over hydration

• vitamin B12 and iron deficiency

anemia symptoms

• orthostatic hypotension

• weakness

• fatigue

• dyspnea on exertion

• pallor

• dizziness

• chest pain

• leg cramps with exercise

polycythemia causes

• severe dehydration

• high altitude

• smoking

• congenital heart disease

• chronic pulmonary disorder (COPD)

• heart failure

polycythemia symptoms

• fatigue

• headache

• dizziness

• visual changes

• transient ischemic attack (TIA)

• dysrhythmias

• brusing

• bleeding

WBC key implication

consider neutropenic implications if low

platelets key implications

fall/bleeding precautions if low

screen for blood clots if high

RBC key implications

monitor vitals for fatigue whether high or low

monitor vitals of blood clots if high

educate fall risk and slow position changes if low

hemoglobin key implicaitons

hold PT if <6g/dL

monitor vitals and symptoms if <8g/dl and educate on fall prevention

hematocrit key implications

if severely low (20%) pt is at high risk for cardiac failure from poor tissue perfusion

if high, monitor for SxS of blood clot

what could a change in skin color or nail beds suggest

suggests changes in circulation

what does bleeding: nose, gums, easy bruising, melena suggest

concern for thrombocytopenia, polycythemia, leukocytosis

what could severe joint pain and swelling suggest

concern for hemarthrosis

what could fatigue, dyspnea, and weakness suggest

concern for anemia, polycythemia, leukocytosis

what could rapid pulse and palpitations suggest

concern for polycythemia, anemia

what could headache suggest

concern for leukopenia, thromboytosis, thrombocythemia, erythrocytosis, polycythemia, anemia

what could a fever for infection suggest

concern for leukocytosis, leukopenia

neurologic manifestations of hematologic issues

• headache

• drowsiness

• dizziness

• syncope

• polyneuropathy

integumentary manifestations ofhematologic issues

• pallor of face, hands, nail beds, and lips

• cyanosis

• wounds

• easy bruising

• easy bleeding

hematologic system red flags

• uncontrolled or unexplained bleeding

• blood in stool (melena)

• blood in vomit

• blood in urine

• unexplained bruising or wounds

• severe joint swelling and pain

• recent infection

hematologic system emergent conditions

• severe thrombocytopenia previously unseen or unreported

• acute sickle cell episode

• DVT or PE

hematologic system urgent conditions

• new episode of muscle or joint pain in a client with known hemophilia

• Sxs of undiagnosed or worsening anemia

• avascular necrosis