Hematology

Autoimmune Idiopathic Thrombocytopenic Purpura (ITP)

A condition characterized by platelet destruction by the immune system leading to increased risk for bleeding, primarily affecting children aged 2-6.

Etiology of ITP

Causes include acute viral illness (rubella or chicken pox), HIV, Hep B triggers, drug reactions, and immune system dysfunction.

Signs and Symptoms of ITP

Bleeding tendencies, petechiae (small red or purple spots), and ecchymosis (bruising).

Diagnostic Tests for ITP

Platelet count (less than 20,000/mm³ indicates severe thrombocytopenia), bleeding time assessment, and bone marrow aspiration.

Therapeutic Interventions for ITP

Corticosteroids, chemotherapy if chronic, transfusions in persistent bleeding, IVIG therapy, vitamin K supplements, and splenectomy.

Nursing Care for ITP

Implement bleeding precautions, recognize and report signs of bleeding, and educate patients and families.

Bleeding Precautions for ITP Patients

Use an electric razor, soft toothbrush, avoid invasive procedures, maintain pressure on blood draw sites, wear protective footwear, and avoid aspirin and NSAIDs.

Pathophysiology of Hemophilia

Condition characterized by missing clotting factors, specifically Hemophilia A (Factor VIII deficiency) and Hemophilia B (Factor IX deficiency).

Etiology of Hemophilia

Primarily hereditary; passed down through families.

Signs and Symptoms of Hemophilia

Episodes of bleeding in joints, muscles, subcutaneous tissue, and potentially intracranially.

Diagnostic Tests for Hemophilia

Partial Thromboplastin Time (PTT) and specific factor level measurements for Factor VIII and IX.

Therapeutic Interventions for Hemophilia

Desmopressin, replacement of clotting factors, and blood transfusions during bleeding episodes.

Nursing Diagnoses for Hemophilia

Acute pain and risk for bleeding.

Definition of Polycythemia

A condition characterized by an overabundance of red blood cells (RBCs) in the bloodstream.

Laboratory Values for Polycythemia

Hemoglobin > 18 mg/dL and hematocrit > 55%.

Impact of Polycythemia

Thickening of blood leading to an increased risk of clotting (hyperviscosity).

Signs and Symptoms of Polycythemia

Hypertension, visual changes, headache, vertigo, tinnitus, bleeding, chest pain, and shortness of breath.

Therapeutic Interventions for Polycythemia

Phlebotomy, low-dose aspirin, radiation therapy, chemotherapy, and medication for itching.

Patient Education for Polycythemia

Drink 3 liters of water daily, avoid restrictive clothing, and report signs of iron deficiency and bleeding.

Definition of Sickle Cell Anemia

An inherited autosomal recessive disorder characterized by sickle-shaped RBCs, sensitive to oxygen changes.

Etiology of Sickle Cell Anemia

Commonly affects African Americans.

Signs and Symptoms of Sickle Cell Anemia

Complications may include thrombosis, stroke, heart failure, abdominal organ issues like hepatomegaly, and skin ulcers.

Diagnostic Tests for Sickle Cell Anemia

Sickledex test, hemoglobin electrophoresis, CBC (showing decreased WBC, hemoglobin, and hematocrit), and ESR.

Treatment Options for Sickle Cell Anemia

Bone marrow transplant as definitive treatment.

Crisis Treatment for Sickle Cell Anemia

Includes antibiotics, hydroxyurea, pain management, blood transfusions, fluid administration, and oxygen supplementation.

Preventive Measures for Sickle Cell Anemia

Low-dose penicillin for prophylaxis and frequent transfusions.

Patient Education for Sickle Cell Anemia

Avoid tight clothing, strenuous exercise, alcohol, cold temperatures, smoking, and unpressurized aircraft.

Capillary Fragility Test

A test involving a blood pressure cuff to assess capillary fragility, observing petechiae.

Types of Blood Products

Includes Packed RBCs (PRBCs), Frozen RBCs, Platelets, Albumin, Fresh Frozen Plasma, and Cryoprecipitates.

Packed RBCs (PRBCs)

One unit of blood is 350 ml, normally stored frozen and thawed for use.

Frozen RBCs

Red blood cells preserved at low temperatures.

Platelets

Component of blood involved in clotting.

Albumin

Used to maintain oncotic pressure in the intravascular space.

Fresh Frozen Plasma

Plasma that is rapidly frozen to preserve clotting factors.

Cryoprecipitates

Contains specific clotting factors that are produced synthetically.