hematologic and renal emergencies

blood is solide components suspended in liquid called…

plasma

solid components of blood created in the…

bone marrow

blood comps. filtered out by…

spleen and liver

red blood cells have…..important for carrying O2

hemoglobin

platelets

fragments of larger cells crucial for forming clots

aspirin prevents aggregation of…

platelets

clotting factors are proteins produced in the…

liver

coagulopathy

abnormal clotting of blood

patients with liver cirrhosis

struggle to produce adequate clotting factors that form stable clots

hemophillia

don’t produce certain clotting factors

Von Willebrand’s disease

1/1000, normal number of platelets, but functionally defective

common blood thinners

Coumadin, Pradaxa, Eliquis, Xarelto, Lovenox

patients with a-fib usually on…

blood thinners

why? Blood pools in atrium and clots

anemia

deficiency in # of RBC’s

acute anemia

can be caused by trauma or big GI bleed —> SHOCK

checking for chronic anemia

color of patient conjuctiva on lower eyelid, anemic pateints very pale as opposed to ormal red/pink

sickle cell

results in sickle cell anemia

RBC’s sickled

lead to premature destruction of RBC

causes blockages in small blood vessels

destruction of spleen (blocked by sickled cells) - infection prone

sick cell crisis- block caps = severe pain

acute chest syndrome = shortness breath + chest pain due to hypoxia

priapism = sickle blockage prevent normal blood drainage

stroke = sickle blockage

jaundice = liver overwhelmed with breakdown of RBC = turn yellow

treatment of sickle

give O2 if chest pain/shortness of breath

monitor those with acute chest sydrome for respiratory failure and use BVM if needed

monitor fever and hypoperfusion patients for shock

transport stroke patients to stroke center

should I request ALS to provide pain control for sickle crisis

UTI’s caused by…

bacteria in the urinary tract

if infection acend to kidney = pyelonephritis (complain of unilateral flank pain)

very bad if bacteria gets into bloodstream (for old people)

kidney stone

calcium buildup in kidney

unilateral flank pain that radiates to groin when stone descends

lodged in ureter and unable to blass into bladder

naseua vomitting

renal failure

kidneys lose ability to filter blood = toxins buildup

end stage = need dialysis

long term damage cuased by diabetes or high blood pressure

fistula

connects arterial and venous flow

flow between surgically connected artery and vein makes noise called thrill when palpated

BP on other arm!

peritoneal dialysis

in home

slower

multiple treatments everyday

SA inside periotneal cavity that surround abdominal organs used to filter toxins and excess fluid

patients have catheter in ab wall and into peritonneal cavity

2 complications with end stage

loss of normal kidney function

missed dialysis

most dialysis patients have diabetes and high bp

missed dialysis

present with signs and symtoms similar to congestive heart failure

shortness of breath due to fluid buildup in lungs and elsewhere (hands, face, feet, ankles)

no longer balanced electrolytes = electrical disturbances in heart = dysrhythmias

elevated K+ levels can lead to patient death

fistula not working

hard to the touch and no more thrill sound when palpated

common complication with peritonneal dialysis

peritonitis - infection of peritoneal cavity

ab pain, fever, dialysis fluid appears cloudy when drained from peritonneal cavity (looks like chicken broth)

ABC’s, control bleeding (elevation + hemostatic dressing), tourniqeut last resort if bleeding cant be stopped, O2, if peritonitis and presenting with shock, supine and keep warm and transport back of dialysis fluid with patient so it can be tested for bacteria