Nursing Health Alterations: Hematologic System Practice Flashcards

Significance of Abnormal Lab Values: The assessment of the hematologic system involves understanding the following abnormal lab values: - RBC (Red Blood Cell count): Indicates the oxygen-carrying capacity of blood. Abnormal levels may suggest anemia or polycythemia. - Hgb (Hemoglobin): Measures the protein in red blood cells that carries oxygen. Low levels can indicate anemia, while high levels may occur due to dehydration or lung disease. - Hct (Hematocrit): The ratio of the volume of red blood cells to the total volume of blood. Low Hct can indicate anemia; high Hct can be due to dehydration or other disorders. - WBC (White Blood Cell count): A count that reflects the immune response. Elevated levels may indicate infection or inflammation; low levels can suggest immunosuppression. - Platelet Count: Involved in blood clotting. Low platelet counts may lead to bleeding disorders, whereas high counts can indicate risk for thrombosis. - INR (International Normalized Ratio) & PT (Prothrombin Time): Tests that measure the time it takes for blood to clot; elevated values indicate a greater risk of bleeding.

Possible Causes: - Insufficient dietary iron intake. - Increased iron needs (e.g., pregnancy, growth spurts). - Blood loss (e.g., heavy menstruation, gastrointestinal bleeding).
Signs and Symptoms (S/S): - Fatigue - Weakness - Pale skin - Shortness of breath - Dizziness - Cold hands and feet
At-Risk Populations: - Women of childbearing age - Infants and children - People with chronic blood loss (e.g., from ulcers or heavy menstruation)
Treatment: - Oral iron supplements (ferrous sulfate recommended). - Dietary changes to include iron-rich foods (e.g., red meat, beans, spinach).
Patient Education on Oral Iron: - Take on an empty stomach to enhance absorption. - Avoid taking with antacids or calcium supplements, which can interfere with absorption. - Iron supplements may cause constipation; consider dietary measures or stool softeners as needed.

Possible Causes: - Inadequate dietary intake of folic acid. - Malabsorption syndromes (e.g., celiac disease). - Increased utilization (e.g., pregnancy).
Treatment: - Folic acid supplements (dosage as prescribed). - Increased dietary intake of folate-rich foods (e.g., leafy greens, citrus fruits, legumes).

Possible Causes: - Lack of intrinsic factor (as seen in pernicious anemia). - Dietary deficiency (strict vegetarian diets lacking in B12). - Malabsorption issues (e.g., Crohn's disease, celiac disease).
Treatment: - Vitamin B12 injections for those with malabsorption issues. - Oral B12 supplements for dietary deficiency.
Alternative Name: - Another name for B12 deficiency anemia is pernicious anemia when due to intrinsic factor deficiency.
Treatment for B12 Deficiency Anemia: - B12 injections or high-dose oral supplements.

Pernicious Anemia vs. Folic Acid Deficiency Anemia: - Pernicious Anemia shows additional neurological symptoms (e.g., numbness, tingling, balance problems due to nerve damage). - Folic Acid Deficiency generally lacks neurological symptoms but may present as general anemia symptoms.

Overview: - The Schilling test is used to determine if the body properly absorbs vitamin B12. - It assesses intrinsic factor levels and the body's ability to absorb B12. - Relevant findings help diagnose pernicious anemia versus dietary deficiency.

Transfusion Reactions: - Define and provide symptoms (S/S) for 2 of the 6 transfusion reactions, which include: - Acute Hemolytic Reaction: Symptoms include fever, chills, back pain, dark urine, or lightheadedness. - Febrile Non-Hemolytic Reaction: Symptoms can include fever, chills, sweating, or flushing.
Vital Signs Monitoring: - Vital signs should be taken at baseline, after 15 minutes, then every 30 minutes until the transfusion is completed.
Interventions for Transfusion Reaction: - Stop the transfusion immediately. - Maintain venous access with normal saline (if needed). - Notify the healthcare provider and blood bank. - Monitor vital signs closely and assess symptoms. - Prepare to administer medications as ordered (e.g., antihistamines, corticosteroids) for allergic reactions.