Blood Clots, Hemorrhage, and Anemia Flashcards

Circulatory System and Blood

• The circulatory system includes arteries, veins, and capillaries.

• Blood consists of red blood cells (RBCs), white blood cells (WBCs), and platelets.

Blood Clot Formation

• Blood clot formation: Interruption of blood flow.

• A dislodged clot can travel to the heart, brain, or lungs (usually the lungs).

• Impact on overall health: Disrupts blood flow and oxygen supply to tissues.

• Psychosocial impact: Anxiety and PTSD due to the scary nature of the event.

Risk Factors for Blood Clots

• Aging adults are at risk.

• Post-operative patients are at risk.

• Immobility is a risk factor.

Clinical Presentation

• Pulmonary embolism (PE)

• Myocardial infarction (MI), aka heart attack

• Stroke

Lab Tests

• D-dimer: Indicates the presence of a clot.

• PT/PTT (clotting factor time).

• Ultrasound and CT scans may also be ordered.

Nursing Role

• Acknowledge client needs.

• Consider environmental factors and safety concerns.

• Client education.

Deep Vein Thrombosis (DVT)

• DVT: Usually occurs in the lower extremities.

• Dehydration can contribute to DVT risk.

• Long-term complications possible.

• Prevention includes compression stockings and sequential compression devices (SCDs) post-surgery.

Aging Adults and Anticoagulation Therapy

• Be cautious due to the risk of falls and bleeding, especially intracranial hemorrhage.

• Warfarin (Coumadin) is an anticoagulant.

• Newer anticoagulants are available.

Clinical Presentation of DVT

• Redness and swelling in the lower extremity.

Diagnostic Tests for DVT

• Venous Doppler.

• Contrast venography.

Nursing Role for DVT

• Monitor post-operative patients for shortness of breath and chest pain (signs of PE).

• Pay attention to labor and delivery patients.

• Female patients can die of AFE, amniotic fluid embolism.

Hemorrhage

• Hemorrhage: Excessive bleeding.

• Adults can tolerate approximately 14% blood loss.

• Related to shock.

Safety Considerations

• Monitor blood pressure for orthostatic hypotension.

• Consider comorbidities in aging adults.

• Prevent falls.

Clinical Presentation of Hemorrhage

• Hemoptysis: Coughing up blood (usually a lot).

• Vomiting blood: Can be frank (bright red) or old (brownish).

• Intracranial hemorrhage.

• Traumatic injuries.

Lab Testing and Diagnostics

• Identify the source of bleeding.

Nursing Role During Hemorrhage

• Determine the source of bleeding.

• Assess the amount and color of blood.

Clinical Judgments

• Prioritize care based on ABCs (airway, breathing, circulation) when a patient is hemorrhaging.

Anemia

Characteristics

• Red blood cells appear pale under a microscope.

• Acute hemorrhage vs. slow bleeding (e.g., GI bleed).

• Pica: Craving non-food items like ice.

Treatment

• Iron pills.

• Iron-rich foods.

• Iron infusions (for severe cases).

Iron Infusions

• Administered via IV with pre-medication (e.g., Benadryl, prednisone) to prevent allergic reactions.

Iron Deficiency Anemia (IDA)

• Shortness of breath.

• Fatigue.

• Pallor.

• Heart palpitations.

• Dizziness.

Lab and Diagnostic Studies

• Complete blood count (CBC).

• Clotting factor tests (PT/PTT) if bleeding.

Nursing Role for IDA

• Supply education regarding iron-rich foods.

Environmental Factors and Populations at Risk

• Pregnancy (due to hemodilution).

• Vegetarians (lack of iron intake).

• Elderly people (vitamin B12 deficiency, risk of falls).

Vitamin B12 Deficiency

• Monitor vitamin B12 levels in patients.

Client Education

• Disease processes.

• Prescribed medications.