RP

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.