Adult Health NR324 (HEMATOLOGY) - Chamberlain.

Adult Health NR324 (HEMATOLOGY) - Chamberlain. Hematologic system consists of blood and the sites where blood is produced Blood is composed of plasma and various types of cells: - RBC - WBC - Platelets Plasma is fluid portion consisting of various proteins, such as: - albumin - globulin - fibrinogen - electrolytes - waste products - nutrients Bone Marrow contains stem cells committed to produce specific types of blood cells Erythrocytes Red Blood Cells (RBCs): delivers oxygen to tissues/body cells Erythropoiesis formation of red blood cells (myeloid stem cell) Erythropoietin hormone produced by primarily kidney Leukocytes white blood cells (WBCs): protect the body from invasion by bacteria Granulocytes eosinophils basophils neutrophils Monocytes transform into macrophages Lymphocytes immune system: produce antibodies Platelets (thrombocytes) essential role in the control of bleeding Hemostasis process of preventing blood loss from intact vessels and stopping bleeding from a severed vessel Spleen Location: upper left quadrant of abdomen - Removes old RBC's - Stores platelets and WBC's - Helps fight certain bacteria that can cause pneumonia and meningitis (vaccination important) Liver Filter, procoagulants essential to hemostasis Lymph system - lymph fluid - lymphatic capillaries - ducts and lymph nodes - primary function of nodes is filtration of pathogens and foreign particles Red Blood Cell (RBCs) Transport oxygen to the body's cells Expected Range: - Female: 4.2 - 5.4 million/uL - Male: 4.7 - 6.1 million/uL White Blood Cell (WBCs) help to fight infections and diseases Expected Range: - 5,000 - 10,000 Elevated: Leukocytosis (infection, inflammation) Decreased: Leukopenia (immunosuppression) Platelets (PLT) help clot the blood Expected Range: 150,000 - 400,000 Increased Level: Thrombocytosis (malignancy, rheumatoid arthritis) Decreased Level: Thrombocytopenia **THINK BLEEDING (enlarged spleen, hemorrhage, leukemia) Hemoglobin - Iron containing protein found in RBCs. - Transports oxygen from the lungs to the tissues - Returns CO2 from the tissues back to the lungs Expected Ranges: - Female: 12 -16 g/dL - Male: 14 - 18 g/dL Increased Levels: Erythrocytosis, COPD, severe dehydration Decreased Levels: Anemia, hemorrhage, kidney disease Hematocrit (Hct) the percent of blood that is made up of RBCs Expected Range: - Female: 37% - 47% - Male: 42% - 52% Increased/Decreased: Same reasons as Hgb Activated Partial Thromboplastin Time (aPTT) - measures how long it takes for a blood clot to form - monitor the effectiveness of the anticoagulant: HEPARIN Expected Range: 30-40 seconds Increased time: vitamin K deficiency, DIC, liver disease, heparin administration (if numbers are too HIGH = patient will DIE - from increased bleeding) Decreased time: (if numbers are LOW = clots will GROW) Prothrombin Time (PT) measures the amount of time needed to form a clot and monitors the effectiveness of the anticoagulant: WARFARIN Expected Range: 11 - 12.5 seconds Increased Time: Clotting factors II, V, VII or X liver disease, warfarin therapy, DIC Decreased Time: Vitamin K excess, pulmonary embolus, thrombophlebitis International Normalized Ratio (INR) calculated from the PT and is used to monitor oral anticoagulation such as: WARFARIN Expected Range: 0.8 - 1.1 Warfarin Therapy = 2-3 Increased Level: Warfarin Therapy (if numbers are too HIGH = patient will DIE - from increased bleeding) Decreased Level: Cancer disorders (if numbers are LOW = clots will GROW) D-Dimer determines if a clot is present Expected range: 0.4 mg/dL Bone marrow aspiration and biopsy is needed to assess how a patient's blood cells are being formed and to assess the quantity and quality of each type produced Procedure: aspirated through special large needle from iliac crest. Done at bedside. Complications: bleeding, infection Splenectomy removal of spleen