1
08
08--26
26--19 Cellular Regulation Exemplar: Anemia
Function of blood Blood serves as:
• Transportation of oxygen, nutrients, hormone’s & waste products within the body
• Regulator of fluids, electrolytes & acid-base balance in body
• Protector: ability to clot and fight infection
Define Hematopoiesis: production of blood cells (whole blood)
hematopoiesis
Essentials to blood cell production:
Iron à B6 à Folic Acid à B12 B12à à Proteins
Lab values r/t
blood (normal) WBC 4,000-10,500 cells/mm3
RBC
RBC-- 3.8 - 5.1 Female (measures amount of red b
blood
lood cells in circulation)
4.3 - 5.7 Male
**Severe anemia
<7.0 g/dl of HGB 11.7 - 16 g/dl Females (oxygen/gases carrying ca
capacity
pacity of RBC)
HGB** 13.2 - 17.3 g/dl Males
HCT 35 - 47 % Females (volume ooff blood that is packed RBC’s)
39 - 50 Males
Conditions that • High altitude
cause an • Congenital heart disease
INCREASE in • Dehydration
rbc’s • Hemoconcentration
Conditions that
cause a • Cancer
DECREASE in • Dietary deficiencies
rbc’s • Genetics
• Hemolysis
• Hemorrhage
• Leukemia
• Pregnancy
• Renal failure
Leukopenia De creased WBC count (or in circulation in body)
• De crease bone marrow production à if d/t heavy metals à chelation thx
• De bilitated infection fighting; autoimmune d/o
• De ficient vitamins
Leukocytosis In creased WBC count (or in circulation in body)
(White Blood • In flammation
Cells
Cells--WBC) • In flicted trauma
• In fection
• In crease stress
• In definite death of tissues (tissue necrosis)
, 2
Hematologic Blood Smears (note the following…)
Studies • Size (microcytic, normocytic, macrocytic)
• Shape (sickle, round, oblong)
• Color (hypochromic, normochromic, hyperch
hyperchromic)
romic)
• Intracellular content of RBC’s
Bone Marrow Common site for BMA
Aspiration • Anterior iliac crest
• Posterior iliac crest (preferred)
-last resort • Sternum (not-preferred d/t close proximity to heart)
option, very
invasive This procedure is used for:
• Dx of leukemia and myeloma
• Document bone cancer
• Stage lymphoma or identify tumors
• Confirm dx of megaloblastic anemia (large blood cells anemia)
• Document deficient iron stores
• Determine if bone marrow is cause of anemia
Before Need… C B S
procedure… Consent (informed consent needs to be signed-C)
B lood (coagulation studies reviewed-B)
Sedative (order obtained for sedative-S)
During Aseptic technique (clean & drape)
procedure… Pressure (applied after to prevent bleeding)
D ressing (dry, sterile pressure dressing-prevent bleeding/infection)
Always clean & I ce (for pain, prevent bleeding à vasoconstriction)
pressed, d ressed Analgesics (for pain)
to impress always
Anemia Decreased rbc production resulting in decreased hemoglobin, hematocrit and decreased oxygen to
tissues à tissue hypoxia
Increased RBC destruction (lysis)
Assessing for s/s • Tachypnea & tachycardia (initial signs of anemia)
• Fatigue and weakness
Listed from seen • Angina
first to later • Pallor
developing signs
• Dizziness
and symptoms
• Cold hands and feet
• Brittle nails
• Difficulty bleeding (easily bleeds)
• Arrythmias
• Depression
Nursing 1) balance rest & activity
PRIORITY care 2) monitor vitals
to anemic pt 3) give meds and O2 as ordered by DR
4) monitor labs
08
08--26
26--19 Cellular Regulation Exemplar: Anemia
Function of blood Blood serves as:
• Transportation of oxygen, nutrients, hormone’s & waste products within the body
• Regulator of fluids, electrolytes & acid-base balance in body
• Protector: ability to clot and fight infection
Define Hematopoiesis: production of blood cells (whole blood)
hematopoiesis
Essentials to blood cell production:
Iron à B6 à Folic Acid à B12 B12à à Proteins
Lab values r/t
blood (normal) WBC 4,000-10,500 cells/mm3
RBC
RBC-- 3.8 - 5.1 Female (measures amount of red b
blood
lood cells in circulation)
4.3 - 5.7 Male
**Severe anemia
<7.0 g/dl of HGB 11.7 - 16 g/dl Females (oxygen/gases carrying ca
capacity
pacity of RBC)
HGB** 13.2 - 17.3 g/dl Males
HCT 35 - 47 % Females (volume ooff blood that is packed RBC’s)
39 - 50 Males
Conditions that • High altitude
cause an • Congenital heart disease
INCREASE in • Dehydration
rbc’s • Hemoconcentration
Conditions that
cause a • Cancer
DECREASE in • Dietary deficiencies
rbc’s • Genetics
• Hemolysis
• Hemorrhage
• Leukemia
• Pregnancy
• Renal failure
Leukopenia De creased WBC count (or in circulation in body)
• De crease bone marrow production à if d/t heavy metals à chelation thx
• De bilitated infection fighting; autoimmune d/o
• De ficient vitamins
Leukocytosis In creased WBC count (or in circulation in body)
(White Blood • In flammation
Cells
Cells--WBC) • In flicted trauma
• In fection
• In crease stress
• In definite death of tissues (tissue necrosis)
, 2
Hematologic Blood Smears (note the following…)
Studies • Size (microcytic, normocytic, macrocytic)
• Shape (sickle, round, oblong)
• Color (hypochromic, normochromic, hyperch
hyperchromic)
romic)
• Intracellular content of RBC’s
Bone Marrow Common site for BMA
Aspiration • Anterior iliac crest
• Posterior iliac crest (preferred)
-last resort • Sternum (not-preferred d/t close proximity to heart)
option, very
invasive This procedure is used for:
• Dx of leukemia and myeloma
• Document bone cancer
• Stage lymphoma or identify tumors
• Confirm dx of megaloblastic anemia (large blood cells anemia)
• Document deficient iron stores
• Determine if bone marrow is cause of anemia
Before Need… C B S
procedure… Consent (informed consent needs to be signed-C)
B lood (coagulation studies reviewed-B)
Sedative (order obtained for sedative-S)
During Aseptic technique (clean & drape)
procedure… Pressure (applied after to prevent bleeding)
D ressing (dry, sterile pressure dressing-prevent bleeding/infection)
Always clean & I ce (for pain, prevent bleeding à vasoconstriction)
pressed, d ressed Analgesics (for pain)
to impress always
Anemia Decreased rbc production resulting in decreased hemoglobin, hematocrit and decreased oxygen to
tissues à tissue hypoxia
Increased RBC destruction (lysis)
Assessing for s/s • Tachypnea & tachycardia (initial signs of anemia)
• Fatigue and weakness
Listed from seen • Angina
first to later • Pallor
developing signs
• Dizziness
and symptoms
• Cold hands and feet
• Brittle nails
• Difficulty bleeding (easily bleeds)
• Arrythmias
• Depression
Nursing 1) balance rest & activity
PRIORITY care 2) monitor vitals
to anemic pt 3) give meds and O2 as ordered by DR
4) monitor labs
