NUR 2063 Essentials of Pathophysiology - Cellular Function Ch 3

Disorders of the RBCs - -Erythropoiesis +Production of erythrocytes +Regulated by erythropoietin +Occurs in bone marrow -Disorders typically result from a deficit or defect in the erythrocytes Hematopoiesis - The process of forming blood -Plasma - liquid protein -Leukocytes - white blood cells -Erythrocytes - red blood cells -Thrombocytes - platelets Erythrocytes - -Hemoglobin: oxygen carrying component -Hematocrit: amount of blood volume occupied by erythrocytes Hemostasis - -Stoppage of blood flow -Normal when it seals a blood vessel to prevent blood loss and hemorrhage -Abnormal when it causes inappropriate clotting or when clotting is insufficient to stop blood flow. Stages of Hemostasis - 1. Vessel spasm 2. Formation of platelet plug 3. Blood coagulation 4. Clot retraction 5. Clot dissolution Disorders of the WBCs - -Leukocytes key players in the inflammatory response and fighting infections -Normal range = 5,000 to 10,000 mm3 -Leukopenia-decreased levels -Leukocytosis-increased levels Neutrophils - -One type of leukocytes -Usually the first to arrive at the site of infection -Normal range is 2,000-7,500 cells/µL Neutropenia - -Neutrophils 1500 -Causes: +Increased usage +Drug suppression +Radiation therapy +Congenital conditions +Bone marrow cancers +Spleen destruction +Vitamin deficiency -Manifestations: +Depends on severity and cause +Infections and ulcerations especially of the respiratory tract, skin, vagina, and gastrointestinal tract +Signs and symptoms of infection (e.g., fever, malaise, and chills) -Diagnosis: neutrophil levels and bone marrow biopsy -Treatment: Antibiotic therapy and hematopoietic growth factors Infectious Mononucleosis - -"Kissing Disease"-oral transmission -Self-limiting -Most prevalent in adolescents and young adults -Caused by Epstein-Barr virus in the herpes family -EBV infects the B cells by killing the cell or being incorporated into its genome -Those B cells incorporated with EBV produce heterophile antibodies -Once the disease is eliminated, a few B cells remain altered, giving the individual an asymptomatic infection for life and occasional spreading the EBV to others -Manifestations +Insidious onset +Incubation = 4 to 8 weeks +Initially see anorexia, malaise, and chills +Manifestations intensify to include leukocytosis, fever, chills, sore throat, and lymphopathy +Acute illness usually last 2-3 weeks; may not fully recover for 2-3 months -Treatment: symptomatic and supportive Lymphomas - -Cancers affect lymphatic system -Most common hematologic cancer in the US -Two main types +Hodgkin's +Non-Hodgkin's Hodgkin's Lymphoma - -Least common lymphoma -Solid tumors with the presence of Reed-Strenberg cells -Typically originate in the lymph nodes of the upper body -Several subtypes -Very curable with treatment -Manifestations: painless enlarge nodes, weight loss, fever, night sweats, pruritis, coughing, difficulty breathing, chest pain, recurrent infections, and splenomegaly -Diagnosis: physical examination, presence of Reed-Sternberg cells in a lymph node biopsy, complete blood count, chest X-rays, computed tomography scan, magnetic resonance imaging, positron emission tomography scan, and bone marrow biopsy -Treatment: chemotherapy, radiation, and surgery