Blood disorders


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Blood disorders

  1. 1. BLOOD DISORDERS Dhuha F Shamsaldeen
  2. 2. What is blood ? Blood is a combination of plasma (watery liquid) and cells that float in it. It is a specialized bodily fluid that supplies essentials substances and nutrients, such as sugar, oxygen, and hormones to our cells, and carries waste away from those cells
  3. 3. Types of blood cells Red blood cells - also known as RBCs or erythrocytes. These are the most abundant cells, and contain hemoglobin (Hb or Hgb). Hemoglobin is a protein which contains iron; it transports oxygen from the lungs to body tissues and cells. 97% of a human's red blood cell's dry content is protein. White blood cells (leukocytes) - these are the cells of our immune system; they defend the body against infections and foreign materials. Platelets (thrombocytes) - are involved in the clotting (coagulation) of blood. When we bleed the platelets clump together to help form a clot.
  4. 4. ANEMIA
  5. 5. • Anemia is a condition in which the hemoglobin concentration is lower than the normal; it reflects the presence of fewer than the normal number of erythrocytes within the circulation. • As a result, the amount of oxygen delivered to the body tissues is also diminished. • Anemia is not a specific disease state but a sign of an underlying disorder. It is by far the most common hematologic condition.
  6. 6. Classification of anemia hypoproliferative Results from defective RBC production bleeding Results from RBC loss hemolytic Results from RBC destruction
  7. 7. hypoproliferative Iron deficiency. Vitamin B12 deficiency (megaloblastic) Folate deficiency (megaloblastic) Decreased erythropoitin production Cancer/ inflammation
  8. 8. Bleeding Bleeding from GI tract, epistaxis (nosebleed), trauma, bleeding from genitourinary tract (menorrhagia)
  9. 9. Hemolytic Sickle anemia Hypersplenism ( hemolysis) Drug-induced anemia Autoimmune anemia Mechanical heart valve- related anemia
  10. 10. Stressors Physiological • Reduced RBC production. • Excessive RBC destruction. sociocultural • Diet habits. developmental • Age group. • sex
  11. 11. Clinical manifestations: Special complications of the condition that produced anemia The duration of anemia The speed of anemia
  13. 13. • Iron deficiency anemia typically results when the intake of dietary iron is inadequate for hemoglobin synthesis. • Iron deficiency anemia is the most common type of anemia in all age groups, and it is the most common anemia in the world.
  14. 14. Causes • The most common cause of iron deficiency anemia in men and women is bleeding from ulcers gastrirtis, inflammatory bowel disease, or GI tumors. The most common causes of IDA in premenopusal woman are menorrhagia ( ie, excessive menstrual bleeding) and pregnancy with inadequate iron supplementation. Other causes include iron malabsorption, as is seen after gastroctomy.
  15. 15. Sings and symptoms Fatigue Weakness Headache Dyspnea Palpitations Chest pain Jaundice Smooth; sore tongue
  16. 16. Diagnostic tests Serum iron ( female 8.9-30.4 umol/l) ( male 11.6-30.4 umol/l) SERUM Hb ( normal 13.2-17.5 g/dk) CBC Bone marrow aspiration
  17. 17. Treatment • Correction of the underlying cause, iron supplements including : Oral • Ferrous phosphate, ferrous glucanate IV or IM • Administer small dose
  18. 18. Patient education ( taking oral iron supplements ): • Take iron on an empty stomach ( 1 hr before or 2 hrs after the meal). Iron absorption is reduced with food, especially dairy products. • To prevent GI distress, the following schedule may work better if more than one tablet a day is prescribed. Start with only one tab/day for a few days, then increase to 2 tab/day, then 3 tab/day. This method permits the body to adjust gradually to the iron. • Increase the intake of vit C , to enhance iron absorption. • Eat foods high in fiber to minimize problems with constipation. • Remember that stool will become dark in color.
  20. 20. • Sickle cell anemia is a severe hemolytic anemia results from inheritance of the sickle hemoglobin gene. • The sickle hemoglobin (HbS) acquires a crystal-like formation when exposed to low oxygen tension.
  21. 21. Clinical manifestations: Always anemic (Hb= 7-10gm/dl) Sometimes enlargement of the bones of face and skull. Jaundice Tachycardia
  22. 22. Sings and symptoms: Pallor Decrease urinary output, Dark urine- smoky,brownish Abdominal or chest pain. Swelling and pain in the joint Weakness Mental depression Difficulty concentrating
  23. 23. Diagnostic test • CBC • Hgb—men 14-18g/dl, women 12-16g/dl • Platelet count—150,000-350,000/100ml 0f blood. • Haematocrit – packed cell volume (PCV). • Bone marrow puncture
  24. 24. Medical management: long term RBC transfusion. hydroxyurea (chemotherapy) Bone marrow transplant
  25. 25. NURSING DIAGNOSIS AND INTERVENTIONS For all anemic patients
  26. 26. Diagnosis: Activity intolerance related to poor tissue oxygenation. Give oxygen Bed rest Monitor vital signs Observe urine for signs of blood Give prescribed fe medication
  27. 27. Diagnosis: Pain related to joint inflammation Assess level of pain Apply warm packs Use distraction technique Give pain medication