This document provides an overview of hematologic disorders and outlines learning objectives for managing patients with blood disorders. It describes the components of blood including plasma, red blood cells, white blood cells, and platelets. The major functions of different white blood cell types and other blood cells are defined. Nursing care of patients with anemias, leukemias, lymphomas, myelomas, and bleeding disorders using the nursing process is discussed.

1. Management of Patients
With Hematologic
Disorders
ARIEL M. ORTUOSTE, RN, MAN

2. LEARNING OBJECTIVES
1. Describe the process of hematopoiesis.
2. Describe the processes involved in maintaining
hemostasis.
3. Differentiate between the hypoproliferative and the
hemolytic anemias and compare and contrast the
physiologic mechanisms, clinical manifestations,
medical management, and nursing interventions for
each.

3. 4. Use the nursing process as a framework for care of
patients with anemia.
5. Compare the leukemias, their incidence,
physiologic alterations, clinical manifestations,
management, and prognosis.
6. Use the nursing process as a framework for care of
patients with acute leukemia.
7. Use the nursing process as a framework for care of
patients with lymphoma or multiple myeloma.

4. 8. Use the nursing process as a framework for care of
patients with bleeding disorders.
9. Identify therapies for blood disorders, including the
nursing implications for the administration of blood
and blood components

5. Anatomic and Physiologic
Overview
• The hematologic system consists of the blood
and the sites where blood is produced,
including the bone marrow and the
reticuloendothelial system (RES).

6. • Blood is a specialized organ that differs from
other organs in that it exists in a fluid state.
Blood is composed of plasma and various
types of cells
• Plasma is the fluid portion of blood; it
contains various proteins, such as albumin,
globulin, fibrinogen, and other factors
necessary for clotting, as well as electrolytes,
waste products, and nutrients.

7. BLOOD
• The cellular component of blood consists of
three primary cell types
• RBCs (red blood cells or erythrocytes),
• WBCs (white blood cells or leukocytes),
and
• platelets (thrombocytes).

8. • EDUCATIONAL VIDEOSWhat's Inside of
Blood_.mp4

9. Blood Cells
CELL TYPE MAJOR FUNCTION
WBC (Leukocyte) Fights infection
Neutrophil Essential in preventing or limiting
bacterial infection via phagocytosis;
average life span is 2 to 4 h
Monocyte Enters tissue as macrophage; highly
phagocytic, especially against fungus;
immune surveillance
Eosinophil Involved in allergic reactions
(neutralizes histamine); digests foreign
proteins
Basophil Contains histamine; integral part of
hypersensitivity reactions

10. CELL TYPE MAJOR FUNCTION
T lymphocyte Responsible for cell-mediated immunity;
recognizes material as “foreign”
(surveillance system)
B lymphocyte Responsible for humoral immunity;
many mature into plasma cells to
form antibodies
Plasma cell Secretes immunoglobulin (Ig, antibody);
most mature form of B lymphocyte

11. CELL TYPE MAJOR FUNCTION
RBC (Erythrocyte) Carries hemoglobin to provide oxygen
to tissues; average life span is 120 days
Platelet (Thrombocyte) Fragment of megakaryocyte, not really
a cell; provides basis for coagulation
to occur; maintains hemostasis;
average
life span is 10 days