WCUI Level 2Medical-Surgical Nursing

Hematology and Lymphatic System Disorders

Text Resources

Christensen• CH 47 p.1528

ATI * CH 26- 27

Disorders- 1

- Review Structure & Function

- Assessment

- Lab & diagnostics Coagulation Platelets and Count

Disorders- 1

Review Structure & Function

Disorders- 1 Anemia

- Sickle-Cell Anemia

-Transfusions

Lymphatic Disorders

Hemophilia Von Willebrand’s Disease DIC Multiple Myeloma Lymphangitis Lymphedema Hodgkin’s Disease Non-Hodgkin’s Disease

- Leukemia - Lymphomas

ANATOMY AND PHYSIOLOGY REVIEW

The heart pumps 5–6 liters of blood per minute through adult circulatory system.

ANATOMY AND PHYSIOLOGY REVIEW

The lymphatic system is a separate vessel system with two main functions:

• Transport excess fluid from the interstitial spaces to the circulatory system.

• Protect the body from infections.

Disorders- 1

Von Willebrand’s Disease

Von Willebrand

Definition • most common hereditary bleeding disorder.

Von Willebrand Causes

• a deficiency of von Willebrand factor. Von Willebrand factor helps blood platelets clump together and stick to the blood vessel wall, which is necessary for normal blood clotting.

• affects both men and women

• most cases are mild

• bleeding may occur after surgery or when you have a tooth pulled.

Disorders- 1

Lymphangitis

&

Lymphedema

Disorders- 1

IRON DEFICIENCY ANEMIA

IRON DEFICIENCY ANEMIA

Occurs when the body does not have enough iron to synthesize functional Hgb.

IRON DEFICIENCY ANEMIA

Symptoms: • Fatigue

• Palpitations

• Tachycardia

• Exertional dyspnea

• Pica

• Stomatitis

• Glossitis

• Brittle hair.

IRON DEFICIENCY ANEMIA

Treatment includes

• iron preparations and

• changes in diet

Disorders- 1

APLASTIC ANEMIA

APLASTIC ANEMIA

Occurs when the bone marrow stops making enough blood cells.

APLASTIC ANEMIA Symptoms:

• Fatigue

• Weakness

• Fever

• Palpitations

• Headaches

• mouth ulcers

• Petechiae

• gingival bleeding

• epistaxis

APLASTIC ANEMIA

Treatment includes

• bone marrow transplants and

• medications

Disorders-1

PERNICIOUS ANEMIA

PERNICIOUS ANEMIA

Inability to absorb vitamin B12 due to the absence of intrinsic factor.

PERNICIOUS ANEMIA

Symptoms: • Weakness

• sore tongue

• Edema

• Ataxia

• Dizziness

• Dyspnea

• Headache

• Fever

• blurred vision, etc.

PERNICIOUS ANEMIA

Treatment includes

• lifetime replacement of vitamin B12.

Disorders-1

ACQUIRED HEMOLYTIC ANEMIA

ACQUIRED HEMOLYTIC ANEMIA

Destruction of RBCs occurs, and iron and hemoglobin are released.

ACQUIRED HEMOLYTIC ANEMIA

Symptoms: • Mild fatigue and pallor

• Jaundice

• Palpitations

• Hypotension

• Dyspnea

• Back and joint pain

ACQUIRED HEMOLYTIC ANEMIA

Treat to

• remove cause

• also blood transfusions

• Splenectomy

• medications

Disorders-1

SICKLE CELL ANEMIA (INHERITED HEMOLYTIC

ANEMIA)

SICKLE CELL ANEMIA (INHERITED HEMOLYTIC ANEMIA)

Genetic disorder that causes abnormally shaped red blood cells.

SICKLE CELL ANEMIA (INHERITED HEMOLYTIC ANEMIA) Symptoms include

• anemia

• enlarged heart

• fatigue

• jaundice

• chronic leg ulcers

• tachypnea

• dyspnea

• arrhythmias

• severe pain

SICKLE CELL ANEMIA (INHERITED HEMOLYTIC ANEMIA) (continued)

Treatment includes medications and symptomatic care during crises.

Disorders-1

POLYCYTHEMIA

POLYCYTHEMIA

Increased production of red blood cells.

POLYCYTHEMIA Symptoms:

headaches dizziness tinnitus blurred vision fatigue, weakness pruritis exertional dyspnea, angina increased blood pressure and pulse.

POLYCYTHEMIA

Treatment includes

• Phlebotomy

• Medications

• Dietary changes

Disorders-1

LEUKEMIA

LEUKEMIA

Malignancy in which the bone marrow produces increased numbers of immature white blood cells that cannot protect the body from infections.

LEUKEMIA (continued)

Four categories:

Acute myelogenous (AML) Acute lymphocytic (ALL) Chronic myelogenous (CML) Chronic lymphocytic (CLL)

LEUKEMIA (continued) Symptoms

fever chills fatigue pallor malaise tachycardia, tachypnea petechiae, bruising epistaxis, melena, gingival bleeding increased menstrual bleeding.

LEUKEMIA (continued)

Treatment includes

• Chemotherapy

• Radiation

• Blood products

• Antibiotics

• Bone marrow transplants.

Disorders-1

AGRANULOCYTOSIS

AGRANULOCYTOSIS

Reduced number of granulocytes.

AGRANULOCYTOSIS Symptoms:

headache fever chills fatigue mucous membrane ulcerations low white blood counts

AGRANULOCYTOSIS

Treat to remove the cause of bone marrow suppression and treat or prevent infection.

Disorders-1

DISSEMINATED INTRAVASCULAR

COAGULATION (DIC)

DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

Syndrome of alternating clotting and hemorrhaging due to a primary disease process or condition.

DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

Symptoms include

• oozing from a venipuncture mucus membrane, wound.

DISSEMINATED INTRAVASCULAR COAGULATION (DIC)

Treatment:

• blood replacement and medications, and for primary condition.

Disorders-1

HEMOPHILIA

HEMOPHILIA

Inherited bleeding disorder in which there is a lack of clotting factors.

The main symptom is bleeding.

Treatment includes replacement of missing clotting factors.

Disorders-1

THROMBOCYTOPENIA

THROMBOCYTOPENIA

Decrease in the number of platelets in the blood.

THROMBOCYTOPENIA

Symptoms:

• Petechiae

• Ecchymoses

• Bleeding from mucous membranes.

THROMBOCYTOPENIA

Treatment:

• transfusions of platelets

• Splenectomy

• Medications

• diet changes

Disorders-1

HODGKIN’S LYMPHOMA &

NON-HODGKIN’S LYMPHOMA

HODGKIN’S LYMPHOMA

Rare lymphoma usually arising as painless swelling in a lymph node.

HODGKIN’S LYMPHOMA

Painless enlarged lymph nodes in neck, groin, above clavicles, fatigue, pruritis, fever, night sweats, anemia.

HODGKIN’S LYMPHOMA

Treatment includes

• Radiation

• Chemotherapy

• Diet changes

NON-HODGKIN’S LYMPHOMA Symptoms:

enlarged, painless lymph nodes in neck, axillary, abdominal, and inguinal areas

fever, night sweats excessive tiredness Indigestion abdominal pain loss of appetite bone pain

NON-HODGKIN’S LYMPHOMA

Treatment:

• Chemotherapy

• Radiation

Disorders-1

MYELOMA

MYELOMA

Plasma cells become malignant, crowd out normal cell production, destroy normal bone tissue, and cause pain.

MYELOMA

Symptoms: • bone pain, swollen and tender joints, low-grade

fever, general malaise.

Myeloma is not curable, so treatment is symptomatic.

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