student hematology

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Hematology

Michele L. Miller, RN, MSN-NE



Objectives

Student will be able to:1. Describe the function of the bone marrow.

2. Explain the process of maturation of blood cells.

3. Explain the function of accessory organs in maintaininghematological homeostasis.

4. Describe the role of platelets in hemostasis.5. Compare and contrast the structure and function of platelet plugsand fibrin clots.

6. Describe the hematological changes with aging.

7. Compare and contrast the actions and uses of anticoagulants,antiplatelet drugs, and thrombolytic agents.

8. Discuss the assessment of a client with a suspected hematologicaldisorder.

9. Explain how disorders of the hematological system affect activitytolerance.



Objectives (cont)

10. Compare and contrast the different types of anemias includingsymptoms and medical management.

11. Explain the pattern of inheritance for Sickle Cell Disease.

12. Identify 3 common clinical manifestations of anemia.

13. Explain the mechanism of action & potential ADR of therapy withhematological growth factors.

14. Compare and contrast the pathological mechanisms of hemolyticanemia versus aplastic anemia.

15. Compare and contrast leukemia and lymphoma for etiology,pathophysiology, and clinical manifestations.

16. Compare the purposes and scheduling of induction therapy andmaintenance therapy for clients with leukemia.

17. Prioritize nursing responsibilities during transfusion therapy.

18. Identify clients at risk for complications transfusion therapy



Assessment

� Demographic data

� Family history and genetic risk

� Personal history� Diet history

� Socioeconomic status

� Current health status



Hematology

� This is the study of Blood.

� The blood is made of Plasma & Cells

� Plasma is found in ECF while Cells are made in the

Bone Marrow.� Plasma in the ECF is composed of Proteins (Globulins,

Albumin, & Fibrinogen).

� Bone Marrow Cells are composed of

Immature/Uncommitted/Undifferentiated Stem Cells.� Special Growth Factors cause the Stem Cells to Commit

and Produce RBCS, WBCS & PLTs



Bone Marrow Also called

Hematopoietic organ

Function- make blood cells

Uncommitted Stem Cells

RBCs, WBCs, Platelets

Committed stem cell (also calledthe precursor cell )

Myeloid

Cells

Inflammation and

immunity

Oxygen deliver y to tissueBlood clotting (coagulation)



Hematologic Changes in the Aging

� Lower levels of Plasma protein

� Decrease blood volume

� RBC & WBC levels decrease.

� WBCs do not increase as much in response toinfection.

� Decease in Hemoglobin levels

� Increase in amount of Fatty Marrow

� Platelet levels remain unchanged� Small portion of remaining Marrow producesblood.



Example of a Bullet Point Slide

Slide 002



Example of a Bullet Point Slide

� Bullet Point

� Bullet Point

±

Sub Bullet

Slide 002



Diagnostic Assessment

� Laboratory Results

� Imaging Results

±

Radioisotope imaging± Bone Marrow Aspiration & Biopsy



RED Blood Cell Disorders

� Anemia

± Decrease in number of cells

�

Polycythemia± Increase in number of cells



THE END

LETS TALK

BLOOD

TRANSFUSIONS



Elsevier items and deriveditems © 2006 by Elsevier Inc.

Transfusion Therapy

� Pretransfusion responsibilities to prevent

adverse transfusion reactions:

± Verify prescription.

± Test donors and recipients blood for

compatibility.

± Examine blood bag for identification.

± Check expiration date.± Inspect blood for discoloration, gas bubbles, or

cloudiness.




Transfusion Responsibilities

� Provide client education.

� Assess vital signs.

�

Begin transfusion slowly and stay with clientfirst 15 to 30 minutes.

� Ask client to report unusual sensations such as

chills, shortness of breath, hives, or itching.� Administer blood product per protocol.




Types of Transfusions

� Red blood cell

� Platelet transfusions

�

Plasma transfusions: fresh frozen plasma� Cryoprecipitate

� Granulocyte (white cell) transfusions




Transfusion Reactions

� Clients can develop any of the following

transfusion reactions:

± Hemolytic

± Allergic

± Febrile

± Bacterial

± Circulatory overload




Autologous Blood Transfusion

� Collection and infusion of clients own blood

� Eliminates compatibility problems; reduces

risk for transmission of bloodborne disease� Preoperative autologous blood donation

(Continued)




Autologous Blood Transfusion(Continued)

� Acute normovolemic hemodilution

� Intraoperative autologous transfusion

�

Postoperative blood salvage

student hematology

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