What is hematopoiesis - answer✔how the blood is made
- blood is made from bone marrow (RBC, WBC, platelets)
what is the job of the RBC - answer✔transport oxygen
- if low RBC then low oxygen which indicates anemia
- might be dizzy, increased HR, low O2, pale, SOB, fatigue
what is the job of WBC - answer✔to fight infection so if low the body is immunocompromised
and will need to be placed in neutropenic precautions
what is the job of platelets - answer✔to help the blood clot so if low then there is an increased
risk for bleeding
what 4 nutrients are needed for the blood formation - answer✔iron, Vit B12, folic acid, and Vit
C
what can cause bone marrow to be disrupted - answer✔different types of cancer like lymphoma
or leukemia or chemo and radiation
- it can cause bone marrow to be depressed and cause less RBCs to be made leading to anemia
what is hemoglobin - answer✔found in RBCs and it is what O2 sticks to allowing oxygen to be
carried thru the body
- iron is needed for HgB formation
what is basic anemia and some common causes - answer✔low RBCs that can be caused by
depressed bone marrow, active GI bleed, or destroyed
- if RBCs are low usually HgB is too unless it is the direct result of low iron
what is important to remember about anemia grading based on specific people -
answer✔hospitals all have a different transfuse number but sometimes depending on the patient
we need to transfuse before then
- watch for chest pain, SOB especially when ambulating, low O2
what does a blood smear show and what will iron def and pernicious look like - answer✔show
shape, color, and size of RBCs
- Iron will be small and be dark in color
- pernicious will be large, floppy, and normal in color
What is sickle cell anemia? - answer✔a genetic disorder more common in AA that has HBS hgb
instead of HSA
- must get HBS trait from both parents, if from just one parent then they would carry the trait
what is the normal lifespan of a RBC compared to SCD - answer✔usually last 120 days but SCD
lasts 10-20 days before they are die
- this causes a lot more RBCs debris in the body which can cause clots and impair the flow of
blood
- body is chronically anemic bc RBCs die too fast before bone marrow can replace
why isn't SCD dx until 5-6 months - answer✔babies are born with HgF hgb before it turns into
HGB
- slow growth of children can be seen
why is there an increased risk of infection for those with SCD - answer✔the spleen helps us fight
infections but it is too busy with all the RBC debris that it doesn't have "time" to fight infection
causing the body to be more susceptible
when in SCD does the cell itself actually become sickled - answer✔when the body becomes
hypoxic the cells begin to sickle which causes them to become more sticky and potentially clot
which can cause high pain
what are two ways to diagnose SCD - answer✔sickledex - finger stick that shows the hgb level
hgb electrophoresis - shows the types of hgb (HBA or HBS)
what are s/s of obstructive SCD - answer✔cool limbs, chest pain, SOB, increased pain, weak
pulses
what causes sickling of cells - answer✔anything that causes low oxygen
- infection
- high altitudes
- pregnancy
- dehydration
- avoid alc, caffeine, nicotine
what are two meds for SCD - answer✔hydroxyureas
- helps increase HBF to reduce sickling
- not for prego
- increased risk for leukemia
- can potentially suppress bone marrow
Endari
- expensive
- decreases ability to sickle which helps expand lifespan
what are s/s of SCD - answer✔- lots of pain in joints and extremities
- fatigue, SOB
- fever (sepsis workup, look at WBC)
- urinalysis for infection
- increased HR and decreased b/p (not enough blood in circulation)
what are some skin changes that will be seen with SCD - answer✔- pale
- jaundice (bilirubin is a byproduct of dying RBCs)
- ulcers due to poor blood flow
- priapism for men due to sickle cells clotting in penis
- kidney damage for sickle cells (check for protein in urine)
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