BLOOD FUNCTIONS ETIOLOGY

Blood Components - Loss of RBCs (occurs from bleeding)

Plasma - Decreased production of RBC
Proteins (albumin, globulin, fibrinogen, inorganic - Increased destruction of RBC
constituents and organic constituents) Signs and Symptoms
Cellular component (RBC, WBC and platelets) - Weakness Fatigue
BLOOD - general malaise
Albumin - pallor of the skin and mucous membranes (sclera,
ROLE: maintenance of BV by providing colloid osmotic oral mucosa)
pressure, pH and electrolyte balance, and the transport of - tongue may be smooth and red (in iron deficiency
metal ions, fatty acids, steroids, hormones and drugs anemia) or beefy red and sore (in megaloblastic
Globulin anemia)
Helps establish colloid osmotic pressure - Individuals with iron deficiency anemia may crave
Fibrinogen ice, starch, or dirt (known as pica); their nails may
accounting for only 4%; essential for blood clotting be brittle, ridged, and concave
Blood Cells - tachycardia, palpitations, dyspnea, dizziness,
Hematopoiesis formation and maturation of blood cells; orthopnea, and exertional dyspnea.
takes place in the bone marrow of the skull, vertebrae, - nausea, vomiting
pelvis, sternum, ribs and proximal epiphysis of long - Melena or dark stools, diarrhea, anorexia, and
bones. glossitis (inflammation of the tongue)
RED BLOOD CELLS (ERYTHROCYTES) - presence and extent of peripheral numbness and
5M/mm3 of blood in the average adult paresthesias, ataxia, poor coordination, and
life span of 120 days confusion.
RBC production is stimulated by a glycoprotein Iron Deficiency Anemia
hormone, erythropoietin, believed to originate in the Clinical Findings
kidney Fatigue Headache
Erythropoietin production is influenced by tissue Paresthesia Ankle edema
hypoxia caused by changes in athmospheric O2, Dry, pale mucous membrane Pearly white sclera
decreased O2 content of arterial blood and decreased Decreased hemoglobin and erythrocytes
hemoglobin concentration Increased iron-binding capacity
WHITE BLOOD CELL (LEUKOCYTES) Megaloblastic of blood
- Normal range is 5,0000-10,000/mm3 Cheilosis –fissures in the mouth
Types:
Granulocytes - originate in red marrow
Neutrophils Eosinophils Basophils
Agranulocytes – originate in red marrow and lymphatic
tissue
Monocytes Lymphocytes
Two types:
- T lymphocytes B lymphocytes
Platelets (Thrombocytes)
- Normal: 150,000 – 400,000/mm3
Function in blood coagulation
- Adhere to each other and to damaged areas of circulatory
system to limit or prevent blood loss
- Release chemicals that constrict damage blood vessels
METHODS FOR STUDYING BLOOD
Descriptive term and methods of measurement
- Blood Cell Count Therapeutic Interventions
- Differential Blood Cell Count - Improve diet: include ascorbic acid, which
- Red Cell Count Hematocrit stimulates iron uptake
- White Cell Count Platelet Count - Appropriate supplements of iron, vitamin B12 and
- Reticulocyte Count Study of Bone Marrow folic acid
- Biochemical Studies Nursing Interventions
HEMATOLOGIC DISORDERS - Teach clients food high in iron, folic acid and
ANEMIA vitamin B12
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 - Teach about the side effects of medications - intravenous hydration with dextrose 5% in water
- Assist client with ADL as needed (D5W) or dextrose 5% in 0.25 normal saline
Pernicious Anemia solution (3 L for 24 hours)
Clinical Findings - O2 adm
- Weakness Sore mouth Nursing Management
- Paresthesia Dyspnea Relieve pain
- Pallor Beefy red tongue - Support and elevate swollen joints until the
- Positive Romberg test (loss of balance when eyes swelling diminishes.
close) - Relaxation techniques, breathing exercises, and
- Gastric analysis: no intrinsic factor distraction are helpful for some patients.
- Schilling test; urine test for B12 absorption Prevent infection
Therapeutic Intervention – lifelong injections of - Antibiotic therapy
cyanocobolamin (B12) - Monitor signs of infection
Nursing Interventions Polycythemia Vera
- Explain the disease process and the need for Clinical Findings
continued treatment - Headache Weakness
- Teach family members how to give IM injections - Itching Increased hemoglobin
or make referral to visiting nurse - Purple-red complexion Dyspnea
Aplastic Anemia (Hypoplastic Anemia) - Bleeding from mucous membrane
Clinical Findings Therapeutic Interventions
- Headache Weakness - Phlebotomy
- Anorexia Dyspnea - Diet low in iron
- Fever - Radioactive phosphorus; busulfan (Myleran)
- Bleeding from mucous membrane Nursing Interventions
- Decreased leukocytes, erythrocytes and platelets - Discuss diet with the client and family
Therapeutic Interventions - Provide supportive care and prevent hemorrhage
- Identify and eliminate causative agent - Assist with phlebotomy
- Blood transfusions - Instruct client to elevate legs while sitting
- Maintenance of fluid and electrolyte balance Thrombocytopenic Purpura
- Corticosteroids and androgens to stimulate bone Clinical Findings
marrow function - History of epistaxis History of gum bleeding
- Splenectomy when enlarged organ destroys normal - Low platelet count Ecchymotic areas
RBCs - Hemorrhagic petechiae
Nursing Interventions Medical Interventions
- Prevent infection by protective isolation - Corticosteroids Immunosuppressive agents
- Provide blood transfusion therapy as ordered - Splenectomy Platelet transfusions
Hemolytic Anemia Nursing Interventions
- RBCs have a shortened life span; thus, the number - Prevent injury and bruises
of RBCs in circulation is reduced. - Encourage client to adhere to medical regimen
Sickle Cell Anemia - Teach the side effects of meds, particularly
Signs and Symptoms proneness to infection
anemic, usually with hemoglobin values of 7 to 10 g/dL Disseminated Intravascular Coagulation (DIC)
Jaundice Clinical Findings
tachycardia, cardiac murmurs, and often an enlarged heart - Restlessmess Anxiety
(cardiomegaly). - Low fibrinogen and prolonged prothrombin and
Dysrhythmias and heart failure partial thromboplastin times
low hematocrit - Hemorrhage
Medical Management Therapeutic Interventions
PHARMACOLOGIC THERAPY - Heparin to prevent the formation of thrombi
- Hydroxyurea (Hydrea) - Transfusion of blood products
TRANSFUSION THERAPY Nursing Interventions
- RBC transfusion - Observe for bleeding
Medical Management - Minimize skin punctures
SUPPORTIVE THERAPY - Prevent injury
- Pain management - Provide emotional support
- Adequate hydration
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