CHAPTER ONE

INTRODUCTION
Anemia is a condition in which the haemoglobin concentration is lower than
normal; it reflects the presence of fewer than normal number of erythrocyte within
the circulation. As a result, the amount of oxygen delivered to the body tissue is
also diminished. Anemia is not a specific disease state but a sign of an underlying
disorder. It is by far the most common hematologic condition.
Anemia is characterized by a reduction in the number of circulating red blood
cells (RBCs), the amount of hemoglobin, or the volume of packed red blood cells
(haemotrocrit).
Haemolytic anemia occurs when circulating red cells are destroyed or are
removed prematurely from the blood because the cells are abnormal or the spleen
is overactive. Most haemolysis takes place in the liver or spleen and the normal
erythroeytes life span of about 120 days can considerably be shortened. If the
condition is relatively mild, red cell number may remain stable because the red
bone marrow production of erythrocytes increases to compensate, so there may be
ongoing haemolysis without anemia. However, the bone marrow cannot
compensate, red blood cell numbers will fall and anemia results. Haemolytic
anemia has a very good prognosis and maybe in many instances. The overall
prognosis depends on the underlying cause of anemia, its severity and the overall
health of the patient.
This care study is on Mrs. A.C. who hails from Nkwelle village, Ogidi, Anambra
state and was admitted on 4'' of October, 2018 in female medical ward of Iyienu
Mission Hospital, Ogidi with the diagnosis of Haemolytic Anaemia.

REASONS FOR CHOOSING THE PATIENT

The reason for choosing the patient is because I want to know about the etiology,
causes, management and prognosis of this condition and also because of the
maximum co-operation gotten from the patient and the relatives. Another reason is
that the patient willingly gave the necessary information which helped me in the
care of illness.
OBJECTIVES OF THE CARE STUDY
1. Review the anatomy and physiology of related organs; Red blood cells.
2. Review the disease condition; Haemolytic Anaemia.
3. Discuss the management of Mrs. A.C. with the diagnosis; Haemolytic
Anaemia.
4. Discuss the drug used for the management of Mrs. A.C. with haemolytic
anaemia.

DEFINITION OF TERMS
Agranulocytosis: Disorder in which there is a severe acute deficiency of
certain blood cells (neutrophils) as a result of damage to the bone marrow by
toxic drugs or chemicals.
Azotemia: The presence of excessive amounts of urea and other nitrogenous
waste compounds in the blood.
Delirum: An acute disorder of the mental processes accompanying organic
brain disease.
Disulfiram: Drug administered by mouth in the treatment of chronic
alcoholism. It acts as a deterrent by producing unpleasant effects such as
headache, nausea, vomiting when taken with alcohol.
• Dizziness: A feeling of unsteadiness or laziness, accompanied by anxiety.
• Euphoria: An exaggerated feeling of wellbeing, often not justified by
circumstances.
• Hallucination: A false perception of something that is not really there.
• Hematochezia: Is the passage of fresh blood through the anus usually in or
with stools.
Hemoglobinopathies: Is a kind of genetic defect that results in abnormal
structure of one of the globin chains of hemoglobin molecule.
• Hypernatremia: Excess of sodium in the blood, usually diagnosed when the
plasma sodium is above 150mmol/litre.
Hypervolemia: An increase in the volume of circulating blood.
Hypocalcaemia: A deficiency of calcium in the blood.
Hypokalaemia: A low level of potassium in the blood.
Melaena: Darkening of the faces blood pigment
Micronagiopathic: Microvascular disease or small vessel disease.
Pancytopenia: Deficiency of all three cellular components of the blood (red
cells, white cells and platelets)
Paresthesia: Tingling or prickling sensation usually temporary often occurs
in the arms, hands, legs or feet.
• Pernicious Anemia: A decrease in red blood cells when the body can't
absorb enough vitamin B12.
Peripheral cyanosis: Is when there is a bluish discoloration to your hands
or feet due to low oxygen level in the red blood cells.
Senescent: Is growing old or is elderly.
Sperocytes: Erythrocytes (red blood cells) that are sphere shaped rather than
bi-concave disk shaped as normal.