Hematologic Problems

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Hematologic Problems
Anemia
Definition
Anemia is a deficiency in the number of erythrocytes (red blood cells RCB), the quantity of hemoglobin, and/or the volume of packed RBCs (hematocrit). Because RCBs transport oxygen, erythrocytes disorders can lead to tissue hypoxia. Anemia is not a specific disease. It’s a manifestation of a pathologic process. Once anemia is identified, further investigation is done to determine its cause. Anemia can result from primary hematologic problems or can develop as a secondary consequence of disease. Types of Anemia:

1. Morphologic (cellular characteristics)
a. It’s based on erythrocytes size and color.
Relationship of morphologic classification and etiologies of Anemia| Morphology| Etiology|
Normocytic, normochromic| Acute blood loss, hemolysis|
Microcytic, hypochromic| Iron deficiency anemia, thalas-semia| Macrocytic (megaloblastic), normochromic (large size, normal color)| | 2. Etiologic (Underlying cause)

Clinical Manifestation
Hemoglobin levels are often used to determine the severity of Anemia. * Mild states of Anemia (Hb 10 to 14 b/dL = 100 to 140g/L) may exist without causing symptoms. * Symptoms: palpitation, dyspnea and mild fatigue

* Mild states of Anemia (Hb 6 to 10 b/dL = 60 to 100g/L) * Symptoms: cardiopulmonary symptoms are increased and patient may experience them while resting bounding pulse and roaring in the ears

* Severe states of Anemia (Hb less than 6 = less than 60 g/L) * Symptoms: multiple body symptoms (systolic murmurs)

Integumentary manifestation
Integumentary changes include pallor, jaundice, and pruritus. Pallor is caused by reduced amount of hemoglobin and reduced blood flow to the skin. Jaundice occurs when hemolysis of RCB results in an increased concentration of serum bilirubin.

Cardiopulmonary manifestation
The low viscosity of the blood contributes to the development of systolic murmurs and bruits.

Nursing Management...
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