Normal Composition
55% fluid: water and dissolved solutes45% cells and formed elemetns: RBC, WBC, thrombocytes (platelets)
Hematocrit
thickness of bloos # of cells per volume of blood Too high indicates dehydration or increased cell productionHigh Hematocrit = increased stress on heart and increased blood clotting
Hemoglobin
the portion of the mature RBC that is to carry O2
Plasma
clear yellow fuild after cells are removed
Serum
Fluid and solutes remaining after cells and fibrinogen have been removed
Components Required for Blood Clotting
Ca ionsVitamin KClotting Factors produced by the liver
Three steps in Blood Clotting
Immediate VasoconstrictionThrombocytes adhere to underlying tissue - if small vessels forms platelet plugIf large Vessels coagulation mechanism needed (pg 248 in book)
Blood Types
O: universal bonor (lacks A & B antigens)A:B:AB: univeral recipent
Diagnostic Tests
CBC: complete blood countDifferential count: % of each type of WBCHematocrit: RBC's per volume in %Hemoglobin: amount of hgb per cellReticulocyte count, bone marrow aspiration and biopsy: used to confirm abnormal production of blood cells (leukemia)Chemical analysis of blood: (O2, CO2, enzymes)
How Clotting disorders are diagnosised
Bleeding TimeProthrombin time (PT): extrinsic pathwayPartial Thromboplastin time (PTT): intinsic pathwayINR: extrinsic pathway
Blood Therapies
Blood transfusions: whole blood, packed RBC's or packed platelets (administered with severe anemia of thrombocytopenia)Plasma or collaidal volume expanding solutions: high hematocritArtificial blood productsProducts to stimulate formation of RBC's Bone Marrow or stem cell transplants
Lymphatic System
Functions to return excess interstitial fluid & protein to the blooddefense system by filtering out the bad and returing the goodconsists of vessels, nodes, lymphoid tissue (tonsils, spleen, thymus)essential for the proper function of immune systemIf the lymphatic system isn't working the blood values may be off
Types of Anemia
Iron DeficiencyPerniciousAplasticSickle CellThalassemia
Iron Deficiency
low iron in diet; especially in puberty, pregnancy, or with excess blood flow
Pernicious
Deficiency in vitamin B12; during pregnancy can lead to spina bifida
Aplastic
decreased WBC decreased RBC platelets due to damaged bone marrow, virus or idiopathicRBC's are abnormal and large
Sickle Cell
Abnormal Hgn when deoxygenated takes a sickle shopa Genetic recessiveIncreased risk of CVA, Mi by occluding arteriesPainfull Crises
Thalassemia
genetic defect that results in decreased amount of Hgb & RBC's produced
Signs and Symptoms of Anemia
Fatigue, pallor, dyspnea, tachycardia (can progress to arhythmis/death) cold intolerance
Diagnosis of Anemia
Blood TestsHctHbgBlood smears
Treatment for Anemia
depends of causeDiet (iron & pernicious)Blood TransfusionsBone Marrow transplant
Polycythemia
increased production of RBC's, other cells in bone marrow, blood volume & viscosity increase, increased chance for MI
Signs and Symptoms of Polycythemia
cyanotic, bluish red skin, enlarged blood vessels, enlarged liver, spleen, heart, increased BP, Spleen & Liver Congestion
Diagnosis & Treatment for Polycythemia
Diagnosis: Cell countsHgb, HctTreatment: drugs, radiation to suppress bone marrow, plebotomy (removal of blood periodically)
Hemophelia A
Etiology: deficit of normal clotting factorsS&S: prolonged or severe hemorrhage, spontaneous hemarthosisDiagnosis: increased PTT, APPT & coagulation timeThese people need to aviod risky behaviors
Disseminated Intravascular Coagulation
a compication of numerous primary problems. for example OB compications, carcinomas, major trauma, chronic DIC often due to chronic infection
Signs and Symptoms of DIC
excessive bleeding and excessive clotting, more often hemorrhage is critical problem. Low BP, Respiratory impairments, seizures and decreased responviveness
Treatment for DIC
Treat the underlying causetreamtent of coagulation imblance is very difficult. Pt is monitored very carefully
Leukemia
Pathology: WBC's that are undifferentiated immature, non functional multiply uncontrollablyS&S: unresponsive infection, excess bleeding, signs of aneamia, bone pain Wt. loss and fatigueDiagnosis: blood counts, smearsTreatment: chemo, maintain nutritions, transfusions, bone marrow transplantTherapy: indurance and bone pain
Hodgkins Lyphoma
starts as single lymph node, spreadsS&S; enlarged lymph nodes, spleen = pressure effects generals signs of cancer. recurrent infection due to affect on immune systemRx: surgery, chemo, radiationif caught early good prognosis
Non-Hodgkins Lymphoma
Starts as enlarged painless lymph nodeMultiple node involvement scattered throughout body non-organized pattern of widespread metastasesClinical signs staging and treatment similar to hodgkins lymphoma