NR 324 Week 4 EDAPT_Hematologic Alterations

erythrocytopenia (low RBC count) can be caused by: • Folate deficiency • iron deficiency • excess menses Normal Laboratory Values • Red Blood Cells (RBC) ▪ Female: 4.2-5.4 x 106 ▪ Male: 4.7-6.1 • Hemoglobin ▪ Female: 12-16 g/dL ▪ Male: 14-18 g/dL • Hematocrit ▪ Female: 37%-47% ▪ Male: 42%-52% • WBC: 5000-10,000 • Platelet Count: 150,000-400,000 Red blood cells are responsible for picking up and delivering oxygen, carbon dioxide, iron, and other nutrients throughout the body. Red blood cells do this job for about 4 months before they are recycled and replaced. White blood cells only last about 20 days in the blood before they are destroyed in the lymphatic system. Immature white blood cells, called “bands” and “stabs,” are used to signal the presence of a new threat. Other white blood cells are triggered as an allergy response. Platelets are the blood cells responsible for repairing injury. They clump together when damage is present and call for clotting factors to surround them as a temporary barrier. Platelets only live for about nine days before they break down and are replaced and recycled. Too many: Thrombocytosis Not enough: Thrombocytopenia If a patient/client is being d/c from the hospital. The appropriate time frame to order a CBC to ensure the platelet count returns to normal is 2 weeks. The life span of a platelet is 9 days, so 2 weeks should be enough time to ensure the platelet count returns to normal. Anemia is measured by looking at three different values: the red blood cell count, hemoglobin, and hematocrit. If one of these three values is below normal, the client has a condition called anemia. This is not a diagnosis; it is a condition caused by an underlying problem. A client can have a normal red blood cell count but a decreased hemoglobin, whereas erythrocytopenia only refers to a low red blood cell count. There are three classifications of anemia, all based on the size of the red blood cell (mean corpuscular volume [MCV]) on the complete blood count (CBC). • Macrocytic anemia—MCV is greater than 100. • Normocytic anemia—MCV is between 80 and 100. • Microcytic anemia—MCV is less than 80. • fatigue or activity intolerance Assessment: Signs • skin color • enlarged or painful lymph nodes • liver enlargement • spleen enlargement • nail changes • jaundice • joint swelling Cell Type Too Many NOT ENOUGH • Impaired gas exchange Impaired gas exchange, altered peripheral tissue Perfusion. Red cells • Risk for thromboembolism Altered cerebral tissue perfusion, risk for shock. Blood pressure, fatigue, and imbalanced nutrition White cells • Impaired tissue integrity Risk for infection • Hyperthermia • Risk for shock Platelets • Risk for thromboembolism Risk for bleeding, risk for shock ➢ Erythrocytosis (polycythemia vera) • impaired gas exchange • risk for thromboembolism ➢ Erythrocytopenia (anemia) • impaired gas exchange • altered peripheral tissue perfusion. • altered cerebral tissue perfusion. • risk for shock Nursing Diagnoses Nursing Actions • Fatigue • Imbalanced nutrition • Monitor for