Hematology

Hematocrit (Hct): - Measure of packed cell volume of RBC expressed as a % Men: 39-50% Women: 35-47%

Hemoglobin (Hb): - Measurement of gas carrying capacity of RBC Men: 13.2-17.3g/dl Women: 11.7-16.0g/dl

Neutropenia: - Abnormally low number of neutrophils in the blood Less than < 1500mm (normal 3000 7000mm) Neutrophils: - A type of white blood cell, help fight bacterial infections. - Most abundant WBC - Side effects of medication, chemotherapy, viral infections Reticulocytes: - Young red cells just released from the bone marrow. - The Retic count tells us how the marrow factory is doing. - Immature RBCs, less than 1% Thrombocytopenia: - Abnormally low platelet count - Bleeding may occur Less than < 100,000-150,000ul (normal 150,000-400,000ul) ESR Erythrocyte sedimentation rate: - Indicative of inflammation - Increased ESR is common during acute and chronic inflammatory reactions Men: 1-15mm Women: 1-20mm

*****ANEMIA******
- A deficiency in the number of RBC, quantity of HgB and the volume of HCT. - There is an abnormality with the structure or function or number of RBCs. - Anemia is not a disease; it is a manifestation of a pathologic process. - Primary hematological problems - Secondary to defects in other body systems - This can lead to hypoxia, a decrease in the oxygen carrying capacity of the blood. CLINICAL MANIFESTATIONS: (Primarily caused by the bodys responses to tissue hypoxia) Mild (10-14 Hgb) - Generally asymptomatic, symptoms can occur with disease or exertion. Moderate (6-10 Hgb) - Cardiopulmonary symptoms may be increased and may be associated with rest as well as activity. - Palpitations, fatigue, dyspnea, & diaphoresis Severe (Less than < 6 Hgb) - Symptoms involve many body systems. - It is caused by severe tissue hypoxia. Pallor, chronic fatigue, chills, HR, murmurs, can lead to CHF, angina, MI - Ischemia - Tissue hypoxia - Chronic fatigue - Sensitivity to cold - Blood is shunted to the major organs - Pallor (reduced hemoglobin and blood flow to skin) - Decreased CO leads to Increased HR - Murmurs due to lack of blood volume - CHF can occur to the increased strain on the heart - In severe cases, angina and MI can occur.

NURSING IMPLEMENTATIONS: - Dietary and lifestyle changes - Blood products - Blood transfusions - Drug therapy Erythropoietin (Procrit, Epogen) - Oxygen therapy GERONTOLOGIC CONSIDERATIONS: - Anemia is common in older adults - Anemia of chronic disease - Nutritional deficiencies - Signs and symptoms unrecognized - Attribute them to the normal aging process - Common signs and symptoms include: pallor, confusion, ataxia, fatigue, worsening angina. NUTRIENTS NEEDED FOR ERYTHROPOESIS: Vitamin B12 RBC maturation (red meats) Folic Acid RBC maturation (green leafy vegetables, liver, meat, fish legumes, whole grains) Iron Hemoglobin synthesis (liver and muscle meats, eggs) Vitamin B6 Hemoglobin synthesis (meats, legumes, potatoes) Amino Acids Synthesis of nucleoproteins (eggs, meat, milk, poultry, fish) Vitamin C Aids in iron absorption (citrus fruits, green leafy veggies, strawberries, cantaloupe)