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Normal Composition
- 55% fluid: water and dissolved solutes
- 45% cells and formed elemetns: RBC, WBC, thrombocytes (platelets)
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Hematocrit
- thickness of bloos # of cells per volume of blood
- Too high indicates dehydration or increased cell production
- High Hematocrit = increased stress on heart and increased blood clotting
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Hemoglobin
the portion of the mature RBC that is to carry O2
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Plasma
clear yellow fuild after cells are removed
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Serum
Fluid and solutes remaining after cells and fibrinogen have been removed
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Components Required for Blood Clotting
- Ca ions
- Vitamin K
- Clotting Factors produced by the liver
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Three steps in Blood Clotting
- Immediate Vasoconstriction
- Thrombocytes adhere to underlying tissue - if small vessels forms platelet plug
- If large Vessels coagulation mechanism needed (pg 248 in book)
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Blood Types
- O: universal bonor (lacks A & B antigens)
- A:
- B:
- AB: univeral recipent
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Diagnostic Tests
- CBC: complete blood count
- Differential count: % of each type of WBC
- Hematocrit: RBC's per volume in %
- Hemoglobin: amount of hgb per cell
- Reticulocyte count, bone marrow aspiration and biopsy: used to confirm abnormal production of blood cells (leukemia)
- Chemical analysis of blood: (O2, CO2, enzymes)
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How Clotting disorders are diagnosised
- Bleeding Time
- Prothrombin time (PT): extrinsic pathway
- Partial Thromboplastin time (PTT): intinsic pathway
- INR: extrinsic pathway
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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 hematocrit
- Artificial blood products
- Products to stimulate formation of RBC's
- Bone Marrow or stem cell transplants
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Lymphatic System
- Functions to return excess interstitial fluid & protein to the blood
- defense system by filtering out the bad and returing the good
- consists of vessels, nodes, lymphoid tissue (tonsils, spleen, thymus)
- essential for the proper function of immune system
- If the lymphatic system isn't working the blood values may be off
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Types of Anemia
- Iron Deficiency
- Pernicious
- Aplastic
- Sickle Cell
- Thalassemia
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Iron Deficiency
low iron in diet; especially in puberty, pregnancy, or with excess blood flow
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Pernicious
Deficiency in vitamin B12; during pregnancy can lead to spina bifida
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Aplastic
- decreased WBC decreased RBC platelets due to damaged bone marrow, virus or idiopathic
- RBC's are abnormal and large
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Sickle Cell
- Abnormal Hgn when deoxygenated takes a sickle shopa
- Genetic recessive
- Increased risk of CVA, Mi by occluding arteries
- Painfull Crises
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Thalassemia
genetic defect that results in decreased amount of Hgb & RBC's produced
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Signs and Symptoms of Anemia
Fatigue, pallor, dyspnea, tachycardia (can progress to arhythmis/death) cold intolerance
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Diagnosis of Anemia
- Blood Tests
- Hct
- Hbg
- Blood smears
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Treatment for Anemia
- depends of cause
- Diet (iron & pernicious)
- Blood Transfusions
- Bone Marrow transplant
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Polycythemia
increased production of RBC's, other cells in bone marrow, blood volume & viscosity increase, increased chance for MI
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Signs and Symptoms of Polycythemia
- cyanotic, bluish red skin, enlarged blood vessels, enlarged liver, spleen, heart, increased BP,
- Spleen & Liver Congestion
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Diagnosis & Treatment for Polycythemia
- Diagnosis: Cell counts
- Hgb, Hct
- Treatment: drugs, radiation to suppress bone marrow, plebotomy (removal of blood periodically)
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Hemophelia A
- Etiology: deficit of normal clotting factors
- S&S: prolonged or severe hemorrhage, spontaneous hemarthosis
- Diagnosis: increased PTT, APPT & coagulation time
- These people need to aviod risky behaviors
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Disseminated Intravascular Coagulation
a compication of numerous primary problems. for example OB compications, carcinomas, major trauma, chronic DIC often due to chronic infection
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Signs and Symptoms of DIC
excessive bleeding and excessive clotting, more often hemorrhage is critical problem. Low BP, Respiratory impairments, seizures and decreased responviveness
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Treatment for DIC
- Treat the underlying cause
- treamtent of coagulation imblance is very difficult. Pt is monitored very carefully
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Leukemia
- Pathology: WBC's that are undifferentiated immature, non functional multiply uncontrollably
- S&S: unresponsive infection, excess bleeding, signs of aneamia, bone pain Wt. loss and fatigue
- Diagnosis: blood counts, smears
- Treatment: chemo, maintain nutritions, transfusions, bone marrow transplant
- Therapy: indurance and bone pain
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Hodgkins Lyphoma
- starts as single lymph node, spreads
- S&S; enlarged lymph nodes, spleen = pressure effects generals signs of cancer. recurrent infection due to affect on immune system
- Rx: surgery, chemo, radiation
- if caught early good prognosis
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Non-Hodgkins Lymphoma
- Starts as enlarged painless lymph node
- Multiple node involvement scattered throughout body non-organized pattern of widespread metastases
- Clinical signs staging and treatment similar to hodgkins lymphoma
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