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Average bl volume
5-6 quarts
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Plasma
bl vol=
water=
disolved substances=
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serum albumin--
serum globulin--
fibrinogen--
(other substances)
- regulates bl volume
- circulates antibodies
- assists with clotting
- (glucose, urea, resp gases, hormones, electrolytes)
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Solids: formed elements 45% of bl volume
Erythrocytes: RBCs
Hemoglobin (see next)
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Erythropoiesis
production of RBCs in the bone marrow stimulated by poietin (growth factor produced by the kidneys with decreased O2 levels)
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Hemoglobin:
norm range:
Main ingredient in RBCs
- :3.5-5.5 million
- destroyed by liver and spleen--life span 120 days
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Hemoglobin measures:
Norm range:
measure grams of hgb in 100mL/blood
: males 14-18 females 12-16
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Hematocrit measures:
norm range:
measures % of RBCs in whole blood
: 3X the Hgb level, directly affected by the hydration status of the patient
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HGB 10
HCT 46
dehydration
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HGB 10
HCT 22
fluid overload
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Leukocytes:
increased:
decreased:
Granulocytes:
nongranulocytes:
- WBCs
- Leukocytosis
- Leukopenia
- G--Neutrophils, Basophils, Eosinophils
- NG--Lympocytes, monocytes
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Thrombocytes:
Formed in/norm range/ lifespan
- Platelets
- formed in red marrow "sticky"/ 150,000-400,000/5-9 days
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Increased RBCs
Sign of polycythemia or result of dehydration
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Decreased RBCs
Result of anemia
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Increased WBCs
Sign of infection or sign of leukemia
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Decreased WBCs
Type of bone marrow suppression--stop putting out cells. result of steroids, chemotherapy, or autoimmunities
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Increased Plateletes
(hypercoaguability) hyperclotting. High temps can trigger this, stress can trigger, heavy exercise can trigger
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Decreased platelets
Increased risk for bleeding. bone marrow suppression.
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Increased hgb
after blood transfusion
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Decreased Hgb
Result of bleeding and hemorrhage
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Increased Hct
fluid loss, dehydration, prolonged diuretics
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Decreased Hct
Fluid overload
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Arterial bl gases measure:
measure functional abilities of the lungs and exchange of O2 and CO2
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bleeding time
duration of bleeding when a skin incision is made
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prothrombin time
norm range:
- time it takes for a fibrin clot to form after Ca++ and thromboplastin have been added.
- Used to help monitor anticoag therapy
- range: 10-11 sec/ therapeutic range:1 1/2X norm
- eval coumadine therapy
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APTT/PT (Activated Partial Thromboplastin Time)
norm time;
measures when fibrin clots can be formed, but different point (3rd stage)
- time:25-36sec
- monitor hep therapy
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Sed rate (ESR)
Help eval the course and chronic illness of disease
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Paul Bunnell Test
Test for mono
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Schilling test
- 24 hour urine test. used to eval pernicious anemia.
- give inj of vit B12-test is norm if pt absorbes the B12 and circulates thru GI tract and excreted byu kidney. Abnorm= B12 not in urine--excreted in bowel
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A, B, AB contain A & B protein. O contains no protein
500 mL of whole bl will increase RBCs and Hgb 15% in 24 hours
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o-
o+
universal donor
universal recipient
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Whole Blood
plasma, blood, everything. usually K+ added as preservative (important to monitor with pt with kidney--may rise)
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Plasma
Fluid portion of blood. Suck off plasma part and freeze it. can give plasma w/o everything else in blood
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Platelets
can freeze well--can use to help with clotting factors. can make "platelet packs" and use for pts with bleeding disorders
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Proteins
can take proteins out (globulins in particular). help body with immune effects
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Packed cells
cells w/o the plasma--out of whole blood. Give if vol of bl in normal, but have a need to hgb--may need O2 (packed RBC) 300-350mL
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Laukocytes
WBC- can give for lifethreatening infections--may not have enough WBCs or may have immature WBCs
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