Nursing Care of Patients with Hematologic Disorders

1
Nursing Care of Patients with Hematologic
Disorders
2
Assessment and Diagnostic Findings

• Hematologic Studies
• - CBC.
• - Hemoglobin and hematocrit.
• Bone Marrow Aspiration Biopsy
• - Assess the quantity and quality of each
  type of
• cell produced in the bone marrow.

3
Anemia

• Anemia is the lack of sufficient circulating
  hemoglobin to deliver oxygen to tissues.
• Causes
• - Chronic diseases.
• - Inadequate production of RBCs.
• - Destruction of RBCs.
• - Blood loss.
• - Deficits in nutrients.
• - Heredity.

4
Anemia (contd)

• Types Of Anemia
• 1. Folic Acid Deficiency Anemia.
• 2. Iron Deficiency Anemia.
• 3. A plastic Anemia.
• 4. Pernicious Anemia.
• 5. Sickle Cell Anemia.
• 6. Thalassemia.
• 7. Glucose-6- phosphate dehydrogenase (G6PD)

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Anemia (contd)

• Clinical Manifestations
• 1. Pallor.
• 2. Fatigue, weakness.
• 3. Dyspnea.
• 4. Palpitations, tachycardia.
• 5. Headache, dizziness, and restlessness.
• 6. Slowing of thought.
• 7. Paresthesia.

6
Anemia (contd)

• Nursing Management
• 1. Direct general management toward addressing
  the cause of anemia and replacing blood loss as
  needed to sustain adequate oxygenation.
• 2. Promote optimal activity and protect from
  injury.
• 3. Reduce activities and stimuli that cause
  tachycardia and increase cardiac output.
• 4. Provide nutritional needs.
• 5. Administer any prescribed nutritional
  supplements.
• 6. Patient and family education

7
Leukemia

• Leukemia Is uncontrolled proliferation of white
  blood cells (WBCs) in the bone marrow.
• Types of Leukemia
• - Acute myelogenous Leukemia (most common in
• adults)
• - Acute Lymphocytic Leukemia (most common in
• children)
• - Chronic Myelogenous Leukemia (uncommon
  before age 20)
• - Chronic Lymphocytic Leukemia (most common in
  
• persons 50 years of age and more)

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Leukemia (contd)

• Etiology
• Underlying cause is unknown.
• Predisposing factors
• - Exposure to radiations.
• - Chemical agents.
• - Heredity.

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Leukemia (contd)

• Signs Symptoms
• - Pallor, fatigue, weakness, fever, weight
  loss, abnormal
• bleeding and bruising, lymphadenopathy.
• - Splenomegaly, hepatomegaly, bone and joint
  pain,
• headache, and neurologic dysfunction.

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Leukemia (contd)

• Diagnostic Evaluation
• - CBC and blood smear.
• - bone marrow aspiration and biopsy.
• Nursing Management
• 1. Preventing infection.
• 2. Preventing and managing bleeding.
• 3. Patient education and health Maintenance.
• 4. Reducing pain.
• 5. Improving activity tolerance.

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Lymphoma

• Lymphomas are malignant disorders of the
  reticuloendotheial system that result in an
  accumulation of dysfunctional, immature lymphoid
  derived cells. They classified according to
• - The predominant cell type.
• - The degree of malignant cell maturity.
• - Types of lymphomas (Hodgkins, Non-
• Hodgkins lymphomas)

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Lymphoma (contd)

• Hodgkins disease affects young adults, higher
  incidence among males than women.
• Non-Hodgkins disease affects men more than women
  , the incidence increases with age.

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Lymphoma (contd)

• Signs Symptoms
• 1. Painless and enlargement of lymph nodes
  (cervical,
• axilla, groin)
• 2. Fatigue, weight loss, chills, fever, night
  sweats,
• pruritus.
• 3. Dyspnea, dysphagia.
• 4. Splenomegaly and hepatomegaly

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Lymphoma (contd)

• Diagnostic evaluation
• - lymph node biopsy to detect type.
• - CBC, bone marrow aspirate and biopsy to
  detect
• bone marrow involvement.
• - Liver and kidney function tests.
• - Ct scan.

15
Lymphoma (contd)

• Nursing Management
• 1. Administer analgesics as prescribed.
• 2. Maintain skin integrity.
• 3. Preserving oral and GI Tract Mucous
  Membranes.
• 4. Patient education and Health Maintenance.