Ms week 5

• Hematologic or hematopoietic system


  Includes the blood, blood vessels, and blood forming organs (bone marrow, spleen, liver, lymph nodes, and thymus gland)
• Components of the blood

  • Plasma
  • Formed Elements (Erythrocytes or RBC, Leukocytes or WBC, Thrombocytes or Platelets)
• Erythrocytes


  Also called Red Blood Cells or RBC's, function primarily to ferry Oxygen in the blood to all cells in the body, also transports Carbon dioxide out of the body, lifespan of 120 days only
• Plasma contains

  • proteins/albumin, fibrinogen, clotting factors, electrolytes, waste products, nutrients
• Blood pH is 7.35-7.45
• Broad functions of blood - Transportation

  • Respiratory - transport of gases by the RBC
  • Nutritive - transport of digested nutrients from the GIT to the different cells of the body
  • Excretory - transport of metabolic wastes to the kidneys and excreted as urine
• Leukocytosis - total WBC count above 11,000/mm³
• Types of Lymphocytes: B lymphocytes or B cells produce antibodies to incapacitate the antigen, T lymphocytes or T Cells attack antigens directly
• Lymphocytes are created in the bone marrow and migrate to the Thymus where they mature
• Blood average volume is 5-6 liters or approximately 6 quarts
• Broad functions of blood - Regulation

  • Hormones and other molecules that help regulate metabolism are carried in the blood
  • Thermoregulation
  • Protection
  • Blood clotting
  • Leukocytes
• Leukopenia - an abnormally low WBC count
• Major function of blood

  To carry necessary materials (oxygen, nutrients) to cells and to remove CO2 and metabolic waste products
• Plasma proteins


  The most abundant solutes in the plasma - Albumin, Globulin, Fibrinogen
• Leukocytes


  Also called White Blood Cells or WBC's, protect the body against any damage, are able to slip in and out of the blood vessels by ameboid fashion in a process called diapedesis
• Arterial blood is usually bright red in color compared to venous blood which has a darker color, due primarily to the large concentration of oxyhemoglobin found in arterial blood
• After becoming immunocompetent, the B & T cells transfer to the lymph nodes & spleen
• Macrophages arise from monocytes
• Liver and Spleen act as the graveyard of RBCs
• 1. Cells


  • Have a license to KILL, HELP, and Suppress
• Thrombocytes are also called Platelets and are important in blood clotting
• Macrophages


  Arise from monocytes formed in the bone marrow and have a major role to engulf foreign particles
• Humoral (Antibody-Mediated) Immune Response

  B Cells mature into Plasma Cells responsible for Antibody production
• Erythropoietin is secreted by the kidneys to stimulate the Red Bone Marrow to produce more RBCs when blood oxygen levels decline
• 1. Cells

  • Killer T Cells, Helper T cells, Suppressor T Cells
• Classes of Immunoglobulins

  • Immunoglobulin M (IgM), Immunoglobulin A (IgA), Immunoglobulin D (IgD), Immunoglobulin G (IgG), Immunoglobulin E (IgE)
• Cellular (Cell-Mediated) Immune Response

  1. Cells respond directly to antigens and destroy target cells through secretions of Lymphokines and Perforin
• Erythropoiesis requires Erythropoietin, Iron, Folic Acid, Vitamin B6, Vitamin B12, and Vitamin C
• Hematopoiesis (Blood Cell Formation) occurs in the Red Bone Marrow and includes Erythropoiesis for RBC production
• Hemostasis (Blood Clotting)


  Includes Platelet Plug Formation, Vascular Spasms, and Coagulation or Blood Clotting
• White Thrombus

  Platelets release chemicals to attract more platelets to the injured site
• Iron Deficiency Anemia is the most common type of anemia
• Coagulation or Blood Clotting

  1. Thromboplastin is released by damaged cells

  2. Plasma Clotting Factors form an activator that triggers the Clotting Cascade

  3. A Blood Clot is formed

  4. Serum is squeezed out within the hour pulling the ruptured edges together
• Iron Deficiency Anemia commonly results from blood loss, increased metabolic demands, syndromes of gastrointestinal malabsorption, and dietary inadequacy
• Pernicious Anemia usually occurs in men and women over age 50, with an increase in blue-eyed persons
• Nursing Interventions for Iron Deficiency Anemia (continued)

  1. For clients with poor absorption or continuous blood loss: IM or IV of Iron Dextran

  2. Give dietary teaching – liver, meats, nuts, egg yolk, shellfish, legumes, etc.

  3. Increase intake of roughage and fluids to prevent constipation
• Assessment Findings of Iron Deficiency Anemia

  • Mild cases – asymptomatic
  • Fatigue
  • Dyspnea
  • Palpitations & dizziness
  • Pallor
  • Brittle hair & nails
  • Pica
  • Glossitis
  • Cheilosis
  • Koilonychia
• Pernicious Anemia results in abnormally large erythrocytes and hypochlorhydria
• Vascular Spasms

  Platelets release Serotonin causing spasms of the blood vessel, constricting it & decreasing blood flow
• Iron stores are depleted in Iron Deficiency Anemia, resulting in a decreased supply of iron for the manufacture of hemoglobin in RBC’s