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The Hematologic and Lymphatic Systems and Assessment

Adult Nursing. The Hematologic and Lymphatic Systems and Assessment. Blood and Blood Cells. Transport oxygen Remove wastes Blood components Plasma RBC WBC Platelets. Blood and Blood Cells. Formation of blood Liver Bone marrow Stem cells.

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The Hematologic and Lymphatic Systems and Assessment

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  1. Adult Nursing The Hematologic and Lymphatic Systems and Assessment

  2. Blood and Blood Cells • Transport oxygen • Remove wastes • Blood components • Plasma • RBC • WBC • Platelets

  3. Blood and Blood Cells • Formation of blood • Liver • Bone marrow • Stem cells

  4. Figure :The formation of different types of blood cells from the stem cell. The stem cell differentiates into one of five types of blast (immature) cells, which then mature into red blood cells (erythrocytes), platelets (thrombocytes), or whit blood cells (leukocytes).

  5. Red Blood Cells • Carry oxygen and carbon dioxide • Biconcave disks

  6. Red Blood Cells • Formed in bone marrow via erythropoiesis • Tissue hypoxia stimulates the kidneys to release erythropoietin to stimulate RBC production in bone marrow

  7. Red Blood Cells • Contain hemoglobin • Life span 120 days • Old RBCs • Destroyed by phagocytes in the spleen, liver, bone marrow, lymph nodes; hemolysis • Amino acids and iron saved and reused by body, circulates as transferrin; stored as ferritin; heme converted to bilirubin • Normal lab values differ by gender

  8. Red Blood Cells • Terms used • Normocytic • Microcytic • Macrocytic • Normochromic • Hypochromic

  9. White Blood Cells • Leukocytes • 5000 to 10,000; make up 1% of total blood volume • Leukocytosis: high WBC count • Leukopenia: low WBC count • Originate from stem cells in bone marrow • Move to where they are needed

  10. White Blood Cells (continued) • Three types • Granulocytes • Eosinophils • Basophils • Neutrophils • Monocytes • Largest WBC • Lymphocytes • Regulate immune response

  11. Platelets • Part of the clotting mechanism • Fragments of cytoplasm without nuclei • Most stored in the spleen • 250,000 to 400,000 in each mL of blood • Excess termed thrombycytosis • Live approximately 10 days

  12. Hemostasis • Blood clotting to stop bleeding • Vessel spasm • Formation of platelet plug • Clot formation • Intrinsic pathway • Extrinsic pathway • Clot retraction • Clot dissolution

  13. Figure: for both the slower intrinsic pathway (on the left) and the more rapid extrinsic pathway (on the right) are necessary to form a stable blood clot.

  14. Lymphatic System • Includes lymph vessels, nodes, organs • Assist immune system • Largest organ is the spleen

  15. Figure for the lymphatic system.

  16. Assessment • Changes in energy level • Usual activities • Pain, burning, tingling • Changes in skin color or temperature • Edema • Bruising, dizziness, fatigue • Diet • Medications • Tobacco, alcohol, recreational drugs • Medical history • Family history

  17. Physical Examination • Inspection • Petechiae • Purpura • Documentation

  18. Figure: Lymph nodes of the head and neck.

  19. Diagnostic Tests • Laboratory • CBC • Clotting studies or coagulation profile • Coombs’ test • Hemoglobin electrophoresis • Iron stores • Schilling’s test

  20. Bone Marrow Aspiration • Nursing care • Preprocedure: consent, purpose, vital signs • Postprocedure: pressure, vital signs, dressing • Teaching: 20 minutes, anesthetic, still, ache

  21. Other Diagnostic Tests • Biopsy • Imaging studies • Lymphangiogram

  22. (continued) Common Laboratory Tests for Hematologic and Lymphatic Disorders

  23. (continued) Common Laboratory Tests for Hematologic and Lymphatic Disorders

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