Hematological System Final Review

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Author:
dmshaw9
ID:
301669
Filename:
Hematological System Final Review
Updated:
2015-04-28 00:01:12
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Hematological System Final Review
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NPTE,Final Review
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NPTE: Final Review
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  1. Hematopoiesis
    • Normal function and generation of blood cells in bone marrow
    • Regulated by cytokines and growth factors 
    • Disorders = aplastic anemia and leukemias
  2. Erythrocyte Sedimentation Rate (ESR)
    • Rate of RBCs that settle out in tube of unclothed blood
    • Increased levels = inflammation
  3. Shock: Definition and Characteristics
    • Abnormal condition of inadequate blood flow
    • Associated with hypotension, inadequate CO and changes in peripheral blood flow resistance 
    • Hypovolemic shock = hemorrhage, vomiting, diarrhea
  4. Progressive Shock Symptoms
    • Restlessness/anxiety
    • Weakness
    • Fall in body temp
    • Lethargy
    • Pallor with cool, moist skin
  5. Anemia: Definition
    • Decreased hemoglobin in blood
    • Due to decrease/destruction of RBCs, loss of blood
  6. Anemia: Symptoms
    • Fatigue/weakness with minimal exertion
    • Decreased exercise tolerance
    • Dyspnea on exertion
    • Pallor/yellow skin of face, hands, lips, nail beds
    • Tachycardia
    • Bleeding of gums, mucous membranes, or skin
  7. Severe Anemia
    • Hypoxic damage to liver and kidney
    • Heart failure
  8. Chronic Hemolytic Anemia/Sickle Cell Anemia: Definition
    • Hemoglobin released into plasma
    • Decreased O2 delivery to tissues
  9. Sickle Cell Crisis: Definition
    Acute episodic condition occurring in children with sickle cell anemia
  10. Sickle Cell Crisis: Symptoms
    • Pain
    • Acute and severe from sickle cell clots in organs, bones, and joints
    • Acute abdominal pain from visceral hypoxia
    • Painful swelling of hands and feet
    • Persistent headache

    • Bone and joint crises
    • Migratory, recurrent joint pain of extremities and back

    • Neurological manifestations
    • Dizziness
    • Convulsions
    • Coma
    • Nystagmus 

    • Pulmonary (acute chest syndrome)
    • Chest pain
    • Coughing
    • Dyspnea
    • Tachypnea
  11. Sickle Cell Anemia: Complications
    • Vascular: stroke, chronic ulcers, bone infarcts, avascular necrosis of fem head, hand and foot syndrome (dacylitis)
    • Pulmonary: HTN
    • Neurological: paresthesias, CN palsies, blindness, hemiplegia
    • Renal: enuresis, nocturia, hematuria, renal failure
    • Anemic crisis: rapid decrease in hemoglobin
    • Aplastic crisis: severe anemia, associated with acute viral/bacterial/fungal infections 
    • Splenic: liver and spleen enlargement, spleen atrophy
  12. Sickle Cell Anemia: PT Goals and Interventions
    • During sickle cell event → pain control
    • Cold contraindicated
    • Low-mod exercise level (decreased exercise tolerance)
  13. Hemophilia: Definition
    • Hereditary bleeding disorder 
    • Sex-linked, affects males
    • Bleeding spontaneous or result of trauma → internal hemorrhage/hematuria
  14. Hemarthrosis
    • Bleeding in synovial joint spaces 
    • Joints swollen and painful with decreased range of motion
    • Long term → synovitis and arthropathy → bone and cartilage destruction
  15. Hemophilia: Complications
    • Joint contractures (hip, knee, elbow flex, PF)
    • Muscle weakness 
    • LLD
    • Postural scoliosis 
    • Decreased aerobic fitness
    • Equinus gait
    • Lack of knee ext torque 
    • ADL deficiencies
  16. Hemophilia: PT Interventions = Acute Phase
    • RICE
    • Prevent deformity
  17. Hemophilia: PT Interventions = Subacute Phase
    • Isometrics and aquatics
    • Factor replacement just before treatment
    • AAROM → AROM, isokinetics & OKC exercise 
    • Strengthen hip, knee, elbow ext and ankle DF
    • NO CKC & PROM/PASSIVE STRETCHING (risk of myositis ossificans)

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