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Unformatted text preview: Notes Hematologic Disorders / Blood Dyscrasias I. Pediatric Differences in hematologic system from adult: 1. Life span of RBC’s in neonate is shortened. Adult is 120 days, neonate is 100 days. 2. By 2 months of age, erythropoiesis increases, leading to increased reticulocytes in the blood and a rise in hemoglobin. 3. In infants, the long bones of the body are filled with red bone marrow actively producing RBC’s. In early childhood, yellow marrow begins to replace this in the long bones, so blood production is then carried out mainly in the ribs, sternum, scapula, vertebrae, pelvis, and skull. 4. The number of RBC’s in the body varies according to age. At birth, the infant has approximately 5 million RBC’s per cc of blood. This concentration diminishes – by 3-4 months of age the RBC count is 4.1 million /cc of blood. It slowly increases until adolescence when it reaches adult values of about 4.9 million /cc. of blood. 5. The infant has a higher average hemoglobin (17-18 g) and hematocrit (45-50%) than the adult. II. Iron deficiency anemia: 1. The cause of iron-deficiency anemia is poor diets, blood loss as in menstrual periods, increased internal demands for blood production, 2. Diagnostic tests confirm iron-deficiency anemia include hemoglobin and hematocrit, RBC count, serum iron, reticulocytes. 3. The two main treatments are: a. Oral iron supplements – Ferrous sulfate b. Dietary teaching – patient teaching regarding foods high in iron. III. Sickle Cell Disease (SCD)/ Sickle Cell Anemia Definition: Genetic term that refers to a group of genetic disorders characterized by the production of an elongated, crescent shaped erythrocyte, or abnormal form of hemoglobin, designated as sickle hemoglobin (HbS) in the place of the normal hemoglobin A, chronic hemolytic anemia, and ischemic tissue injury. The most common form of sickle cell disease is sickle cell anemia. Etiology and Pathophysiology: It is an autosomal recessive inherited disease. Occurs almost exclusively among African Americans, occasionally in Hispanics, and infrequently in Caucasians. Defect of beta chain of hemoglobin. Because fetal hemoglobin contains a gamma, not a beta chain, the disease usually will not result in clinical symptoms until the child is about 6 months old when their hemoglobin changes from the fetal form to the adult form of hemoglobin (Hgb A)....
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- Spring '11
- Iron deficiency anemia, Bone marrow