1. WCUI Level 2
Medical-Surgical Nursing
Hematology and Lymphatic
System Disorders

2. Text Resources
 Christensen
• CH 47 p.1528
 ATI * CH 26- 27

3. Disorders- 1
 - Review Structure & Function
 - Assessment
 - Lab & diagnostics
 Coagulation
 Platelets and Count

4. Disorders- 1
Review Structure & Function

8. Disorders- 1
Anemia
- Sickle-Cell Anemia
-Transfusions

9. Lymphatic Disorders
 Hemophilia
 Von Willebrand’s Disease
 DIC
 Multiple Myeloma
 Lymphangitis
 Lymphedema
 Hodgkin’s Disease
 Non-Hodgkin’s Disease
 - Leukemia
 - Lymphomas

10. ANATOMY AND
PHYSIOLOGY REVIEW
 The heart pumps 5–6 liters of blood per
minute through adult circulatory system.

11. ANATOMY AND
PHYSIOLOGY REVIEW
 The lymphatic system is a separate vessel
system with two main functions:
• Transport excess fluid from the interstitial spaces
to the circulatory system.
• Protect the body from infections.

12. Disorders- 1
Von Willebrand’s Disease

14. Von Willebrand
 Definition
• most common hereditary bleeding disorder.

15. Von Willebrand
 Causes
• a deficiency of von Willebrand factor. Von
Willebrand factor helps blood platelets clump
together and stick to the blood vessel wall,
which is necessary for normal blood clotting.
• affects both men and women
• most cases are mild
• bleeding may occur after surgery or when you
have a tooth pulled.

16. Disorders- 1
Lymphangitis
&
Lymphedema

22. Disorders- 1
IRON DEFICIENCY
ANEMIA

23. IRON DEFICIENCY ANEMIA
 Occurs when the body does not have
enough iron to synthesize functional Hgb.

24. IRON DEFICIENCY ANEMIA
 Symptoms:
• Fatigue
• Palpitations
• Tachycardia
• Exertional dyspnea
• Pica
• Stomatitis
• Glossitis
• Brittle hair.

27. IRON DEFICIENCY ANEMIA
 Treatment includes
• iron preparations and
• changes in diet

28. Disorders- 1
APLASTIC ANEMIA

29. APLASTIC ANEMIA
 Occurs when the bone marrow stops
making enough blood cells.

31. APLASTIC ANEMIA
 Symptoms:
• Fatigue
• Weakness
• Fever
• Palpitations
• Headaches
• mouth ulcers
• Petechiae
• gingival bleeding
• epistaxis

32. APLASTIC ANEMIA
 Treatment includes
• bone marrow transplants and
• medications

33. Disorders-1
PERNICIOUS ANEMIA

34. PERNICIOUS ANEMIA
 Inability to absorb vitamin B12 due to the
absence of intrinsic factor.

35. PERNICIOUS ANEMIA
 Symptoms:
• Weakness
• sore tongue
• Edema
• Ataxia
• Dizziness
• Dyspnea
• Headache
• Fever
• blurred vision, etc.

39. PERNICIOUS ANEMIA
 Treatment includes
• lifetime replacement of vitamin B12.

40. Disorders-1
ACQUIRED HEMOLYTIC
ANEMIA

41. ACQUIRED HEMOLYTIC ANEMIA
 Destruction of RBCs occurs, and iron and
hemoglobin are released.

42. ACQUIRED HEMOLYTIC ANEMIA
 Symptoms:
• Mild fatigue and pallor
• Jaundice
• Palpitations
• Hypotension
• Dyspnea
• Back and joint pain

45. ACQUIRED HEMOLYTIC ANEMIA
 Treat to
• remove cause
• also blood transfusions
• Splenectomy
• medications

46. Disorders-1
SICKLE CELL ANEMIA
(INHERITED HEMOLYTIC
ANEMIA)

47. SICKLE CELL ANEMIA (INHERITED
HEMOLYTIC ANEMIA)
 Genetic disorder that causes abnormally
shaped red blood cells.

51. SICKLE CELL ANEMIA (INHERITED
HEMOLYTIC ANEMIA)
 Symptoms include
• anemia
• enlarged heart
• fatigue
• jaundice
• chronic leg ulcers
• tachypnea
• dyspnea
• arrhythmias
• severe pain

53. SICKLE CELL ANEMIA (INHERITED
HEMOLYTIC ANEMIA) (continued)
 Treatment includes medications and
symptomatic care during crises.

54. Disorders-1
POLYCYTHEMIA

55. POLYCYTHEMIA
 Increased production of red blood cells.

58. POLYCYTHEMIA Symptoms:
 headaches
 dizziness
 tinnitus
 blurred vision
 fatigue, weakness
 pruritis
 exertional dyspnea, angina
 increased blood pressure and pulse.

60. POLYCYTHEMIA
 Treatment includes
• Phlebotomy
• Medications
• Dietary changes

61. Disorders-1
LEUKEMIA

62. LEUKEMIA
 Malignancy in which the bone marrow
produces increased numbers of
immature white blood cells that cannot
protect the body from infections.

65. LEUKEMIA (continued)
Four categories:
 Acute myelogenous (AML)
 Acute lymphocytic (ALL)
 Chronic myelogenous (CML)
 Chronic lymphocytic (CLL)

66. LEUKEMIA (continued) Symptoms
 fever
 chills
 fatigue
 pallor
 malaise
 tachycardia, tachypnea
 petechiae, bruising
 epistaxis, melena, gingival bleeding
 increased menstrual bleeding.

67. LEUKEMIA (continued)
 Treatment includes
• Chemotherapy
• Radiation
• Blood products
• Antibiotics
• Bone marrow transplants.

68. Disorders-1
AGRANULOCYTOSIS

69. AGRANULOCYTOSIS
 Reduced number of granulocytes.

70. AGRANULOCYTOSIS Symptoms:
 headache
 fever
 chills
 fatigue
 mucous membrane ulcerations
 low white blood counts

71. AGRANULOCYTOSIS
 Treat to remove the cause of bone marrow
suppression and treat or prevent infection.

72. Disorders-1
DISSEMINATED
INTRAVASCULAR
COAGULATION (DIC)

73. DISSEMINATED INTRAVASCULAR
COAGULATION (DIC)
 Syndrome of alternating clotting and
hemorrhaging due to a primary disease
process or condition.

76. DISSEMINATED INTRAVASCULAR
COAGULATION (DIC)
 Symptoms include
• oozing from a venipuncture mucus membrane,
wound.

77. DISSEMINATED INTRAVASCULAR
COAGULATION (DIC)
 Treatment:
• blood replacement and medications, and for
primary condition.

78. Disorders-1
HEMOPHILIA

79. HEMOPHILIA
 Inherited bleeding disorder in which there is
a lack of clotting factors.
 The main symptom is bleeding.
 Treatment includes replacement of missing
clotting factors.

83. Disorders-1
THROMBOCYTOPENIA

84. THROMBOCYTOPENIA
 Decrease in the number of platelets in
the blood.

86. THROMBOCYTOPENIA
 Symptoms:
• Petechiae
• Ecchymoses
• Bleeding from mucous membranes.

88. THROMBOCYTOPENIA
 Treatment:
• transfusions of platelets
• Splenectomy
• Medications
• diet changes

89. Disorders-1
HODGKIN’S LYMPHOMA &
NON-HODGKIN’S LYMPHOMA

90. HODGKIN’S LYMPHOMA
 Rare lymphoma usually arising as painless
swelling in a lymph node.

92. HODGKIN’S LYMPHOMA
 Painless enlarged lymph nodes in neck,
groin, above clavicles, fatigue, pruritis,
fever, night sweats, anemia.

94. HODGKIN’S LYMPHOMA
 Treatment includes
• Radiation
• Chemotherapy
• Diet changes

95. NON-HODGKIN’S LYMPHOMA
Symptoms:
 enlarged, painless lymph nodes in neck,
axillary, abdominal, and inguinal areas
 fever, night sweats
 excessive tiredness
 Indigestion
 abdominal pain
 loss of appetite
 bone pain

98. NON-HODGKIN’S LYMPHOMA
 Treatment:
• Chemotherapy
• Radiation

99. Disorders-1
MYELOMA

100. MYELOMA
 Plasma cells become malignant, crowd out
normal cell production, destroy
normal bone tissue, and cause pain.

102. MYELOMA
 Symptoms:
• bone pain, swollen and tender joints, low-grade
fever, general malaise.
 Myeloma is not curable, so treatment is
symptomatic.

103. Coming UP…