Running head: BLOOD DISORDERS

Blood Disorders Ann Gove HCA/240 August 12, 2012 Margaret Mcgannon

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Blood Disorders- Thrombocytopenia Spencer who has thrombocytopenia, a term given for low platelet count which is a blood disorder that involves the thrombocytes that play an important role in the clotting of blood. This condition is given when the term when for any reason your platelet count drops below the normal range. Normally a person has 150,000 to 450,000 platelets per microliter of circulating blood, it may surprise some to learn that your platelets only have a lifespan of about ten days, so your body is continuously producing new platelets in your bone marrow. Thrombocytopenia.(2012). There are many causes of thrombocytopenia and most often occurs as a result of a separate disorder such as Leukemia or an immune system problem or may be a side effect from a medication. Pregnancy can also cause mild thrombocytopenia, bacteria in the blood and sometimes thrombocytopenia may be idiopathic; meaning unknown and your body mistakenly identifies platelets as a threat and forms antibodies that attack them. The signs and symptoms of thrombocytopenia can appear suddenly or over time, mild thrombocytopenia often has no signs and is diagnosed through a blood test. The first signs of this disorder are external bleeding; this may cause purpura or petechiae. Purpura is purple, brown, and red bruises. This bruising may happen often and easily. Petechiae are small red or purple dots on your skin. (What Is Thrombocytopenia, n.d.). Other signs are prolonged bleeding even after a minor cut, nosebleeds or bleeding from gums when brushing your teeth. Other severe and possibly fatal signs of this disorder are internal bleeding such as blood in the urine or stool or bleeding from the rectum. Headaches and other neurological symptoms are signs of bleeding in the brain; although very rare they can and do occur. With Spencer experiencing symptoms of purpura over the past few weeks and experiencing this morning the petechiae around his eyes after coughing it is extremely important for him to see his doctor as these are signs of a severe

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thrombocytopenia and further tests need to be evaluated to rule out a more serious reason for his thrombocytopenia. When preventing thrombocytopenia it depends on its specific cause. Usually this condition isnt one that can be prevented and is usually from an underlying cause, in the case of pregnancy induced thrombocytopenia it usually resolves itself after giving birth there are things that can be done to prevent health problems associated with this condition. One important lifestyle change is to avoid alcohol as alcohol slows the production of platelets. Avoid medicines that have decreased your platelet count in the past and that may affect your platelets such as aspirin and ibuprofen. It is important to avoid toxic chemicals as pesticides, and benzene slow platelet production. Talk to your doctor about getting vaccines for viruses that affect your platelets. Taking safety precautions is important in preventing injuries or bruising that can cause bleeding so its best to avoid contact sports. As shown below Thrombocytopenia

purpura (bruises) and petechiae (dots) in the skin. Thrombocytopenia pictures (2008).

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Blood Disorders- Iron Deficiency Anemia When we talk of anemia and the many different types the most common form is iron deficiency anemia. In our bodies the red blood cells the most abundant cells in the human body, these cells are biconcave sacs filled with an iron rich oxygen carrying protein called hemoglobin. In iron deficiency anemia when the iron stores of the body becomes depleted, iron deficiency occurs and with this progression of this deficiency the red blood cells lose their shape and now appear cigar shaped, and they cannot provide your body with the iron or oxygen from them you need. (Zelman, Tompary, & Raymond, Mulvihill, "Chapter 7, A Systemic Approach," 2010). You get iron from certain foods, and your body reuses iron from old red blood cells some causes of this disorder is an iron poor diet (the most common), your body cannot absorb iron very well, even though youre eating enough iron. Long term blood loss usually through menstrual periods, or bleeding in the digestive tract is another cause of anemia to. Rapid growth in the first year of life or in adolescence, when more is needed can also cause this type of anemia. Another important cause of iron deficiency anemia in children is lead poisoning. Children like Lily a four- year- old girl who like many children her age is a picky eater. With a small budget for feeding her large family her mother cannot provide some of the important foods necessary to help prevent this common disorder and Lilys diet is mainly comprised of foods such as pasta, breads, and hot dogs, along with artificial fruit punch drinks. Symptoms of this type of anemia can vary from having no symptoms if this is a mild case to life threatening symptoms in severe cases symptoms can range from. The "University of Maryland Medical Center" (2011) website. Blue-tinged or very pale whites of the eyes Blood in the stools

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Brittle nails Decreased appetite (especially in children) Fatigue Headache

Pale skin (pallor) Shortness of breath Irritability Unusual food cravings (called pica) Weakness

In Lilys case because her mother cannot provide the proper nutrition for her to receive enough iron from her diet, and Lilys pickiness of foods she has developed symptoms of iron deficiency anemia as is feeling tired all of the time, and is very pale both common symptoms of this disorder from an iron poor diet. Fortunately for Lily her disorder is one which is preventable and treatable but that doesnt mean its attainable. Unfortunately Lilys mom is in a predicament like many families are today, unable to afford the proper foods for their children to eat a healthy diet. The problem with something that seems so simple to fix can cause these children with this type of anemia to have a huge impact on their school performance, decreased attention spans, reduce their alertness, and have learning difficulties. According to University of Maryland Medical Center (2010). If the diet cannot include iron rich foods such as raisins, meats, (especially liver), fish, poultry, egg yolks, whole-grain breads, an iron supplement should be taken daily. Iron supplements have been shown to improve learning, memory, and cognitive performance.

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Normal red blood cells notice the biconcave shape of the cells to carry the oxygen to the body and its The Weblog (2012) website

The Weblog (2012) website. Notice the shape of the iron deficiency anemia red blood cells, they are no longer biconcave but now are cigar shaped

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Blood Disorders- Sickle Cell Anemia Before we discuss the blood disorder Sickle Cell disease or anemia that Davon may have lets first understand the disorder. Sickle cell affects the red blood cells (erythrocytes) their the oxygen carrying cells that carry oxygen from the lungs to the bodys tissue and taking the carbon dioxide back to your lungs to be exhaled. American Red Cross- Blood Components.(2011). While evaluating a child for Sickle Cell disease is usually done at birth before a baby comes home from the hospital by doing a simple blood test called a hemoglobin electrophoresis. With Davons mother a known carrier he should have been previously tested, but with a new Pediatrician and Davon soon starting school it is good choice for his mom to have him tested at this time, and with Davon showing no symptoms of the disease at this time it is helpful to know if he has it or if he is a carrier like his mom. The sickle cell disease or sickle cell anemia as commonly known is an incurable inherited blood disease, with an average life span of 50-60 years of age, but it depends on the type of disorder and how it affects their health. This disease is caused by abnormal hemoglobin type called hemoglobin S, protein part of the RBCs that carries the oxygen and is an inherited blood disease that is passed genetically from each parent with the gene. Sickle cell disease is common in people whose ancestors are from Africa, India, Middle East, and Mediterranean countries are more likely to inherit the gene. If only one parent has the gene they can pass it on to the child, and they will have the sickle-cell trait, which means you dont have the disease but can pass the gene onto your children. Approximately 10% of African-Americans have the sickle cell trait. Sickle cell disease is when the normally round red blood cells are in the shape of a sickle or crescent moon, in normal red blood cells the life span is 120 days, compared to someone with sickle cell the life span is usually no more than 20 days. WebMD(2010). Normally red blood

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cells move easily through the blood vessels, taking oxygen to your body, but in sickle cells they develop crystals in the cells making them rigid and inflexible and can cause them to get stuck and block the blood vessels resulting in hemolytic anemia and cause pain, and without oxygen getting to the organs they can be damaged as well as harming muscles and bones. This condition is an extremely painful condition resulting in decreased quality of life and lifelong issues with infections, pain, anemia and strokes. (Zelman, Tompary, & Raymond. J. Holdaway. Mulvihill. M.L., A Systemic Approach, 2010). The symptoms of sickle cell usually do not occur until the child is around six months of age, this is because until six months the infant is protected by the high fetal hemoglobin (hbf) in their blood which protects their red blood cells from sickling. WebMD (2010). Sickle cell anemia is called a crisis in which painful episodes occur that can last anywhere from hours to days. During these crisis there can be pain in the bones of the back, the long bones, and in the chest. Some may experience an episode every few years and others may have many episodes each year, requirering hospitalization for symptoms of fatigue, abdominal pain, jaundice (yellowing of the skin, eyes), shortness of breath, rapid heart rate (tachycardia), infections, fever and pain management and intravenous fluids. Some people may not know they have the disease until a crisis occurs, or realize they are carriers so it is important for anyone who is unsure of their sickle cell status to be tested. A.D.A.M. (2010). While sickle cell is an inherited, incurable disease, and it is possible for people to die from the disease it is a manageable disease. Early treatment for children includes daily antibiotics from two months to five years of age to help prevent infections and routine immunizations are important. Many with this disease receive transfusions of healthy red blood cells to help carry oxygen to their tissues more effectively and treat complications. Some ways a

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person with this disease try to stay as healthy as possible and maybe lessen the crisis episodes or the severity are to learn the triggers of a crisis. Avoid triggers like cold, windy temperatures, dehydration, and avoid too much exercise. Low oxygen caused by smoking, plane flights, and high altitudes is another common trigger. This may help in decreasing the flare-ups but this disease cannot be prevented. WebMD.(2010). The most important thing to do is to eat a balanced, healthy diet, take medications, including folic acids, exercise in moderation, get plenty of rest, and avoid alcohol, drugs. Remember to learn as much as you can about your disease so you can live a full active life, knowing your limits and triggers. Miller.MD.(2009).

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Sickled Cells

Normal Cells

The Mason (2009) website.

The Mason (2009) website.

The "National Heart Lung And Blood Institute" (2011) website. Depiction of normal RBCs in the veins and the sickle cells in the veins and causing a crisis by clumping up in the veins causing pain and other complications.

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REFERENCES

Zelman, M., Tompary, E., & Raymond, Mulvihill, M.L. (2010). Human diseases (7th ed.). Retrieved from The University of Phoenix eBook Collection. Thrombocytopenia pictures. (2008). American Society for Clinical Pathology, (570981), Retrieved from http://www.medscape.com/viewarticle Thrombocytopenia. (2012, April). Mayo Clinic, DS00691(), Retrieved from http://www.mayoclinic.com What Is Thrombocytopenia. (n.d.). National Heart Lung and Blood Institute, (), Retrieved from http://http;//www.nhlbi.nih.gov Dugdale, D.C. (2010, February 5). Thrombocytopenia. (2012). Retrieved from http://www.urac.org Health Central. (2012). Retrieved from http://www.healthcentral.com Children-Iron Deficiency Anemia. (2010). University of Maryland Medical Center. Retrieved from http://www.umm.edu Glader, B. (2007). Nelson Textbook of Pediatrics (18th ed.). Philadelphia, PA: SaundersElsevier University of Maryland Medical Center. (2011). Retrieved from http://www.umm.edu/ency/article/007134sym.htm Weblog. (2012). The NP Mom. Retrieved from http://thenpmom.wordpress.com/2012/02/15 Zelman, M., Tompary, E., & Raymond. J. Holdaway. Mulvihill. M.L., (2010). Human Diseases. Retrieved from The University of Phoenix eBook Collection. American Red Cross- Blood Components. (2011). Retrieved from http://www.redcrossblood.org Miller.MD. R. E. (2009, July). Sickle Cell Anemia. Teens Health.org, (), p 1-4. http://www.kidshealth.org

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WebMD. (2010). Retrieved from http://www.webmd.com Chen. MD, Y. (2011). Sickle Cell Anemia- PubMed Health. Retrieved from http://www.ncbi.nlm.gov Mason, James. R. (2009). Health all refer. Retrieved from http://health.allrefer.com/pictures-images National Heart Lung and Blood Institute. (2011). Retrieved from http://www.nhlbi.nih.gov/health