Lippincott Certification Review Medical-Surgical Nursing

8 Hematologic Disorders

Chapter

Introduction ●● The average adult human has 4.5 to 5.5 L of blood in their body.

●● Blood circulates in the cardiovascular system, carrying oxygen and removing waste from cells. ●● The continuous movement of blood prevents stasis, which can increase the risk of infection and injury. ●● Red blood cells (RBCs), white blood cells (WBCs), and platelets are subject to pathologic alterations that can cause severe disruptions in homeostasis. ●● Nursing history ●● The nurse asks the patient about their chief complaint . ●● A patient with a hematologic disorder may report any of the following signs or symptoms: aching bones, anorexia, bleeding gums, bruising, dyspnea, fatigue, infection, lethargy, malaise, nausea, nosebleeds, numbness, paresthesia, swollen and tender lymph nodes, tarry stools, tingling, vomiting, and heavy menses. ●● The nurse then questions the patient about their present illness . ●● Ask the patient about their symptoms, including when they started, associated symptoms, location, radiation, intensity, duration, and frequency. ●● Question the patient about what factors make the symptoms feel better or worse. ●● The nurse asks about medical history . ●● Ask about the present and past use of prescription and over-the-counter drugs, herbal remedies, and vitamin and nutritional supplements because many of these products can interfere with hematologic function. ●● Ask the patient about previous problems, such as anemia, leukemia, enlarged lymph nodes, malabsorption, and spleen or liver disorders. ●● Ask about previous treatments, such as blood transfusions and radiation treatments. ●● Question the patient about their diet, and look for deficiencies—for example, in folic acid, iron, or vitamin B 12 . ●● Ask about previous infections (cytomegalovirus [CMV], hepatitis C virus, Epstein–Barr virus [EBV], herpes simplex virus, and COVID-19). ●● The nurse then assesses the family history .

●● Ask about a family history of blood and lymph disorders, acquired and genetic. ●● Ask about a family history of cancers involving the blood or lymph systems. ●● The nurse obtains a social history . ●● Ask about ethnicity and race.

●● Inquire about the use of cigarettes, alcohol, and recreational drugs. ●● Ask about occupational or household exposure to radiation or chemicals. ●● Physical assessment ●● The nurse begins with inspection . ●● Observe the patient’s general appearance. Do they appear alert, confused, tired, or irritable? ●● Note the patient’s skin color; look for ecchymosis, diaphoresis, dyspnea, lesions, petechiae, and swelling of the lymph nodes. ●● Note the size and color of their tongue. ●● Ask the patient whether their abdominal girth is enlarged. Copyright © 2025 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.

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