Clinical Learning Guide #3
The Client with a Hematologic Disorder
The hematologic system consists of the blood and the sites where blood is produced, including blood marrow and lymph nodes. In contrast to the anemia states in which there is a defect of erythrocytes and/or hemoglobin, polycythemia is an abnormal increase in erythrocyte mass with a normal or increased hemoglobin level. Leukemia’s demonstrate unregulated proliferation or accumulation of white cells in the bone marrow, replacing normal marrow elements. Lymphomas are neoplasms of the cells of the lymphoid system.
The student will prepare for the clinical assignment by reviewing:
a. common terms related to assessment and management of patients with hematologic disorders.
b. common hematologic laboratory tests.
c. the nurse’s responsibilities for patients donating and receiving of blood products.
The student will obtain one nursing journal article related to the client with a hematological issue.
The student will present an outline and a copy of the article to the faculty during post conference.
Designated students will be prepared to lead the group in a discussion in post conference of the following as pertaining to assigned clients:
Discuss the common needs of clients with blood disorders.
Discuss the common features of the leukemias and the nursing process to assist the client to a higher level of wellness.
Identify nursing interventions for clients with lymphomas including neutropenic, infection, and bleeding preventions.
Compare the bleeding disorders primary thrombasthenia, idiopathic thrombocytopenic purpura (ITP), platelet defects and hemophilia; include the nursing management of clients.
Discuss the nursing process for clients with DIC (Disseminated Intravascular Coagulation), including psychosocial and spiritual aspects.
List the types of blood products available for administration to clients, including those which require a filtered system.
Discuss the major maladaptive (adverse reactions) responses to blood product administration, both acute and delayed.
List the most important concepts in administration of blood products.
Discuss in post conference, nursing interventions for the client with a reaction to a blood product, including psychosocial, spiritual, and cultural aspects.
Discuss in post conference, the moral, ethical/legal aspects of blood product administration.
