Medical-surgical Nursing Demystified

CHAPTER 4 Hematologic System^187

• Platelets—replaces needed cells.


• Cryoprecipitate—replaces fibrinogen.


• Administer anticoagulant drugs to decrease coagulation; not done in all
  patients:


• heparin


• Bed rest.

NURSING DIAGNOSES

• Ineffective tissue perfusion


• Risk for deficient fluid volume

NURSING INTERVENTION

• Monitor for bleeding from obvious sites (wounds, suture lines, venipuncture,
  etc.) and occult sites (GI, urine).


• Avoid cleaning clots from exposed areas—may start bleeding from the site
  and not have sufficient clotting factors to stop.


• Explain to the patient:
  
  
  • Avoid situations that might cause bleeding—use electric razor, soft tooth-
    brush, don’t floss between teeth.
  
  
  
  

Hemophilia

WHAT WENT WRONG?

The patient is missing a coagulation factor that is essential for normal blood
clotting and as a result the blood does not clot when the patient bleeds. It is an
X-linked recessive inherited disorder, passed on so that it presents symptoms in
males, and rarely in females. Hemophilia A is the result of missing clotting factor
VIII. Hemophilia B is the result of missing clotting factor IX and is also known as
Christmas disease.

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