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Hematologic System
Hemoglobin
Hemoglobin Has Four Iron Hemes
Lots Of Hemoglobin In Red Blood Cells
High O2 Levels Increase O2 Binding
High Temperature Reduces O2 Binding
High CO2 Levels Reduce O2 Binding
Low pH Reduces O2 Binding
Myoglobin Binds Oxygen in Muscle
2 mins
Whole Blood Composition
Characteristics
Plasma
Electrolytes And Other Solutes
Proteins
Albumin
Fibrinogen
Globulins
Water
Formed Elements
Buffy Coat
White Blood Cells (WBC)
Platelets
Red Blood Cells (RBC)
2 mins
Coagulation Cascade Overview
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
2 mins
Clotting Overview
Characteristics
Endothelial Cells are Damaged
Platelets Respond to Exposed Collagen and Stick
Platelets Release Recruiting Factors
More Platelets are Attracted
Soluble Fibrinogen Turns to Insoluble Fibrin
Fibrin Seals the Clot
Clot Dissolves
Liver Produces Clotting Factors
2 mins
Blood Types
Allele A is Dominant
Allele B is Dominant
Allele O is Recessive
Genotypes AA and AO have Type A Blood
Genotypes BB and BO have Type B Blood
Genotype AB is co-dominant and has Type AB Blood
Genotype OO Results in Type O Blood
2 mins
Blood Types and Compatibilities
ABO Compatibility
No Antigens (Type O Blood)
Universal Donor
A Antigen (Type A Blood)
B Antigen (Type B Blood)
AB Antigen (Type AB Blood)
Universal Recipient
Rhesus (Rh) Compatibility
Rh (Rhesus) Antigen
Never Rh+ to Rh-
Considerations
Blood Transfusion
Obstetric Patient
2 mins
Types of Shock
Hypovolemic
Depleted Volume
Cardiogenic
Pump Failure
Obstructive
Indirect Pump Failure
Distributive
Lost Vascular Tone
Neurogenic
Anaphylactic
Septic
2 mins
Lymphatics
Characteristics
Recycles 10% of Interstitial Fluid
Transport Large Lipids from Lacteals
Unidirectional Valves
Lymph Nodes Filter Lymph
WBCs Monitor Lymph for Pathogens
Merge with Veins
2 mins
Types of Blood Products
Types
Whole Blood
Packed Red Blood Cells
Fresh Frozen Plasma
Immunoglobulins
Clotting Factors
Albumin
Platelets
Considerations
Use within 24 Hours
Washing Removes Antibodies
Irradiation Destroys WBCs
2 mins
IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
3 mins
Normal Electrolyte Lab Values
Potassium (K+)
3.5 to 5.0 mEq/L
Calcium (Ca2+)
8.5 to 10.5 mg/dL
Phosphate (PO43–)
2.5 to 4.5 mg/dL
Magnesium (Mg2+)
1.5 to 2.5 mEq/L
Sodium (Na+)
135 to 145 mEq/L
Chloride (Cl–)
95 to 105 mEq/L
2 mins
Potassium (K+) Lab Value
3.5 to 5.0 mEq/L
20 secs
Sodium (Na+) Lab Value
135-145 mEq/L
24 secs
Chloride (Cl-) Lab Value
95-105 mEq/L
28 secs
Calcium (Ca2+) Lab Value
8.5 to 10.5 mg/dL
26 secs
Phosphate (PO43-) Lab Value
2.5 to 4.5 mg/dL
29 secs
Magnesium (Mg2+) Lab Value
1.5 to 2.5 mEq/L
28 secs
BUN (Blood Urea Nitrogen) Lab Values
10-20 mg/dL
40 secs
Creatinine Lab Values
Measures Renal Function
0.6 - 1.3 mg/dL
1 min
Bilirubin Lab Value
0.2-1.2 mg/dL
Increased Bilirubin Causes Jaundice
54 secs
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