Post-hemorrhagic anemia

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Post-hemorrhagic anemia by Mind Map: Post-hemorrhagic anemia

1. pathophysiologic etiology

1.1. Acute blood loss following a trauma or surgery in a short period of time. Low number of hemoglobin and red blood cells. RBCs have hemoglobin that carry oxygen.

1.2. "Damage to vessels exposes collagen fibrils that trigger a series of adhesive reactions, allowing platelets to bind to the subendothelium and to other platelets to form a temporary hemostatic plug." (Kruger, 2017)

1.2.1. The hemostatic plug stops bleeding in a superficial wound.

2. causative factors

2.1. Patients taking certain medications are susceptible to blood loss.

2.1.1. Blood thinners

2.1.2. NSAIDs

2.2. bleeding from minor wounds or the oral cavity

2.3. gastrointestinal bleeding

2.4. bleeding following tooth extraction or surgery;

2.4.1. total knee replacement

2.4.1.1. 47% patients require blood transfusion

2.5. cutaneous manifestations

2.6. menorrhagia

2.7. postpartum hemorrhage

2.8. muscle hematoma

2.9. hemarthrosis

2.10. CNS bleeding.

3. diagnostic tests

3.1. increased levels of factors II, VIII, and X

3.2. shortened bleeding time and PTT

3.3. decreased levels of antithrombin III

3.4. MCMDM-1 VWD Bleeding Questionnaire

3.4.1. grades the worst episode for each of the following: epistaxis; cutaneous manifestations; bleeding from minor wounds or the oral cavity; gastrointestinal bleeding; bleeding following tooth extraction or surgery; menorrhagia; postpartum hemorrhage; muscle hematoma; hemarthrosis; and CNS bleeding.

3.5. measurement of the lactate dehydrogenase (LDH) level

3.6. a coagulation panel with D-dimer

3.7. <10,000/µL: risk for intracranial hemorrhage

3.7.1. acute drop in the platelet count of >50%

3.8. Urine / Stool sample for blood test

3.9. Endoscopy for bleeding

3.10. CBCs

4. Common findings

4.1. weak, tired, dizzy, or lightheaded

4.2. fast or irregular heartbeat

4.3. Pale or cold, clammy skin

4.4. Shortness of breath, or fast, shallow breaths

4.5. Nausea or loss of appetite

4.6. Altered mental status

4.7. Diaphoresis

5. References:

5.1. Brito, S. A., M.D., Rankin, E. A., M.D., & Mcnear, M., PhD. (2016). Acute blood loss anemia in the octogenarian total knee arthroplasty, estimated blood loss and transfusions rates. Journal of the National Medical Association, 108(1), 86-89. doi:http://dx.doi.org/10.1016/j.jnma.2015.12.011

5.2. Kruger, Danielle, PA-C,M.S.Ed. (2017). Treatment of disorders of primary hemostasis. The Clinical Advisor : For Nurse Practitioners, 20(12), 12-20,22-23,26-28. Retrieved from Log In - ProQuest

6. TREATMENTS

6.1. Blood transfusion

6.2. Monitor Vital signs

6.3. Monitor adverse reaction

6.4. Surgery to stop bleeding

6.5. Fluid administration

6.6. Oxygen

6.7. Iron supplements