Hematological System

Question 1

Anemia

Answer 1

decrease in hemoglobin levels in the blood secondary to decrease in RBC production, destruction or loss of blood

• symptoms
  
  • fatigue and weakness with minimal exertion
  • dyspnea on exertion
  • pallor or yellow skin
  • tachycardia
  • bleeding of gums, mucuous membranes in absence of trauma
  • severe = hypoxic damage to liver and kidney, heart failure
• medical
  
  • variable
  • transfusion
  • nutritional supplements
• PT: RED FLAGS
  
  • exercise should be instituted gradually w/ physician approval
  • perceived exertion levels should be used

Question 2

Sickle Cell Disease

Answer 2

characterized by group of inherited autosomal recessive blood cell disorders; specifically hemoglobin of erythrocytes are abnormal = crescent instead of biconcave. HbSS most severe

• ischemia, occlusion, infarction
• Sickle Cell Crisis
  
  • pain from clots, hand foot syndrome
  • bone and joint crises
  • neurological manifestations
  • pulmonary
• aplastic and splenic crisis

Question 3

Sickle Cell Treatment PT

Answer 3

• During event
  
  • application of warmth
  • relaxation
  • *Cold is contraindicated
• exercise and activity training
  
  • exercise intolerance is common

Question 4

Hemophelia

Answer 4

group of hereditary bleeding disorders

clotting factors 8 and 9 deficient

• bleeding into joints, chronic synovitis
• medical intervention
  
  • blood infusion
  • acetaminophen NOT aspirin
  • RICE and NWB during bleeds
• Complications
  
  • joint contractures
  • muscle weakness
  • LLD
  • postural scoliosis
  • decreased aerobic fitness
  • gait deviations
    
    • equinus and lack of knee ext torque
  • ADLs deficient

Question 5

Hemophelia PT exam and intervention

Answer 5

• exam
  
  • signs/sympt of acute bleeding
  • goni
  • joint deformities
  • muscle strength
  • funx mob
  • pain
  • ADLs
• Intervention
  
  • RICE
  • maintain position
• Intervention Subacute
  
  • factor replacedment before tx
  • isometric and aquatic exercise
  • pain management
  • OKC exercise (NOT CKC)
  • NO PROM
  • contracture management
  • funx gait training as needed
• Chronic Stage
  
  • daily HEP
  • outpatient pt
  • emotional support