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KNOWLEDGE COMPETENCIES
Analyze laboratory test results used to assess the status of the hematologic and immune systems:
Complete blood count (CBC)
White blood cell (WBC) differential
International normalized ratio (INR)
Activated partial thromboplastin time
d-dimer
Describe the etiology, pathophysiology, clinical presentation, patient needs, and interprofessional interventions for common hematologic problems in critically ill patients:
Contrast the clinical presentation, patient needs, and principles of management of the immunocompromised patient with that of a patient with an intact immune response.
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The hematologic and immune systems play a major role in the body’s response to illness. Organs and tissues require a continuous supply of oxygen from the red blood cells (RBCs), while the white blood cells (WBCs) provide a first line of defense against infection and mount an immune response. The platelets and other coagulation components are essential for hemostasis. Assessment of these processes and treatment of hematologic and immune problems are an important part of patient management.
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SPECIAL ASSESSMENT TECHNIQUES, DIAGNOSTIC TESTS, AND MONITORING SYSTEMS
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A complete patient assessment guides the selection of screening tests for hematologic and immune problems. Historical data are particularly important and include family history, occupational exposures, lifestyle behaviors, travel, diet, allergies, past medical problems, surgeries, comorbid conditions, transfusion of blood or blood components, and recent and current medications. Abnormal physical assessment data from each body system collectively assist in the identification of risk factors or acute abnormalities pertinent to hematologic and immune function. In addition, a variety of laboratory tests including those listed in Table 13-1 assist the clinician to evaluate problems in these systems.
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