Hematologic and immunologic dysfunction
Several tests can be performed to assess hematologic function, including additional procedured to identify the case of the dysfunction. the following discussion is limited to a description of the most common and one of the most valuable tests, the complete blood cell count (CBC). Other procedures, such as those related to iron, coagulation, and immune status, are discussed throughout the chapter as appropriate. The nurse should be familiar with the significance of the findings from the CBC (Table 26-1) and aware of normal values for age, which are listed in Appendix C.
As with any disorder, the history and physical examination are essential to identify hematologic dysfunction, and the nurse is often the first person to suspect a problem based on information from these sources. Comments by the parent regarding the child's lack of energy, food diary of poor sources of iron, frequent infections, and bleeding that is difficult to control offer clues to the more to common disorders affecting the blood. A careful physical appraisal, especially of the skin, can reveal findings (e.g., pallor, petechiae, bruising) that may indicate minor or serious hematologic conditions. Nurses need to be aware of the clinical manifestations of blood diseases to assist in recognizing symptoms and establishing a diagnosis.