Introduction

Hematological disorders refer to blood conditions that affect blood and organs that are facilitate

the formation of blood. The functions of blood in the body are many and disorders may be

identified as the blood passes through the heart, veins, capillaries and arteries. Blood is crucial in

providing components such as oxygen, hormones and electrolytes to different tissues in the body.

Hematological disorders impair the normal functioning of the body and as such, it is important

that medical professionals such as nurses are able to identify symptoms associated with blood

disorders (Zhang, Wei & Ma, 2019). Different blood disorders require different priority

interventions to save the lives of clients. Blood disorders include anemia, cancers of the blood,

sickle cell disease and genetic disorders. Blood disorders require immediate nursing

interventions in order to ensure that clients are relieved of their pain and to ensure that body

organs are not damaged.

SCENARIO 1

Data collection report

The registered nurse should be immediately made aware of the following. The nurse should

report that the client in room three has been recovering from septic shock. The nurse should also

report that blood was oozing out of the two IV sites on his left arm. The tea colored urine is an

important detail that should also be included in the report. It is vital to report that blood is oozing

from the client’s central line in the chest.

Reasons for data collection report

Since the client has a history of septic shock it is important that the registered nurse monitor

blood levels, hemodynamic status and control infection if any. The two IV sites on the client’s
left arm needs to be assessed for infection or swelling; the arm also needs to be elevated to

relieve pressure on the arm. Tea colored urine that may be caused by blood in the urine could be

a sign of inflammation of the kidneys, which signifies that further tests need to be done to assess

kidney function (Formeck et al., 2022). The client’s central line to the chest needs to be changed

regularly, every 24 to 48 hours and apply pressure dressing if bleeding is seen to persist (Brown

& Semler, 2019).

Risk Factors for Disseminated Intravascular Coagulation (DIC)

The client’s history with septic shock resulting from complications with sepsis may put him/her

at a risk of uncontrollable bleeding. This is because DIC results from disorders with blood

clotting. Sepsis is a major cause of DIC in patients due to extensive inflammation in the body,

which, combined with low blood pressure, and organ dysfunction may lead to DIC complications

(Iba et al., 2021).

SCENARIO 2

Nurse’s intervention on knee pain

The nurse should be concerned about the client’s knee pain. This is because the pain has been

worsening overnight and the pain is at 7 out of 10 on the pain scale. The client has a medical

history of hemophilia A that presents symptoms such as joint pain, which may be acute or

chronic. In this case, the pain is acute. Hemophilia A causes bleeding in joints and muscles that

occur spontaneously. The client despite having no history of trauma is experiencing worsening

pain on the right knee and this is an indicative factor of joint bleeding. The client should be given

medication to help with pain relief before considering further measures as directed by the

physician. Considering the client’s history with hemophilia A, the nurse should immobilize the
right knee and use icepacks to diminish the inflammation and pain. The nurse should also give

prophylactic factor infusions in order to prevent further bleeding and further damage to the joint

(Zhou et al., 2019).

Why hemophilia is prominent in male clients

Hemophilia A affects both females and males; however, it is more common in males.

Hemophilia A is a condition that is caused by genetic mutations in genes that give instructions

for when clotting factor proteins need to create blood clots. The genes are found on the X

chromosome and since males have only one X chromosomes as opposed to their female

counterparts, they cannot offset damage to the gene as females do. Women have an upper hand

in combating this blood disorder since the extra X chromosome can counter the effects of the

gene mutation that causes hemophilia A. If a male gets the hemophilia allele on his X

chromosome, the male will get the blood disorder. The deficiency of blood clotting protein called

the Factor VIII due to the gene mutation causes abnormal bleeding. Additionally, hemophilia is

more common in men since the Y chromosome has no genes for clotting factors. Females who

have hemophilia may also present symptoms that are milder than those that males experience.

Females who are carriers of hemophilia may pass on hemophilia alleles through generations

(Castellano, 2020).

SCENARIO 3

Priority nursing intervention for sickle cell disease

The client presented severe pain of 10/10 in the chest and arms regions in just an hour, the nurse

should administer analgesic agents, this is to reduce inflammation and relieve pain either by

using non-steroidal anti-inflammatory drugs or opioids. The nurse should also elevate or support
joints of the client that are swollen; this is to relieve any pressure on the joints thus reducing

swelling or inflammation; therefore, the arms and chest of the client should be supported and the

client should be in a comfortable condition. The nurse can also help the client to learn some

relaxation techniques such as breathing exercises that will help them to ease their pain and

distract them from the pain. Once the client is relieved from their pain and the severity of the

pain has decreased, the nurse can implement measures that will preserve the client’s function.

Such measures include providing physical therapy, transcutaneous nerve stimulation or

whirlpool baths that will help the client to restore normal nerve function (Tanabe et al., 2019).

Conclusion

Hematological disorders present in different ways that needs immediate nursing interventions,

these three different scenarios have shown the different complications that arise from blood

disorders. These scenarios have depicted blood disorders including sickle cell disease,

hemophilia A and septic shock. These conditions require different priority nursing interventions

and an understanding of the client’s medical history. By establishing, the degree of pain that the

patient is in and the medical history of the patient the nurse is able to treat the patient as required.

Hematological disorders require immediate and effective interventions to ensure that the clients

lead comfortable lives. It is vital that hematological disorders are handled immediately so that

there is no damage inflicted on the organs of the body that ensure they remain as healthy as

possible. Blood is the lifeline of the human body and therefore, proper blood circulation through

different body organs is essential to healthy human body function. This can be attained by proper

nursing interventions for different blood disorders.

 References

Brown, R. M., & Semler, M. W. (2019). Fluid management in sepsis. Journal of intensive care

medicine, 34(5), 364-373.

Castellano, M. E. M. (2020). General concepts on hemophilia A and on women carrying the

disease. Blood Coagulation & Fibrinolysis, 31(1S), S1-S3.

Formeck, C. L., Manrique-Caballero, C. L., Gómez, H., & Kellum, J. A. (2022). Uncommon

Causes of Acute Kidney Injury. Critical Care Clinics, 38(2), 317-347.

Iba, T., Connors, J. M., Nagaoka, I., & Levy, J. H. (2021). Recent advances in the research and

management of sepsis-associated DIC. International Journal of Hematology, 113(1), 24-

33.

Tanabe, P., Spratling, R., Smith, D., Grissom, P., & Hulihan, M. (2019). Understanding the

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Zhang, N., Wei, M. Y., & Ma, Q. (2019). Nanomedicines: A potential treatment for blood

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Zhou, J. Y., Barnes, R. F., Foster, G., Iorio, A., Cramer, T. J., & von Drygalski, A. (2019). Joint

bleeding tendencies in adult patients with hemophilia: it’s not all

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