Let's break down aplastic anemia in a way that makes sense.
First thing you need to understand is that your bone marrow in the center of your bones is spongy material that creates blood cells.
So it's a blood cell factory.
Bone marrow stem cells are going to make your red blood cells, your white blood cells, and your thrombocytes or your platelets.
Aplastic anemia is a blood disorder that is caused by your bone marrow not functioning properly.
So if your bone marrow is not functioning properly to make those three things, we're going to have something called pancytopenia.
So because we have low red blood cells, your patient is going to be anemic.
So we're going to notice that they're pale, they're fatigued, they could be dyspneic, especially if they're doing activity.
Your patient will be leukopenic.
Low white blood cells means your patient is at risk for infection, so monitor for signs of infection like a low grade fever.
Thrombocytopenia, because we have decreased platelets, remember we want to make sure we have bleeding precautions in place.
Bleeding from the gums.
So soft bristle, toothbrush, always.
We use electric razors instead of regular razors.
Make sure your patient is on a stool softener, because what you don't want is for them to be straining when they're having a bowel movement and then they're bleeding.
And you have blood in the stool.
Because we have low platelets, your patient is going to have easy bruising, easy bleeding.
You might even notice like little pinpoint dots, petechiae, look like that.
How do we diagnose it?
So it's a bone marrow disorder, so we need a bone marrow biopsy and aspiration.
When they're looking at those cells, they're going to notice that the bone marrow is actually composed of a lot more adipose tissue than it is stem cells.
We need the stem cells to make red blood cells, white blood cells, and platelets.
So that's what diagnoses it, but how do we treat it?
We need a bone marrow transplant.
In order for us to be able to do a bone marrow transplant though, just remember, our immune system is really smart.
So we need to suppress their immune system prior to this transplant.
That way their body doesn't go on attacking and destroying the bone marrow that's being transplanted into them.
And this patient is being immunosuppressed or getting prepared for this bone marrow transplant.
We want to make sure we have this patient on neutropenic precautions.
So what does this mean?
We always do strict hand hygiene, but in this case specifically we want to make sure this patient has a private room.
We don't do raw food, we don't do fresh flowers, things that can make that patient prone of getting an infection.
Limit visitors, especially screen them, like were they in contact with somebody that was sick, are they sick themselves and you're not coming in the room.
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