Hemophilia is a lifelong, inherited disorder that causes abnormal bleeding. It is a disorder of one’s blood-clotting system, where the plasma part of the blood does not have enough protein to help blood clot. This means that if you have hemophilia, you will bleed for a longer time if you have a cut than others that do not have hemophilia. The danger of this disorder is that one can have deep internal bleeding or bleeding into one’s joints. There are three types of hemophilia, type A, B, and C. Type A is the most common type and is caused by the lack of clotting factor 8. Type B is the second most common type and is caused by the lack of clotting factor 9. Type C is a mild type of hemophilia and is caused by the lack of clotting factor 11. The type of hemophilia one inherits depends on the clotting factor that is deficient. Hemophilia is a sex-linked recessive disorder, a genetic disease linked to a defective gene on the X chromosome. The gene that cause hemophilia A and B cannot be passed on from father to son, but hemophilia C can be passed by either parent. Most of the people diagnosed with hemophilia can trace back the disorder in their family for many generations. However, some people get hemophilia after a mutation has occurred in their clotting factor 8 or 9 gene; these people can then pass on this disorder to their children. For people with hemophilia in their family history, they can test their fetus during pregnancy to see if it has the disorder. The other way to diagnose the disease is to have a physical exam and analyze a blood sample to see if one does not have enough of a clotting factor. However, sometimes, the disorder cannot be diagnose until after a parent witnesses a bleeding problem with their children, or if one has gone under surgery and has resulted in too much bleeding. The main signs and symptoms of hemophilia include excessive bleeding and easy bruising. However, the degree of the bleeding depends on how severe one’s disorder is. People with mild hemophilia do not show signs of excessive bleeding until after a dental procedure, an accident, or surgery. Signs of external bleeding include heavy bleeding from a minor cut, nosebleeds for no reason, continuous bleeding, and bleeding in the mouth from losing a tooth. Signs of spontaneous bleeding include large, deep bruises, joint pain and swelling, blood in urine or stool. Emergency signs of hemophilia include sudden joint pain, painful, lasting headache, repeated vomiting, extreme fatigue, neck pain, and double vision. Internal bleeding from the kidney or bladder lead to blood in the urine, from the intestines or stomach lead to blood in the stool, from large muscles lead to large bruises. Internal bleeding of the brain is the most serious complication of hemophilia and shows emergency signs; it can happen after a bump on the head or a more serious injury. Since the disorder itself cannot be prevented because it is an inherited disorder, instead it can be managed and treated. The main treatment for hemophilia is replacement therapy. This is where one would take extra clotting factors by drip or injection. This, however, may have many complications and could cause more harm before the replacement therapy can start working. Other treatments include injection of the hormone desmopressin for mild hemophilia A, plasma infusions, antifibrinolytic medicines to use before dental work or to treat nose or mouth or intestinal bleeding, or gene therapy. Minor cuts and scrapes can be taken care of with pressure and bandages; small areas of bleeding beneath the skin can be taken care of with ice packs; minor bleeding in the mouth can be slowed down with ice pops. Maintaining physical activity can also help to keep one’s…
ipratropium 500 mg by nebulizer q4-6h; enalapril 10 mg PO q AM.
In this case, I will discuss the definition of COPD/emphysema, causes, S/S, risk factors, contributing factors, normal lab values, current lab values, diagnostic tests, prevention, treatment, patient care, education, and discharge instructions.
Chronic Obstructive Pulmonary Disease (COPD); Emphysema
Patient D.Z.is a 65-year-old male admitted to medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD;…
stool will be black and tarry
Growth factors: (e.g. Erythropoietin [Epogen]; Filgrastim [Neupogen,GCSF]; Neumega
Dextrose 5% and water is the only solution that is compatible with filgrastim (Neupogen).
Factor replacement therapy (for hemophilia)
Anticoagulants (e.g. Heparin, Warfarin)
Thrombolytic meds (e.g. Heparin, Aspirin, Alteplase [tPA])
Traditional meds (e.g. Phenytoin [Dilantin], Carbamazepine [Tegretol], Valproic acid [Depakene, Depakote], Phenobarbital)…