 What come to nursing school explain in this video on aplastic anemia, which is a rare, but can be a very serious condition and aplastic anemia results in what's called pancytopenia. The pathophysiology is that there is bone marrow suppression and then we have a low count of all the blood cells and these include not only red blood cells which is typically the term for anemia but also white cells as well as platelets because the bone marrow for some reason has been suppressed and is not able to produce any type of blood cells or only a small amount. And so reasons that cause that could be HIV or Hepatitis C, radiation and chemotherapy that kind of wipe out the blood marrow. Certain chemical exposures can cause aplastic anemia as well as it can be caused for some sort to autoimmune reasons. And so science and symptoms are as with any anemia pretty typical weakness, fatigue, dizziness, shortness of breath and then also increase in heart rate and decrease in blood pressure as the body is starving for that oxygen. But not only, so these are typical symptoms of general anemia but because we're also low in white cells and platelets the patient is more likely to have an infection and they're also more likely to have bruising or bleeding as can be seen in bleeding from the gums or any other parts of the body as well as maybe they have some particular and even purpure if it gets really bad. So diagnostic tests on a CBC we're going to see with any type of anemia, low red blood cells and low HNH. The MCV, mean copacular volume, will be normal. Reticulous sites in many types of anemias are increased, but in a plastic because the bone marrow is not working at all, we're not even going to have any immature red blood cells. We're going to have decreased white cells and decreased platelets because we know the bone marrow can produce them. Generally, we're also going to probably see some iron studies in B12 and folate levels measured to rule out any of these types of anemias, but most likely they'll be normal and then we also definitely need to check PT and INR because we know the patient is at high risk for bleeding and bruising. And so a plastic anemia is classified as a normalcytic and normal chromic anemia meaning that the size and the color of the blood cells are normal. We just have an overall decreased count in all these blood cells. And I have a separate video on that red blood cell indices that goes a little bit more into describing the differences in these different lab studies. Complications. So a plastic anemia, like I mentioned, is rare, but it can have severe consequences and the mortality rate is greater than 70 percent. And the patient, there can be hemorrhage and also severe infection and those are the most common causes of that mortality. So what do we want to do to treat the patient? We want to remove the cause. So if the cause is because of some chemotherapy, medication, the patient is not tolerating or radiation treatment or chemicals, we can certainly try and remove the cause if we figure out what that is. We can give them blood transfusion to replenish all the blood cells that they are lacking, but really the end-all treatment is a bone marrow transplant where we just give the patient new bone marrow and that bone marrow basically takes over producing normal blood cells. If there is an autoimmune cause for a plastic anemia, we can also try and suppress that immune system that's on hyperdrive to try and help resolve the a plastic anemia. And maybe while the patient is waiting for a bone marrow transplant or a blood transfusion, we can also give them erythropoietin, which will help stimulate the red cell growth and the red cell production. For nursing care, as always, we're checking vital signs because we know the patient might be tachycardic and hypotensive along with tachypnea. We want to check them for bleeding and that particularly pertains to checking the bleeding of the gums and then also check for any blood in the stool or urine because these might be the first signs. We want to have fall precautions because we know that there are a risk for being dizzy and then when they're falling they can severely get injured. We want to give them oxygen to help with that oxygen carrying capacity that they're lacking. Give them a blood transfusion if that's what's been ordered and then also put them on bleeding precautions so make sure that there is no sharp edges or anything that they can get cut on and then possibly even put them in reverse isolation if their white cell count is really low. Certainly, as always, the nurse's big part is teach the patient. So if we have a patient with a plastic anemia, we want to teach them about all these good infection prevention measures that we know are so important and also tell them to report any increase in their body temperature because that could be an early sign of an infection and we don't want that to become severe. We want to emphasize the importance of proper nutrition to keep their body as healthy as possible to help stimulate these blood cells and then also avoiding any trauma or injury and that not only pertains to falls but also maybe not eating with a metal fork or spoon because that could even cause some micro trauma in the mouth and put them at risk for bleeding. Please also check out the other videos that I have about the other types of anemia in my hematologic disorder playlist. Thanks for watching Nursing School Explained. See you soon.