anemia

Question 1

Normocytic, normochromic RBC causes anemia by:

Answer 1

normal size and color
• Acute blood loss, hemolysis, chronic kidney disease, chronic disease, cancers, sideroblastic anemia, endocrine disorders, starvation, aplastic anemia, sickle cell anemia, pregnancy

Question 2

Microcytic, hypochromic RBC causes anemia by:

Answer 2

small size, pale color)

• Iron-deficiency anemia, vitamin B6 deficiency, copper deficiency, thalassemia, lead poisoning

Question 3

Macrocytic (megaloblastic), normochromic RBC causes anemia by:

Answer 3

large size, normal color
• Cobalamin (vitamin B12) deficiency, folic acid deficiency, liver disease (including effects of alcohol abuse), post splenectomy

Question 4

causes of anemia

Answer 4

elated to an underlying cause such as iron deficiency, bleeding, chronic disease/inflammation, renal insufficiency, or a hematologic cancer.

Question 5

three main causes of anemia are

Answer 5

1) decreased production of red blood cells
2) blood loss
3) increased destruction of red blood cells.

Question 6

Expand on the causes of anemia

1) decreased production of red blood cells
2) blood loss
3) increased destruction of red blood cells.

Answer 6

1) decreased production of red blood cells
- Decreased hemoglobin synthesis
- Defective DNA synthesis
- Decreased number of RBC precursors

2) blood loss
- Acute (Trauma, Blood vessel rupture, Splenic sequestration crisis)
- Chronic (Gastritis, Menstrual flow, Hemorrhoids)

3) increased destruction of red blood cells.
- Hereditary (sickle cell disease)
- Acquired (Extrinsic) (trauma, immune, malaria)

Question 7

What does Mean corpuscular volume measure? (MCV)

Answer 7

Average volume of red cells in a specimen
High MCV = large red bloodcells (macrocytic)
Low MCV = small bed blood cell (microcytic)

Question 8

What does red cell distribution width measure (RDW)?

Answer 8

a measurement of the range in the volume and size of your red blood cells (erythrocytes).

Question 9

What’s a normal hemoglobin range

Answer 9

12-17.5 g/dL

men, 13.5 to 17.5 grams per deciliter.
For women, 12.0 to 15.5

Question 10

hemoglobin rante in mild, moderate and severe anemia

Answer 10

In mild anemia (Hgb 10 to 14 g/dL [100 to 140 g/L])
In moderate anemia (Hgb 6 to 10 g/dL [60 to 100 g/L])
In severe anemia (Hgb <6 g/dL [<60 g/L])

Question 11

Assessment findings to suggest anemia

Answer 11

• Weight loss
• Anorexia
• Lethargy
• Sensitivity to cold
• Apathy
• Pallor
• Increased respirations and pulse
• Confusion, impaired cognition

Question 12

Symptoms
Mild
Moderate
Severe

Answer 12

MILD
• May exist without symptoms
• with exercise Palpitations, dyspnea, diaphoresis

MODERATE
•Increased heart rate present while resting
• Increased heart rate present with activity

SEVERE
• Pallor or jaundice
 • Pruritus
• Icteric conjunctiva and sclera
• Retinal hemorrhage
vBlurred vision
• Glossitis or a smooth tongue
• Tachycardia
• Increased pulse pressure
• Systolic murmurs
• Intermittent claudication
• Angina
• Heart failure or myocardial infarction (MI)
• Tachypnea, orthopnea, dyspnea at rest
• Headache or vertigo
• Irritability, depression, impaired thought processes
• Anorexia
• Hepatomegaly, splenomegaly
• Difficulty swallowing, sore mouth, bone pain, cold sensitivity

Question 13

Anemia treatment

Answer 13

Dietary and lifestyle changes

Blood or blood product transfusions

Drug therapy

Oxygen therapy

Question 14

Nursing interventions for anemia

Answer 14

Monitor VS

Monitor hematocrit, hemoglobin

Management of Oxygen therapy

Client teaching (relaxation, breathing)

Alternate rest with activity (1:3)

Limit visitors & interventions to promote rest (save energy for priority tasks)

Assist with ADL’s

Question 15

Signs and symptoms of anemia in older adults may include

Answer 15

pallor, confusion, ataxia, fatigue, worsening cardiovascular and respiratory problems.

Question 16

Explain Erythroctye Production

Answer 16

in red bone marrow.
• cells come from undifferentiated hemocutoblast.
• hemocytoblast stimulated by erythropoietin they evolve into RBC
erythropoietin comes from kidney
• RBC has 4 heme and 4 globin proteins

Question 17

Iron-Deficiency AnemiaCollaborative Care

Answer 17

Treat the underlying disease

↑ Intake of iron

Nutritional therapy

Oral or occasionally parenteral iron supplements

Transfusion of packed RBCs

Question 18

Oral Iron Replacement Therapy

Answer 18

• for iron deficiency anemia
• Inexpensive/Convenient
• Enteric-coated or sustained-release capsules are counterproductive and expensive
• Iron is best absorbed in an acidic environment.
• Undiluted liquid iron may stain the patient’s teeth.
• GI side effects may occur, including heartburn, constipation, and diarrhea

take before meals with vitamin C

Question 19

Parenteral Iron Replacement

Answer 19

• IM or IV
• may stain the skin
• IV has risk of an allergic reaction
• use is indicated for malabsorption, intolerance of oral iron, a need for iron beyond oral limits, or poor patient adherence in taking the oral preparations

Question 20

?mg per day is the recommended dose for folic acid replacement.

Answer 20

1

Question 21

who is at increased risk for development of iron deficiency anemia:

Answer 21

premenopausal and pregnant women, people from low socioeconomic backgrounds, older adults, and individuals experiencing blood loss

Question 22

Concerns with acute blood loss

Answer 22

1) Rapid blood loss leads to hypovolemic shock: tacaycardia and hypotension
2) Slower blood loss leads to↑ Plasma volume faster than ↑ in RBC therefore
↓ O2 due to ↓ RBCs available
3) Pain (Tissue distention, organ displacement, nerve compression )

Question 23

What does reticulocyte count measure?

Answer 23

Immature cells.
Meausres how fast reticular cells are made by bone marrow and released into blood
High can mean bleeding, kidney disease or distruction of RBC

Question 24

What does Erythrocyte Sedimentation rate measure (Westergren)?

Answer 24

• Test of immflamation (part of immune response system)
• Measures how fast eurythrocytes will settle at the bottom of a test tube that contains a sample.
• Faster rate = inflammation in the boidy

Question 25

Three extrinsic categories in Aquired Hemolytic anemia

Answer 25

1)  Physical factors
Physical destruction of RBCs results from extreme force on the cells.
2) Immune reactions
Antigen–antibody reactions destroy RBCs
3)  Infectious agents and toxins

Question 26

Sickling episodes

Answer 26

commonly triggered by a low oxygen tension in the blood.

Sickled RBCs become rigid and take on an elongated, crescent shape.

Question 27

sickle cell symptoms

Answer 27

• PAIN: the pain is quite severe as a result of tissue ischemia
• fever, swelling, tenderness, tachypnea, hypertension, and nausea and vomiting.

Question 28

Thalassemia symptoms

Answer 28

Thalassemia minor symptoms
Frequently asymptomatic
Mild to moderate anemia with microcytosis (small cells) and hypochromia (pale cells)

Thalassemia major symptoms
Delayed physical and mental development
Pallor
Splenomegaly, hepatomegaly, and jaundice from hemolysis of RBCs
Chronic bone marrow hyperplasia causing expansion of the marrow space
Thickening of the cranium and maxillary cavity

Question 29

sickle cell treatment

Answer 29

• pain control
• anti sickling agent hydroxyurea
• Hydration Therapy
• Oxygen Therapy
• Blood Transfusions

Education
Teach the patient ways to avoid sickle cell crises. This may include taking steps to avoid dehydration and hypoxia, such as avoiding high altitudes and seeking medical attention quickly in an attempt to counteract potential causes of sickle cell crises, such as upper respiratory tract infections.

Question 30

Thalassemia Major treatment

Answer 30

Managed with blood transfusions or exchange transfusions in conjunction with oral deferasirox or intravenous or subcutaneous deferoxamine (chelating agents that bind to iron) to reduce the iron overloading (hemochromatosis) that occurs with frequent transfusion therapy. Because RBCs are sequestered in the enlarged spleen, thalassemia may be treated by splenectomy.
Although hematopoietic stem cell transplantation remains the only cure for patients with thalassemia, the risk of this procedure may outweigh the benefits.