Anemia Flashcards
Anemia patho
- There isn’t enough RBCs to carry oxygen to tissue
- Hg<12g/dL for women and Hg < 13.5 in men or 14
Values
RBcs 4-6M cells/ mCL
Hgb M: 14-18 W: 12-16
Hematocrit 42-52% M or W: 37-47%
Reticulocytes: insight into whether the production is low or destruction is high
MCV: (Mean Corpuscular VAlue) (80-95)
Tells whether it is Microcytic, Macrocytic, Normocytic
Increased destruction of RBCs (hemolytic)
Sickle Cell Disease
Decreased Production of RBCs ( Normocytic)
Anemia of chronic disease
Macrocytic Anemia (DNA issue)
-Vitamin B12 and folic acid defiency
Microcytic ANemia (hemgolben issue)
Iron defiency anemia
Anemia assessment
FAtigue Pallor Jaundice Dysrhtymias Tachycardia Dyspnea SOB Syncope Dizziness Headache Chest Pain
Anemia interventions
- oxygen chest pain: 12 lead Ortho hypotension: get up really slowly intolerance of cold: warm blanket increased fatigue: take rest breaks
When Hgb is less than 7g/dL or pt is anemic and symptomatic
A blood transfusion is needed
Iron defiency Anemia
-Most common type in world Causes: poor diet, blood loss, Poor GI absoprtion -Small RBCs has low iron -microcytic and low MCV - mouth fissures
Iron defiencey Anemia Interventions
- red meat ad liver
-legumes
-Leafy greens
-shell fish
Oral supplements: may cause GI upset
IV iron infusions only for severe cases
Anemia of Chronic diseases
Anemia of inflammation
- Most commonly in elderly
- Tends to be mild to moderate
Commmon causes:
- Kidney disease
- infection
- Cancer
- IBD
- Diabetes
Often normocytic
- Treatment at underlying cause
Macrocytic (B12 and Folic acid)
Vitamin B12
Caused by: dietary, chronic diarhhea, pernicious anemia
Looks like
- Pallor
- Fatigue
- Jaundice
- weight loss
- Glossitis
- PArastheisas
Folic Acid
Causes:
Diet, malabsorption, drugs, alcohol
Looks like: Pallor Fatigue Jaundice Weight loss Glossitis
B12 Def interventions
Dietary changes, oral supplements. B12 injections
Folic Acid interventions
Dietary screenings, supplement
Screen: poor nutrition, alcoholics, older adults
Sickle Cell Anemia
- autosomal recessive geetic disorder
- causes mutation results in HbS
-SS disease versus AS ( carrier) has mild symptoms
Most common in African Americans
sickle cell patho
- abnormal shape due to altered beta chain
-HbS is sensitive to low O2
-Low O2 = sickling of RBCs
sickled cells clump together - create a vaso-occlusive event
Shortens RBCS to 20 days - increased reticulocytes
sickle cell crisis
-periods when extensive sickling occur
repeated episodes o sickle cell crisis and VOE’s cause long term damage to tissues and organs
-Ultimately lead to organ failure
causes of sickling
- situations that require high o2 demand
sickle cell assessment
- pain
-fatigue
-pallor
-jaundice
-cyanosis
-Le ulcers
joint pain/ limited rom/ swelling
-SHOB
-Pallor
-Jug vein distension
-cognitive changes
High cap refill - diminsed pulses
-cool - tachycardia
-coping, understanding, support
Acute chest syndorme
- Most common cause of death for people with sicle cell
- SHOB
- Ccough
- infiltrate on XR
Diagnostics for Sickle cell
Hemoglobin electrophoresis
- Hematocrit ( new normal is 20-30%)
- Billirubin ( May be high > 1.2 mg/dL)
- Reticulocytes ( > 2%)
- WBCs (> 10^9 cells/L)
Imaging: XR, MRI, CT, ECG-12
Interventions
Oxygen, Pain management, Hydration (D5/ 2NS) !!!
Other:
- promote circulation
- Prevention of infections
- early detection of infections
- Temp adjeustmenst
- Blood transufsions
- Crisis prevention
- Hydroxurea
