Anemia Flashcards
Function of Plasma
Transports nutrients, hormones, & proteins
Plasma
Yellow watery liquid that makes up about 55% of the body’s blood volume
Thrombocytes
Platelets - form clots to stop bleeding
Platelets make up….
Less than 1% of blood
Erythrocytes
Red Blood Cells - Carry fresh oxygen through the body and remove carbon dioxide
Leukocytes
White blood cells - Part of body’s immune system; detect and fight viruses & bacteria
What is anemia?
- Deficiency in RBCs
- Deficiency in HGE (hemoglobin)
AND/OR - Deficiency in volume of packed RBCs (Hematocrit)
Normocytic, normochromic RBCs
Normal size & color
Microcytic, hypochromic RBCs
Small in size & little color
Macrocytic/megaloblastic, normochromic
Large in size & normal color
How is anemia diagnosed?
CBC panel, blood smear, & reticulocyte count
Is anemia a primary or secondary problem?
It can be primary or a secondary consequence of a disease or disorder
Etiology of anemia
- Blood loss
- Decrease in RBC production
- Increase in RBC destruction
Tissue Hypoxia
An absence of enough oxygen in the tissues to sustain bodily functions
Why can any RBC disorder lead to tissue hypoxia?
RBCs have hemoglobin & that is the O2 carrying protein
Normal Hgb in female & male
Female: 12-16
Male: 13.5-17.5
Mild Anemia Hgb
10-12
Moderate Anemia Hg
6-10
Severe Anemia Hgb
<6
General symptoms of anemia
- Headaches
- Fatigue/weakness
- Cold hands/feet
- Yellowish skin, pallor, pruritus (itchy skin)
- Increased HR, chest pain, murmurs
- Dizzy/light headed
- Dyspnea
Symptoms of anemia in the elderly
- Confusion, ataxia (impaired coordination), & fatigue
Cobalamin
Vitamin B12
Cobalamin Deficiency
Megaloblastic anemia; the body can’t make enough healthy RBCs b/c it doesn’t have enough Vitamin B12
Cobalamin Deficiency occurs in patients who…
- Have gastric issues or surgeries - especially those involving the ileum
- Smokers
- Excess alcohol consumption
- Strict vegetarians
Why do people with GI issues have a problem with Cobalamin Deficiency?
They are unable to absorb cobalamin properly
Why are vegetarians more likely to have a Cobalamin Deficiency?
Because of the lack of meat and vitamin B12 rich foods. Vitamin B12 isn’t as easy to absorb from vegetables as it is from meat
Primary body systems affected by Cobalamin deficiency
GI & neuromuscular
GI symptoms of Cobalamin deficiency
- Anorexia
- Nausea/vomiting
- Abdominal pain
Neuromuscular symptoms of Cobalamin deficiency
- Weakness/muscle weakness
- Ataxia (impaired coordination)
- Paresthesia (pins/needles feeling)
- Reduced position sense
- Impaired thought process
Treatments for Cobalamin Deficiency
Parenteral vitamin B12, or intranasal Nascobal
Life expectancy of untreated Cobalamin Deficiency
1-3 yrs
Aplastic Anemia
Rare condition that happens when your bone marrow cannot produce enough new blood cells for your body to work
Pancytopenia
Condition in which there are a lower than normal number of RBCs, WBCs, & platelets in the blood
Etiology & onset
- Can be born with it
- Autoimmune diseases - T cells target and destroy hematopoietic stem cells
- Abrupt or gradual onset
Diagnostic Tests
- CBC
- Bone marrow biopsy to confirm findings from CBC
Symptoms of Aplastic Anemia
- General symptoms of anemia
- Thrombocytopenia
- Increase susceptibility to infection (Low WBCs)
- Septic shock
- Death
Thrombocytopenia
Low platelets lead to increased risk of bleeding
Treatment for Aplastic Anemia
- Hematopoietic stem cell transplant (as long as the patient is younger & and has few blood transfusions)
- Immunosuppressive therapy
- Ongoing supportive blood transfusions
- If severe, the prognosis is poor
Why can a patient that has had many blood transfusions not have a hematopoietic stem cell transplant?
The more blood transfusions you have the more risk of your body rejecting the new blood
Hemolytic Anemia
RBCs are destroyed faster than they are replaced
Intrinsic factors causing Hemolytic Anemia
Result from defects in RBCs themselves or hereditary
Extrinsic factors causing Hemolytic Anemia
RBCs are normal but external factors cause damage
- Dialysis or bypass machines
- Parasites: Malaria
- Autoimmune diseases: Lupus
- Blood transfusion reactions
Symptoms of Hemolytic Anemia
- General symptoms of anemia
- Jaundice
- Splenomegaly
- Hepatomegaly
- Altered renal function
Why do people have altered renal function with Hemolytic Anemia?
Their kidneys are working overtime to get rid of the waste in the blood so tubules get clogged
Splenomegaly
Enlargement of spleen
Hepatomegaly
Enlargement of the liver
Treatment for Hemolytic Anemia
-Supportive care - remove the causative agent
- Possible immunosuppressive agents
Nursing Management/Interventions for anemia
- Correcting the underlying cause is main goal
- Acute Inverventions
- Symptom management
- Education on dietary & lifestyle changes (decrease alcohol, smoking cessation)
Acute interventions for anemia
- Blood transfusions
- Drug therapy
- O2 therapy (for hypoxia)
- Aggressive hydration/electrolyte replacement (for kidney injury in hemolytic anemia)
What kind of diet is best for Cobalamin deficiency?
Meat, salmon, dairy, eggs, enriched grains
