Anemia Flashcards
anemia
decreased RBCs, Hgb, Hct
neutropenia
decreased neutrophils
thrombocytopenia
decreased platelets
pancyotpenia
decrease in all cellular components of the bone marrow
caused by bone marrow suppression
hematopoiesis
formation of all blood cells
erythropoiesis
production of RBCs
depends upon release of EPO from the kidney in response to blood cell oxygen demand
sufficient production dependent on iron, vitamins, hormones
aging hematologic system
decreased # of stem cells in marrow
decreased effectiveness of EPO
decreased platelet adhesiveness
average H&H decreases slightly to low normal
no changes in RBC life span, blood volume, WBC count, platelet structure and quantity
3 main causes of anemia
- decreased RBC production
- increased RBC destruction
- blood loss
clinical demonstration of anemia
decreased RBCs, H&H
reasons for decreased RBC production
iron deficiency
pernicious anemia
aplastic anemia
chemotherapy induced anemia
anemia of inflammation
reasons for increased RBC destruction
hemolytic anemia: drug induced, infectious agents, physical agents, microangiopathy
reasons for blood loss
hemorrhage (trauma, postop, anticoagulation)
chronic bleeding (cirrhosis, colitis, colon cancer, diverticulitis)
heavy menstrual cycle
frequent lab sampling
mild anemia symptoms/manifestations
Hgb = 10-12 g/dL
moderate anemia symptoms/manifestations
7-10 g/dL
fatigue
exertional dyspnea
tachycardia/palpitations
diaphoresis with exertion
severe anemia symptoms/manifestation
Hgb </= 7g/dL
dyspnea and palpitations at rest
dizziness/headaches
irritability
insomnia
hypersensitivity to cold
difficulty concentrating
pallor (palms, nails, conjunctiva)
anorexia/indigestion
compensatory responses to anemia
heart: increase BP, HR, SV, O2 demand
potential angina
lungs: increase respiratory rate depth, RR< work of breathing
orthopnea, dyspnea
kidneys: Increase RAAS activity, EPO secretion
stimulation of bone marrow
anemia interventions
decrease energy expenditure
alternate rest and active periods
maintain comfortable room temp for pt
maintain normothermia
assist with physical activities PRN
administer oxygen 2-4L/min per nasal cannula
sickle cell anemia pathophysiology
when well-oxygenated, Hgb S has normal function
when PaO2/SaO2 decrease, Hgb S forms fibrous polymer thus sickle cell shape
sickle cell characteristcs
rigid RBC membrane -> decreased oxygen carrying capacity
increased blood viscosity -> slowed blood flow
increased adherence of cells to blood vessel endothelium
shortened RBC lifespan to 10-20 days
elevated erythropoiesis
abnormal RBCs destroyed in spleen -> tissue ischemia and autosplenectomy
sickle cell anemia diagnostic tests
sickle cell screening test
hemoglobin electrophoresis
sickle cell anemia lab values
decreased Hgb
decreased platelets
increased reticulocytes
triggers to sickle cell crisis
dehydration
fever/infection
high attitudes/elevation
exposure to cold
smoking
pain
sickle cell anemia clinical manifestation
chronic hemolytic anemia
microvascular occlusion affecting all organs (stroke, lung injury, AKI)
sickle cell anemia treatment
hydration (@150-200mL/hr)
oxygenation (2-4L/min via NC)
pain managements (IV opiates)
dx and tx infections
reverse sickling crisis
