Anemia

Question 1

anemia

Answer 1

decreased RBCs, Hgb, Hct

Question 2

neutropenia

Answer 2

decreased neutrophils

Question 3

thrombocytopenia

Answer 3

decreased platelets

Question 4

pancyotpenia

Answer 4

decrease in all cellular components of the bone marrow
caused by bone marrow suppression

Question 5

hematopoiesis

Answer 5

formation of all blood cells

Question 6

erythropoiesis

Answer 6

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

Question 7

aging hematologic system

Answer 7

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

Question 8

3 main causes of anemia

Answer 8

1. decreased RBC production
2. increased RBC destruction
3. blood loss

Question 9

clinical demonstration of anemia

Answer 9

decreased RBCs, H&H

Question 10

reasons for decreased RBC production

Answer 10

iron deficiency
pernicious anemia
aplastic anemia
chemotherapy induced anemia
anemia of inflammation

Question 11

reasons for increased RBC destruction

Answer 11

hemolytic anemia: drug induced, infectious agents, physical agents, microangiopathy

Question 12

reasons for blood loss

Answer 12

hemorrhage (trauma, postop, anticoagulation)
chronic bleeding (cirrhosis, colitis, colon cancer, diverticulitis)
heavy menstrual cycle
frequent lab sampling

Question 13

mild anemia symptoms/manifestations

Answer 13

Hgb = 10-12 g/dL

Question 14

moderate anemia symptoms/manifestations

Answer 14

7-10 g/dL
fatigue
exertional dyspnea
tachycardia/palpitations
diaphoresis with exertion

Question 15

severe anemia symptoms/manifestation

Answer 15

Hgb </= 7g/dL
dyspnea and palpitations at rest
dizziness/headaches
irritability
insomnia
hypersensitivity to cold
difficulty concentrating
pallor (palms, nails, conjunctiva)
anorexia/indigestion

Question 16

compensatory responses to anemia

Answer 16

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

Question 17

anemia interventions

Answer 17

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

Question 18

sickle cell anemia pathophysiology

Answer 18

when well-oxygenated, Hgb S has normal function
when PaO2/SaO2 decrease, Hgb S forms fibrous polymer thus sickle cell shape

Question 19

sickle cell characteristcs

Answer 19

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

Question 20

sickle cell anemia diagnostic tests

Answer 20

sickle cell screening test
hemoglobin electrophoresis

Question 21

sickle cell anemia lab values

Answer 21

decreased Hgb
decreased platelets
increased reticulocytes

Question 22

triggers to sickle cell crisis

Answer 22

dehydration
fever/infection
high attitudes/elevation
exposure to cold
smoking
pain

Question 23

sickle cell anemia clinical manifestation

Answer 23

chronic hemolytic anemia
microvascular occlusion affecting all organs (stroke, lung injury, AKI)

Question 24

sickle cell anemia treatment

Answer 24

hydration (@150-200mL/hr)
oxygenation (2-4L/min via NC)
pain managements (IV opiates)
dx and tx infections
reverse sickling crisis