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Nursing 3 > Anemia > Flashcards

Anemia Flashcards

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1
Q

Nursing Diagnosis for Anemia

A
  • Imbalanced nutrition: < body requirements r/t inadequate iron intake
  • Activity Intolerance r/t decrease of O2 carrying capacity of the blood
  • Ineffective tissue perfusion r/t decrease of O2 carrying cap. of the blood
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1
Q

Platelets

(Transfusion Therapy)

A
  • pt w/ platelets count < 20,000/ 80,000 if active bleeding is present
  • filter can be used
  • infuse in 15-30 min
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2
Q

Hemolytic Anemias S/S

A
  • Bone deformity & fractures
  • Splenomegaly
  • Jaundice
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3
Q

Hemolytic Anemias

A
  • Premature destruction of RBCs
  • lysis of RBCs may occur w/in the circulatory system or from phagocytosis by WBCs in the spleen

hemolysis–> increases hemtopoietic activity in the bone marrow–> increased immature RBCs released into circulating blood

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3
Q

Diagnostics for Acute Blood Loss

A
  • BP
  • HR
  • RR
  • Urine Output
  • Hematocrit values
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3
Q

Erythropoietin

A

-hormone produced by the juxtaglomerular cells of the kidneys during hypoxia

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4
Q

Intrinsic Factor

A
  • Secreated by gastric mucosa
  • Binds w/ vitamin B-12
  • travels to the ileum (where B-12 is absorbed)
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5
Q

Hypoxia

A

Decreased blood O2 level

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6
Q

Hematocrit

A

Is the % of RBCs in relation to the total blood volume

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7
Q

Iron dietary sources

A
  • Beef
  • Chicken
  • egg yolk
  • turkey
  • whole-grain breads
  • dried fruits & beans
  • greens
  • brown rice
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9
Q

Anemia (General S/S)

A
  • Pallor (skin, nail beds, mucous membranes
  • SOB/Fatigue, especially upon exertion
  • Tachycardia & palpitations
  • Bone Pain
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9
Q

Anemia lab & diagnostic testing

A
  • CBC: Hgb, Hct, total RBCs,reticulocyte count
  • Serum B-12 & folate levels
  • Iron staus
  • Hgb electrophoresis
  • Schilling test
  • Bone marrow aspiration
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10
Q

Anemias are due to:

A
  • Blood loss
  • Inadequate RBC production (hypoproliferative)
  • Increased RBC destruction (hemolytic)
  • Deficiency of necessary components (folic acid, iron, erythropoietin, vitamin B-12)
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11
Q

Iron studies

A

Use serum transferrin to measure the iron stores in the body

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12
Q

Hemoglobin

A

Transports O2 & CO2 to and from the cells and can be used as an index of the O2 carrying capacity of blood

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13
Q

What is Anemia?

A
  • Abnormally low amount of circulating RBCs, Hgb concentration, or both
  • It’s an indicator of an underlying disease/disorder
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14
Q

Aplastic Anemia

A
  • Bone marrow fails to produce all 3 types of blood cells
  • Normal bone marrow is replaced by fat
  • Anemia develops as bone marrow fails to repllace RBCs at the end of their lifespans
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15
Q

Therapies (Collaborative care) Aplastic anemia

A
  • Withdrawal of causative agent, if known
  • blood transfusions
  • Bone marrow transplant as indicated
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17
Q

Pernicious Anemia S/S

A
  • Smooth, sore, beefy red tongue
  • diarrhea
  • paresthesias
  • propioception deficits
18
Q

Therapies (Collaborative care) Vitamin B-12 deficiency anemia

A
  • increase dietary intake of foods w/ B-12
  • oral & parental supplements
  • parental B-12 if malabsorption/ lack of intrinsic factor
19
Q

Normal hemoglobin (Hgb) levels

A

adult males: 13.8-18g/dL

adult females: 12-15g/dL

19
Q

Ferrous sulfate (Iron)

A

-prevents/treats iron deficiency anemia

S/E: dizziness, seizures, hypotension, tachycardia, skin staining (IM), dark stools (PO), constipation (PO), staininng of teeth (PO)

-Teach: to monitor for overdose (stomach pain, N/V, bluish lips & fingernails)

vitamin C enhances absorption

20
Q

Management of acute blood loss

A

Monitor:

  • hematologic studies
  • urine output
  • cardiovascular indicators
  • skin changes
  • pain descriptions
  • administer transfusions as indicated
22
Q

Vitamin B-12 deficiency anemia S/S

A
  • Pallor/slight jaundice
  • weakness
  • fainting
  • headache
  • forgetfulness
  • nausea
  • anorexia
  • night cramps
23
Q

Iron deficiency anemia S/S

A
  • cheilosis (cracks at the mouth)
  • spoon-shaped nails
  • smooth, sore, bright red tongue
23
Q

Folic Acid dietary sources

A
  • green leafy veggies
  • broccoli
  • organ meats
  • eggs
  • wheat germ
  • milk
  • yeast
  • asparagus
  • Kidney beans
23
Q

Hgb electrophoresis

A
  • separates normal Hgb from abnormal
  • used to detect thalassemia & sickle cell disease
23
Q

Schilling Test

A
  • measures B-12 absorption w/ or w/o intrinsic factor
  • distinguishes between malabsorption & pernicious anemia
25
Q

Therapies (Collaborative care) Sickle Cell anemia

A
  • Hydroxyurea (q.d.)
  • During sickle cell crisis: Rest, O2 therapy to maintain SaO2, narcotic analgesia, vigorous hydration
  • During acute chest syndrome: careful hydration, vitals monitored, O2 therapy, transfusion
  • Folic acid supplements
  • Blood transfusion during sugery/ pregnancy as necessary
  • Genetic conseling recommended
27
Q

Activity Intolerance (Interventions)

Side note: S/S are SOB w/ weakness, fatigue, vertigo on exertion

These will increase O2 demand

A
  • help identify ways to conserve energy when performing desired activities
  • Assist in scheduling alternating periods of activities & rest for throughout the day
  • Encourage 8-10 hrs of sleep
  • Monitor vitals before & after activities
  • Stop activity if pt shows signs of intolerance
  • instruct pt not to smoke
28
Q

Risk Factors

A
  • Acute/chronic blood loss
  • Increased hemolysis
  • Inadequate dietary intake/malabsorption
  • Bone-marrow suppression
  • smoking
  • excessive alcohol intake
  • sdentary lifestyle
29
Q

Pernicious Anemia

A
  • it develops from the lack of intrinsic factor
  • In the abscence of Intrinsic factor, vitaminn B-12 can’t be absorbed into the body
30
Q

Vitamin B-12

A

Necessary for DNA synthesis & found in foods derived from animals

-Important for neurological function

31
Q

Aplastic Anemia S/S

A

Low RBCs: fatigue, pallor, progressive weakness, exertional dyspnea, headache, ultimately heart failure & tachycardia

Low Platelets: Bleeding problems, gum bleeding, excessive bruising

Low WBCs: increased risk of infection, sore throat & fever

33
Q

Patient Outcomes

A
  • The pt will make appropriate dietary choices to increase iron intake
  • The pt will demonstrate appropriate self-administration of supplements
  • The pt’s RBC count/hemoglobin will improve
34
Q

Epogen (Erythropoietin)

A

-Increases the production of RBCs in the bone marrow

S/E: bone pain

Teach: give to pt w/ kidney failure on a weekly basis

35
Q

Vitamin B-12 deficiency anemia

A
  • Occurs when inadequate B-12 is consumed/ poorly absorbed from the GI tract
  • Deficiencies impair cell division; maturation of nucleus; causes rapid proliferation RBCs
  • Creates Large, oval-shaped RBCs, that are fragile and incapibale of carrying adequate amounts of O2
35
Q

Vitamin B-12 (cyanocobalamin)

A
  • required for RBC formation
  • treats pernicious anemia

S/E: diarrhea, itching, rash, hypokalemia, anaphylaxsis

-Teach to eat foods high in vitamin B-12

37
Q

Vitamin B-12 dietary sources

A
  • liver
  • fresh shrimp&oysters
  • eggs
  • milk
  • kidney
  • meats (muscles)
  • cheese
39
Q

Anemia Pathology

A
  • Regardless of cause, anemia is due to the decrease in the O2-carrying capacity of the blood
  • Insufficient O2 reaching the cells & tissues
  • Tissue Hypoxia

[Anemia is usually asymptomatic. The body’s compensatory mechanisms prevent S/S, until when it really needs O2 (during exercise & infecton)]

40
Q

Therapies (Collaborative care) for iron deficiency anemia

A
  • Increase dietary intake of iron-rich foods
  • Oral/parental supplements
41
Q

Iron deficiency anemia

A
  • develops when supplies of iron are inadequate for optimal RBC formation
  • body can’t synthesize hemoglobin w/o Fe, and Fe is necessary for RBC production
  • Characterized by low number of RBCs; also small, pale, or malformed RBCs
43
Q

Transfusion therapy

A
  • monitor for fluid overload, transfusion reaction
  • severe reactions occur during the 1st 50 mL of blood transfused
  • stay w/ pt. for the intial 15-30 min. of the infusion
44
Q

Whole Blood and Packed Blood

(Transfusion therapy)

A
  • infuse w/ NS only
  • complete transfusion in 4hrs
  • never add drugs to blood
45
Q

Anemia Hemoglobin levels

A

Mild: Hgb 10-12 g/dL

Moderate: Hgb 7-11 g/dL

Severe: Hgb < 7 g/dL

46
Q

Fresh Frozen Plasma

(Transfusion therapy)

A
  • clotting factor deficiency, liver disease, DIC, and PT or PTT > than 1.5 times normal
  • infuse over 20-30 min
  • use blood filter for infusion

Nursing 3 (3 decks)

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