ANEMIA Flashcards
a condition in which there is
lack of enough healthy red blood
cells in the body to carry
adequate oxygen to the body’s
tissues
anemia
Most common anemia of pregnancy
- A microcytic, hypochromic anemia
- hematocrit : <33%
- hemoglobin : <11g/dl
iron deficiency anemia
iron deficiency anemia is confirmed by
low serum iron <30 ug/cl and high iron binding capacity
- Associated with LBW & preterm births
- Some women develop pica
iron deficiency anemia
causes of iron deficiency anemia
- low iron stones
- inadequate vit b6, b12, ascorbic acid, copper, and zinc
- S/Sx: pallor, fatigue, lethargy & headache
- Clinical findings: inflammation of the lips & tongue
IDA
iron deficiency:
- Mean corpuscular hgb. concentration (MCHC) –
< ___ g/dL
30
iron deficiency:
___ and ___ are low
plasma iron and serum ferritin
iron deficiency:
Total iron binding capacity is higher than normal; over ___ ug/dl
400
maternal:
- Tires easily
- More susceptible to infection
- Has increased chance of preeclampsia-eclampsia &
postpartal hemorrhage - Cannot tolerate even minimal blood loss during birth
- Episiotomy healing may be delayed
IDA
fetus:
- Reduced red cell volume, hemoglobin & iron stores
- Reduction in fetal oxygen supply
- Risk of lbw, prematurity, stillbirth & neonatal death increases w/
severe IDA (Hb <6g/dl)
IDA
Iron is best absorbed in an ___ medium
acid
Iron absorption is higher for ___ products than ___ products
animal; vegetable
true or false: Iron supplements may cause constipation &
the stool will turn black & more formed
true
true or false: Oral iron supplements should be
ingested w/ milk or milk products,
coffee, tea & egg
false
Daily supplement of ___ mg elemental iron
is recommended by many caregivers (ferrous gluconate, ferrous fumarate, or
ferrous sulfate)
30
w/ IDA – ___ mg elemental iron/day
120-200
___ - intramuscular or intravenous iron dextran can be prescribed
severe anemia
necessary for the
normal formation of RBCs in the mother as well as being associated with preventing neural tube & abdominal wall
defects in the fetus
folic acid
example of NTD
myelomeningocele (spina bifida cystica), anencephaly
- Most common cause of megaloblastic anemia
- Occurs most often in women with:
- Multiple pregnancies
- Secondary hemolytic illness
- Hydantoin use
- Oral contraceptive use
folic acid deficiency anemia
Associated with increased risk for:
* Spontaneous abortion
* Abruptio placenta
* Fetal anomalies
FDA
causes:
- Poor diet
- Cooking w/ large volumes of water
- Increased alcohol use
- Use of certain medications - phenytoin [Dilantin],
methotrexate, sulfasalazine, triamterene, pyrimethamine,
trimethoprim-sulfamethoxazole, barbiturates, & oral
contraceptives
FDA
assessment of FDA
measuring the average RBC volume (mean corpuscular volume)
Deficiency manifestations may
take a number of weeks to
develop, it primarily becomes
apparent during the ___
trimester of pregnancy
second
s/sx:
▪ Pallor
▪ Fatigue
▪ Headache
▪ Lethargy
▪ Glossitis
▪ Skin roughness
FDA
Women expecting to become pregnant should
take a supplement of ___ µg folic acid daily in
addition to eating folacin-rich foods
400
During pregnancy, folic acid requirement increases to ___ µg/day.
600
- Recessively inherited hemolytic anemia
caused by an abnormal amino acid in the
beta chain of hemoglobin - Majority of RBCs are irregular or sickleshaped
sickle cell anemia
Recessively inherited hemolytic
anemia caused by an abnormal
amino acid in the beta chain of
hemoglobin
sickle cell anemia
- If abnormal amino acid replaces amino acid ___ – HbS results
(sickling)
valine
- If abnormal amino acid replaces amino acid ___ – HbC results
(non-sickling)
lysine
If an individual is heterozygous (HbAS) – has sickle cell ___
trait
- If an individual is homozygous (HbSS) – has sickle cell ___
disease
- Characterized by sickling of the
RBCs in the presence of decreased
oxygenation - Condition may be marked by crisis
with profound anemia, jaundice,
high temperature, infarction, &
acute pain.
SCA
- Painful episode that occurs in people
who have sickle cell anemia - happens when sickle-shaped red
blood cells block the blood vessels - Blood & oxygen cannot flow to the
tissues causing pain
sickle cell crisis
All ___ women who have not been previously tested should be screened
for sickle cell anemia at first prenatal visit
african-american
SCA: ___ levels for all women with sickle
cell disease should be obtained throughout
pregnancy
hemoglobin
true or false: in SCA There is accompanying rise in her indirect
bilirubin.
true
A woman with sickle cell disease may normally have a hemoglobin
level of ___ mg/ 100 mL; hemoglobin level can fall ___ mg/
100 mL
6-8; 5-6
SCA: Assess a woman’s lower extremities for ___ of blood in leg veins
varicosities or pooling
- Fetal health is usually monitored during pregnancy by an ultrasound
examination at ___ weeks & by weekly nonstress or ultrasound
examinations beginning at about ___ weeks
16-24 weeks; 30
if a crisis occurs, control pain, administer ___
as needed, & increase the ___ of the circulatory system to lower viscosity
oxygen; fluid volume
SCA: Administer IV fluid: ___ solution
hypotonic
If the woman has the disease & her partner has the trait, the chances
that the child will be born with the disease are ___
50%
true or false: If both parents have the disease, all their children will also have the disease
true
true or false: as a rule, women with sickle cell disease are given an iron supplement during pregnancy.
false - they are NOT given
SCA: ___ of RBCs obtained during fetal life by percutaneous
umbilical blood sampling or amniocentesis
electrophoresis
