Anemia 3 (Ch. 42 part 1) Flashcards
True or False: Anemia is a clinical sign, not a specific disease.
True
What is a cause of sickle cell disease?
Autosomal recessive inheritance of two defective gene alleles for hemoglobin synthesis
What are 4 causes of iron deficiency anemia?
Iron deficient diet
Chronic alcoholism
Malabsorption syndromes
Partial Gastrectomy
Rapid metabolic activity in patients with iron deficiency anemia can be caused by these 3 things:
Pregnancy
Adolescence
Infection
Vitamin B12 deficiency can be caused by:
Dietary deficiency
Absorption issues such as partial gastrectomy, pernicious anemia, malabsorption syndroms
Folic Acid deficiency can be caused by:
Dietary deficiency
Malabsorption syndrome
The following drugs: Oral Contraceptives, Anticonvulsants, Methotrexate
Aplastic Anemia can be caused by:
Radiation and Chemicals
Explain the pathology of Sickle Cell Disease:
RBCs are distorted, fragile and clump together. This can lead to a vaso-occlusive event which can lead to hypoxia and cause a chain reaction of blood clots. It can also damage organs or even cause them to fail.
What things can trigger sickling?
Hypoxia, venous stasis, dehydration, infections, pregnancy, alcohol consumption, high altitudes, abnormal body or environmental temps, stress, acidosis, excessive exercise and anesthesia.
Sickle Cell Disease occurs in __________ (number) of African Americans?
1 in 500.
What is the most common symptom of Sickle Cell Disease Crisis?
Pain.
How often should you assess a patient’s perfusion when they have SCD?
At least every 8 hours.
Where do you assess a patient with darker skin for jaundice?
The roof of their mouth
Which two organs are the first to be damaged during SCD crisis?
liver and spleen
What are the top 4 priorities (in order) for patients with SCD?
- Acute Pain
- Chronic Pain
- Potential for Sepsis
- Potential for multiple organ dysfunction and death
What is the most common problem in people with SCD?
Pain.
Are analgesics also used to help with pain in patients with SCD?
Yes. This is an “action alert” in chapter 42. It says, “Do not assume that complimentary therapies alone will provide adequate pain relief. Analgesics are needed to manage sickle cell pain.
What do you teach sexually active women who are taking Hydroxyurea?
Teach them to use at least two methods of birth control while taking the medication and for 1 month after the drug is discontinued because the drug can cause severe birth defects. This is an “action alert” in ch. 42.
Do you want to give caffeine to patients with SCD?
Nope.
What are some things important for a nurse to know when caring for a patient with SCD?
Do not raise knee position of bed, encourage patient to keep extremities extended, elevate the head NO MORE than 30 degrees, remove any constrictive clothing.
What are some contraindications for hydroxyurea?
Pregnancy or whether they are likely to become pregnant. This drug can cause birth defects.
A patient in SCD crisis needs IV fluids at what rate?
200 mL/hr
What are some preventative measures for SCD crisis?
1) 3 - 4 L of water a day
2) Avoid tobacco and alcohol
3) Get Flu shots
4) avoid temp extremities
5) avoid planes with unpressurized cabins
6) Avoid travel to high altitudes
7) Avoid strenuous exercise
8) consider genetic counseling and inform health care provider of scd.
True or False: You should avoid PRN pain meds in the hosptial environment for patients with SCD crisis.
True. They are not enough. However, they are often given to patient for use at home.
True or False: Patients with damage to vital organs are advised against becoming pregnant.
True.
What causes thrombosis?
Vascular Stasis
Teaching for Polycythemia Vera?
Drink at least 3L of water a day. No tight clothing Keep health-care appointments Contact physician at first sign of infection Anticoagulants Support Stockings Elevate feet USE AN ELECTRIC RAZOR SOFT BRISTLED TOOTH BRUSH DO NOT FLOSS. (you want to avoid anything that will cause you to bleed)
Treatment of thrombocytopenia
avoid IM injections and venipunctures Test stool for occult blood Avoid trauma to mouth Avoid trauma to rectum Avoid contact sports Shoes with firm soles
Which disorder makes a patient create antibodies to their own platelets.
Thrombocytopenic Purpura
What class drugs are given to folks with autoimmune thrombocytopenic Purpura
Immunosuppressants
People who have a spleenectomy are at risk for what?
Infections.
What is the most common form of hemophelia?
Hemophelia A
What causes Hemophelia A?
A deficiency in Factor VIII
What causes Hemophelia B?
A deficiency in Factor IX
True or False: Women who are carriers of Hemophelia can pass along the disease without actually having the disorder.
True
Hemophelia A affects which gender the most?
Males
In Hemopheliacs the PTT time will be…
Longer than Normal
In hemopheliacs, PT time (not to be confused with PTT) is…
Normal
Which Hemophelia is called “Christmas Disease”?
Hemophelia B.
Previous Test question….. A kid was playing in the sand box, has hemophelia and is bleeding. What do you do?
Administer Fresh Frozen Plasma.
Is it ok to infuse drugs with blood products?
No. Blood must be administered alone.
How many people have to sign off on a blood transfusion?
Two. The nurse must be one of them.
