Anemia Flashcards
1
Q
Oral iron: examples and characteristics
A
- ferrous sulfate
- ferrous fumarateIron
- fortified formula for infant
- Foods high in iron (dark green leafy vegetables, dried fruits, egg yolks, kidney beans, liver, raisins, shell fish, tofu, whole grains, legumes, red meat, molasses, nuts, potatoes, prune juice)
2
Q
Oral iron: considerations
A
- Give between meals for absorption
- Avoid milk and antacids as this can decrease iron absorption
- Vitamin C increases the absorption of iron
- Liquid iron should be diluted and ingested through a straw (iron stains teeth).
- Teach to brush teeth after administration
- Can cause constipation, dark stool, heartburn, and a foul aftertaste
3
Q
Parenteral iron: examples and characteristics
A
- ferric gluconate
- iron dextran
- iron sucrose
- Indicated for malabsorption, oral iron intolerance, need for iron beyond normal limits, poor patient compliance
- ***Can be given IM or IV (IV mixed with NS)
- ***IM may stain skin.
- IM should be given Z track bc can be painful
- Use different needle to draw up an adm solution bc so thick and hard to deal with
4
Q
Management of Iron Toxicity: example and characteristics
A
- Deferoxamine mesylate (Desferal)
- Chelating agent for iron
- Give IM, IV, subcutaneous
- Can cause rash, visual changes
- Iron is a metal that can be toxic when administered in high quantities
- Chelating agents are used to prevent toxicity – holds onto iron and takes it out of body before it can do damage
5
Q
Megaloblastic Anemias: TX options
A
Cobalamin:
- Parenteral or intranasal administration of cobalamin
- ***Cyanocobalamin (B12) Injections are weekly initially and then monthly for life if intrinsic factor deficiency or GI issue
- Oral multivitamins have B12
- Increase in dietary cobalamin if problem is lack of dietary intake
Folic Acid:
- Insidious onset
- But Absence of neurologic problems
- Treated by replacement therapy (1 mg/day orally; if malabsorption then up to 5 mg/day orally)
- Encourage patient to eat foods with large amounts of folic acid.
6
Q
Dietary sources of Vitamin B 12
A
- Brewer’s yeast
- Citrus fruits
- Dried beans
- Green, leafy vegetables
- Liver
- Nuts
- Organ meats
7
Q
Dietary sources of folic acid
A
- Green leafy vegetables
- Liver
- Meat
- Fish
- Legumes, whole grains
- Orange juice
- Peanuts, dried beans
8
Q
Erythropoiesis stimulating agents: example and characteristics
A
- Epoetin Alfa (Epogen)
- Synthetic form of erythropoietin
- Promotes the synthesis of RBCs
- Used to treat anemia associated with chronic kidney disease
- Given in conjunction with iron
- Longer acting form is darbepoetin (Aranesp)
- Both given IV or subcutaneously
9
Q
Colony stimulating factors: examples and characteristics
A
- Filgrastim (G-CSF, Neupogen); Stimulates the production of neutrophils, Administer IV, subcutaneously
- Pegfilgrastim (Neulasta)
Used prophylactically with chemotherapy - Sargramostim (GM-CSF, Leukine) Enhances # of neutrophils, eosinophils and monocytes, enhances activity; Leukemia, Hodgkins disease, bone marrow transplant
- Adverse effects: Bone pain and respiratory distress
FPS + -fil-/-gra-/-stim
10
Q
Colony stimulating factors: indications and considerations
A
- Drugs used to stimulate production of WBCs (leukopoiesis) for patients with neutropenia
- Indications for use with chemotherapy or radiation therapy patients, transplant patients, cancer patients
Nursing implications
- Monitor neutrophil counts, for infection
- Adverse effects (N, V, fatigue, fever, flushing)
11
Q
Thrombopoietic Growth factors: examples and characteristics and adverse effects
A
- Platelet enhancers- increase platelet production
- Oprelvekin (Neumega, Interleukin-11)
- Used for patients at risk for thrombocytopenia – enhance platelet production
- Given subcutaneously
- Adverse effects include allergic reactions including anaphylaxis (BACK BOX WARNING), blurred vision, optic neuropathy, peripheral edema
- Nursing interventions – monitor for fluid overload (weight gain swelling, cardiac rhythm issues, teach not to drive (dizzy, drowsy)
