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Pharmacology for Advanced Practice Nurses > Anemia > Flashcards

Anemia Flashcards

1
Q

Anemia

A

Condition in which red blood cells have a reduced capacity to deliver oxygen to tissues

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2
Q

Anemia consider a sign of an

A

underlying disorder

Goal: identify underlying cause and treat

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3
Q

Anemia causes

A

Blood loose due to hemorrhage
Increase erythrocyte destruction
Decreased erythrocyte production

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4
Q

Anemia S/S

A

pallor, decrease exercise tolerance, fatigue, lethargy; dizziness or fainting; severe – heart failure

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5
Q

Anemia Classified by

A

erythrocytes size and color

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6
Q

sizes example

A

normal (normocytic), small (microcytic), or large (macrocytic).

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7
Q

Color example

A

Color – normal red (normochromic) or light red (hypochromic).

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8
Q

Macrocytic–normochromic

Description and example

A

Large, abnormally shaped erythrocytes with normal hemoglobin concentration

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9
Q

Goal for anemia is

A

identify the underlying cause to treat

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10
Q

Microcytic–hypochromic

example and descrption

A

Small, abnormally shaped erythrocytes with decreased hemoglobin concentration

Iron-deficiency anemia, thalassemia

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11
Q

Normocytic–normochromic example and description

A

Destruction or depletion of normal erythroblasts or mature erythrocytes

Aplastic anemia, hemorrhagic anemia, sickle-cell anemia,

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12
Q

Iron Deficiency Anemia

A

Cells are microcytic and hypochromic.

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13
Q

Iron Deficiency Anemia caused

A

Inadequate iron absorption or consumption decreases erythropoiesis, which causes anemia.

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14
Q

Conditions associated with iron-deficiency anemia include

A 
Gastrointestinal (GI) bleeding (found in more than 50% of clients with this anemia)
Chronic peptic ulcer disease (PUD)
GI malignancies
Pregnancy
Blood loss during menses
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15
Q

Test to determine time of anemia

A

peripheral smear

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16
Q

Treatmetn of anemia varies according to

A

severity

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17
Q

Mild anemia treatment

A

increased dietary intake of iron-rich foods such as fish, red meat, fortified cereal, and whole-grain bread

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18
Q

Moderat anemia treatment

A

oral iron supplementation

19
Q

severe anemia treatment

A

iron supplementation; IV or IM iron therapy may be given if the client cannot tolerate oral supplements

20
Q

Most common cause of iorn deficience anemia

A

GI bleeding

21
Q

Iron preperations build

A

serum iron and iron storage in the body

22
Q

Iron preparations pharmacokinetics

A

Enhanced absorption if iron stores low
Ferrous form absorbed more readily
Food affects absorption
Eliminated via shedding of gastrointestinal (GI) mucosal cells or via bleeding

23
Q

Iron preperations precautions and contraindications

A

Hemochromatosis and hemolytic anemia

24
Q

Iron preparations ADR

A 
GI symptoms (constipation, GI upset)
Acute toxicity possible, especially in children
25
Q

Iron preparations drug interacions

A

Chelation

Decreased absorption

26
Q

Iron prepartions clinical use and dosing

A

Iron-deficiency anemia
Treatment for 3 to 4 months after Hgb/Hct return to normal
Adults: 150 to 300 mg elemental iron daily
Premature infants: 2 to 4 mg/kg/day
Infants and young children: 4 to 6 mg/kg/day

27
Q

Iron preparations monitoring

A

Monitoring
Reticulocyte count 5 to 10 days after starting therapy
Hgb, hct, ferritin at 4 weeks, then 3 months, then annual
If Hgb, Hct, and ferritin do not return to normal levels, the patient should be evaluated for a source of blood loss in other pathology.

28
Q

Iron preparations take with what to enhance absorption

A

Take with vitamin c to enhance absorption

29
Q

Pernicious Anemia

A

Vitamin B12 deficiency the result of Large, immature RBCs

30
Q

Pernicious anemia S/S

A

pallor, fatigue, lethargy, dizziness & faintness

31
Q

Vitamin B12 cannot

A

Cannot be synthesized from the body, only bacteria in the gut can
Must interact with the intrinsic factor

32
Q

Deficiency in B12 can be

A

caused by inflammatory diseases of the small intestine, or by gastric resection

33
Q

Vitamin B12 supplement route

A

Vitamin B12 supplement - parental, oral. Intranasal not generally used.

34
Q

Vitamin B12 ADR

A

: uncommon but can include hypokalemia, rashes, itching & sodium retention

35
Q

The most common cause of vitamin B12deficiency is absence of

A

intrinsic factor, a protein secreted by stomach cells. Intrinsic factor is required for vitamin B12to be absorbed from the intestine.The hematopoietic stem cells produce abnormally large erythrocytes that do not fully mature.

36
Q

The symptoms of pernicious anemia are often

A

nonspecific and develop slowly, sometimes over decades. Nervous system symptoms may include memory loss, confusion, unsteadiness, tingling or numbness in the limbs, delusions, mood disturbances, and even hallucinations in severe deficiencies.

37
Q

Vitamin B12 deficiency etiology

A 
Poor intake (vegans, vegetarians)
Impaired absorption caused by lack of intrinsic factor, diseases of the ilium, stasis (constipation)
Gastrectomy, bariatric surgery
38
Q

B12 pharmacokinetics

A

IM, SC, or intranasal well absorbed

Stored in liver and excreted in urine

39
Q

B12 dose prevention

A

Pregnancy: 2.2 mcg/day, lactation 2.6 mcg/day
Infants: 0.3 to 0.5 mcg/day
Children age 1 to 10 years: 0.7 to 1.4 mcg/day

40
Q

B12 dose deficiency

A

1,000 mcg oral cobalamin daily for 6 to 12 weeks

41
Q

pernicious anemia B12 initial dose

A

Initial dose 1,000 mcg/day IM or SC for 7 days, then 100 to 1,000 mcg IM per week for a month

42
Q

pernicious anemia B12 maintenance dose

A

1,000 mcg IM monthly
500 mcg intranasal cyanocobalamin weekly
1,000 mcg orally daily

43
Q

pernicious anemia B12 monitoring

A

Reticulocyte counts, Hgb and Hct, iron, folic acid, and vitamin B12 serum levels prior to treatment, at 5 to 7 days of therapy, then frequently until Hgb and Hct are normal

Monitor potassium levels

Liver function tests every 2 to 4 weeks to monitor for hepatotoxicity

Pharmacology for Advanced Practice Nurses (50 decks)

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