Anemia/Cancers/Lymph System Flashcards
1
Q
Anemia
A
- low RBCs produced, hemolysis, blood loss
- microcytic– sm. RBCs, iron deficiency—most common, less RBCs from low hgb lvl, comes from red meat
- macrocyctic—lg RBCs, folic acid/B12 deficiency, most common macro anemia, pernicious: B12 (DNA synethesis) loss results in intrinsic factor loss= no B12 absorption, unhealthy RBCs from O2 lack
- hereditary, hemolysis
2
Q
Anemia S/S
A
- pallor, fatigue, Dyspnea, tachy (common signs from O2 & hemoglobin loss in RBCs)
- pernicious— hand/feet numb from disease nerve damage & O2 loss, glossitis, these take longer to see, B12 IM shots not PO because of absorption issue
- iron deficient— glossitis, spoon nails/oral fissures, pica, take Fe supplements PO w OJ NO MILK. Until 2 hrs after can also be IV, use straw with oral ..can stain teeth
3
Q
Anemia Labs
A
- CBC— RBC shape/sz, hgb & hct lvls(range: 12-18)
- iron profile— pherotyn, total fe capacity, will see if PT fe deficient
- marrow biopsy— posterior iliac crest
- find blood loss source—sigmoidoscopy, colonoscopy, occult tests of stool/urine
4
Q
Anemia Therapy
A
- treat causes, maybe blood transfusions, iron foods (spinach, lentils)
- correct chronic blood loss
- oral/PN (Z-track)fe therapy—increased absorption from OJ/vit. C, take when hungry, no milk or antacid until 2 hrs prior to med, oral stains teeth so use straw
- fe therapy may cause nausea , vomiting, constipation, dark/tarry stools diarrhea
5
Q
Aplastic anemia
A
- bone marrow loses clotting factors (pancytopenia), turns yellow, fatty, fibrous
- fatal if untreated
- differs from other anemias
6
Q
Anemia Nursing
A
- watch V.S., —pulse/RR increases >20%, limit activity
- conserve energy
- O2 PRN
- safety risk for falls from weakness/dizzy
- oral hygiene
7
Q
Aplastic anemia S/S
A
- varies with bone failure
- early: weakness, fatigue, pallor, SOB, headaches
- later: pancytopenia get worse from marrow cell loss, tachy (H.F.), ecchymosis/petechiae, bloody mm/injection sites, bleeding into organs, death/infection from WBC loss
8
Q
Aplastic anemia labs
A
- starts with CBC— low values: pancytopenia, WBC range 4500-11000
- RBCs may be normal from 120 day life span
- marrow biopsy—definitive, dry tap, finds fatty/yellow tissue
- iron binding capacity tests
- serum iron level test
9
Q
Aplastic anemia nursing
A
- Similar to general anemia
- low platelets= risk for bleeding: thrombocytopenia, bleeding precautions, no aspirin, no NSAIDs, low WBCs=infection risk: leukopenia, infection protection
10
Q
Sickle cell anemia
A
- recessive & from parent
- RBCs sickle-shaped, rigid/crack easily, clumps & congests vessels and organs, painful, shape change from hgb/hct body change
- normal hgb, abnormal hgs from O2 changes
- found mostly in African/asian/ Mediterranean PTs
11
Q
Sickle Cell Pathology
A
- bilirubin rises
- jaundice, gallstones, splenomegaly/hepatomegaly
- increased bile pigment
- RBC lifespan reduced from 10-20 days to
12
Q
Sickle cell S/S
A
- starts after 6 mos old
- sickling constant— cells can rt to normal if O2 improves
- can Turn into sickle cell crisis aka vasocclusive disorder
13
Q
Sickle cell crisis
A
- any O2 decreases can cause it I.e. pneumonia, cold, dehydration infection
- sickling» thick blood in capillaries/chest & abdomen veins, joints/bones
- infarction, necrosis»pain/fever/swelling
14
Q
Sickle Cell Crisis s/s
A
- severe back & joint pain, joints/elbows/knee swelling
- abdominal pain from splenomegaly
- hand-foot syndrome (toe growth), life quality impaired
- death from infection, strokes, organ failure
- O2 need»avoid exertion ..sickling
15
Q
SCC labs
A
- blood smear
- low hgb
- low cbc
- high WBCs
16
Q
SCC therapy
A
- no cure, PT education: crisis prevention
- low dose antibiotic
- acute: opioids—pain management, transfusions—replaces some RBCs, O2 therapy—help resp. Status Po fluids/IVF—flush debris from sickle cells
- WARM Compress, no tight clothes, bedrest
