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Nursing 3 Test 1 > Anemia: Class 2 > Flashcards

Anemia: Class 2 Flashcards

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0
Q

Normal Hemoglobin levels for male and female

A
  1. 14-18 g/dl for Male

2. 12-16 g/dl for Female

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1
Q

Clinical Manifestations of Anemia R/T??

A

Tissue hypoxia

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2
Q

Normal Hematocrit Level for male and female

A
  1. 40-54% for male

2. 38-47% for female

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3
Q

Mild Hemoglobin levels

-Symptoms

A

10-14 g/dl

  1. May exist w/out symptoms
  2. Symptoms may include:
    - Fatigue / diaphoresis / palpitations / dyspnea
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4
Q

Moderate Hemoglobin levels

-Symptoms

A

6-10 g/dl

  1. Increased cardiopulmonary symptoms
    - Experienced at rest or during activity
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5
Q

Severe Hemoglobin levels

A

<6 g/dl

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6
Q

Integumentary manifestations of Anemia

-All 3

A
  1. Pallor
  2. Jaundice
  3. Pruritus
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7
Q

Integumentary manifestations of Anemia

-Pallor

A
  1. Caused by decreased Hgb and decreased blood flow to skin
  2. Look for pallor in Pt’s
    - Oral mucosa, hands, nail beds, conjunctiva
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8
Q

Integumentary manifestations of Anemia

-Jaundice

A
  1. Increase concentration of serum bilirubin

2. Caused by hemolytic anemias (RBC’s lysed releases bilirubin)

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9
Q

Cardiopulmonary manifestations of Anemia

A
  1. Increased pulse pressure
  2. Systolic murmur due to lowered viscosity of the blood
  3. Angina/MI from Tissue Hypoxia (Ischemia)
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10
Q

Hemolytic Anemias

-Symptoms (severe anemia)

A
  1. Splenomegaly
  2. Bone deformities and fractures
  3. Jaundice
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11
Q

Aplastic Anemia

-Symptoms (severe anemia)

A
  1. Petechiae

2. Purpura

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12
Q

Iron Deficiency Anemia

-Symptoms (severe anemia)

A
  1. Behavior disturbances (PICA)
  2. Spoon shaped nails
  3. Cheilosis
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13
Q

Pernicious Anemia

-Symptoms (severe anemia)

A
  1. Paresthesia
  2. Proprioception deficits
  3. Diarrhea
  4. Sore beefy red tongue
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14
Q

Vitamin B12 Anemia

-Symptoms (severe anemia)

A
  1. Headache
  2. Fainting
  3. Forgetfulness
  4. Anorexia
  5. Nausea
  6. Night Cramps
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15
Q

Sickle Cell Anemia

-Symptoms (severe anemia)

A
  1. Pain
  2. Gallstones
  3. Abdominal Pain
  4. Joint Pain
  5. Heart Failure
  6. Chronic leg ulcers
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16
Q

Acute Blood loss

-What to assess?

A
  1. Hypovolemic Shock
    - hypotension w/ tachycardia
    - Changes in level of consciousness
  2. Reduced Plasma Volume
    - Decrease amount of RBC causes decreased 02
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17
Q

Acute Blood Loss and Anemia

A
  1. Secondary iron deficiency anemia related to blood loss.
  2. The body might try to refill sources and use up iron stores
  3. Reticulocyte count will show if a pt is bleeding
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18
Q

Clinical Manifestation of Anemia

-Pain

A
  1. Ischemia

2. tissue distention (compression of nerves)

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19
Q

Retroperitoneal bleeding

A
  1. Punctured Femoral artery
    - change in vascular integrity causes bleeding
  2. Can cause Numbness
  3. Pain in extremities or back
  4. bruising
  5. Listen for bruis over affected area
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20
Q

Pt comes into ER with Blood loss. What do you do?

A
  1. Assess for signs of bleeding
  2. Start two IV’s in both arms
  3. Give the Pt fluids
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21
Q

Assessment of Stool

A
  1. Hemroids are bright red stool

2. Ulcers would be black tarry stools

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22
Q

Nutritional anemias

A
  1. Microcytic (small cells) Hypochromic (pale) cells

2. Assess people in low socioeconomic class due to inability to get good nutrition

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23
Q

Iron Deficient Anemia

-Diagnostics

A
  1. Lab tests
    - Bilirubin - check for hemolytic anemias
    - Platelets - check for aplastic anemia (Affects all CBC)
  2. Stool guaiac test
  3. Endoscopy & Colonoscopy
24
Q

Oral and Parenteral Iron supplements

A
  1. Ferrous sulfate or Ferrous gluconate

2. Iron Dextran IM or IV

25
Q

Foods High in Iron

A
  1. Firm Tofu
  2. Spinach
  3. Broccoli
26
Q

How to take Iron supplements

A
  1. Take with acidic product like orange juice

2. Take liquid Iron through Straw because it stains the teeth

27
Q

Iron IM administration

A

Use the Z-track method because it can stain the skin

28
Q

Change in Stools while on Iron therapy

A
  1. Black, Dark / tarry stools
29
Q

Megaloplastic Anemias

-Classifications

A
  1. Vitamin B12 (Cobalamin) and folic acid deficiency
30
Q

Erythroleukemia

A
  1. Malignant disorder characterized by Erythropoeitic cells in the bone marrow
31
Q

Intrinsic Factor

A
  1. Protein secreted by the parietal cells of the gastric mucosa
  2. Required for B12 absorption in the small intestine (ilium)
32
Q

Vitamin B12 Deficiency

Causes what?

A
  1. Pernicious anemia

2. Nutritional deficiencies

33
Q

Schilling test

-Stage 1

A
  1. Give pt 2 doses of Oral and IV B12
    - Check urine in 24 hrs to see how much B12 was excreted
  2. 5% or more B12 is excreted is normal (It is a nutrition problem)
    - Less than 5% excreted Go to stage 2
34
Q

Schilling test

-Stage 2

A
  1. Administer B12 with IF
  2. If normal, it is an IF problem
  3. If abnormal, it is a malabsorption problem
35
Q

Schilling test

-Stage 3

A
  1. Done after 2 weeks of antibiotic therapy
  2. Could be H. Pylori
  3. If it helps it is a bacterial problem
36
Q

Schilling test

-Stage 4

A
  1. Pancreatic enzymes for 3 days followed by IV B12
37
Q

Oral B12 and Intrinsic Factor

A
  1. Pt cannot have oral Vitamin B12 if they do not have intrinsic factor
38
Q

Folic Acid Deficiency

-Common Causes

A
  1. Alcohol abuse and anorexia **
  2. Drugs
  3. Hemodialysis
39
Q

Folic Acid Deficiency

-Manifestations

A
  1. Absence of neurological complications

2. Similar to B12 deficiency

40
Q

Folic Acid Deficiency

-Pregnancy

A
  1. Can cause neural tube defects in children
41
Q

Folic Acids

-Foods

A
  1. Fruits and green leafy veggies
42
Q

Hemolytic Anemia

-Manifestations

A
  1. Jaundice
    - breakdown of RBC’s releases bilirubin
  2. General symptoms of anemia
  3. Enlarged Spleen or liver
    - Hyperactive with macrophage phagocytosis of defective RBC’s
  4. TUBULAR NECROSIS (monitor urine output as nurse)**TEST
    - Accumulation of Hgb molecules can obstruct tubules
43
Q

Thalassemia

A
  1. Genetic disorder that causes inadequate production of normal Hgb
  2. Common in Mediterranean people and people near the equator in Asia and Africa
  3. Hemolysis occurs
  4. Problem with globulin protein
44
Q

Thalassemia Minor

A
  1. One defective Gene
  2. Usually asymptomatic
    - May have moderate anemia
    • Splenomegaly
  3. Microcytic and hypochromic
45
Q

Major Thalassemia

A
  1. 2 thalassemic genes
46
Q

Thalassemia major

-Clinical Manifestations

A
  1. Life-Threatening
  2. Pale
  3. Mental and physical growth retardation
  4. Splenomegaly, hepatomegaly, Jaundice
  5. Chronic Bone marrow hyperplasia
    - Expansion of bone marrow space
47
Q

Thalassemia

-Collaborative Care

A
  1. Body adapts to decreased Hb in thalassemia minor
  2. Pt rarely reaches adulthood in thalassemia major and pt is given blood transfusions to increase life
  3. No specific Drug or Diet is available for treatment of thalassemia
48
Q

Hemosiderosis

A
  1. Associated w/ excess iron accumulation in the body
49
Q

Glucose 6 phosphate dehydrogenase Anemia (G6PD)

A
  1. Hereditary
    - Occurs more in mediterranean and African decent
  2. Hemolysis occurs when person is exposed to stressors
    - Aspirin and Sulfonamides can be stressors
  3. Defective Gene is on X chromosome–affects more Males
  4. Develop Jaundice, Pallor, elevated Reticulocyte count,
50
Q

G6PD

-Pt Education

A
  1. Avoid Aspirin and Sulfonamides

- These can be stressors that cause hemolysis to occur

51
Q

Aplastic Anemia

A
  1. Decrease in all blood cell types: WBC’s RBC’s and Platelents
  2. Can be congenital or acquired
  3. It is acquired in cancer due to treatment
52
Q

Aplastic Anemia

-Management

A
  1. Erythropoietin

2. Blood transfusions

53
Q

Aplastic Anemia

-Manifestations

A
  1. Symptoms caused by suppression of any or all bone marrow elements
    - Infection
  2. General manifestations of anemia
    - Fatigue, pallor
54
Q

Aplastic Anemia

-Diagnostics

A
  1. Decreased Hb, WBC, and platelets
  2. Reticulocyte count is low
    - decreased production of RBC’s in bone marrow
  3. Bleeding time prolonged -
55
Q

Aplastic Anemia

-Nursing Mgmt (Treatment Options

A
  1. Bone marrow transplant
  2. Immunosuppressive therapy
  3. Erythropoietin therapy
  4. Blood transfusions if necessary

Untreated prognosis is poor

56
Q

Iron-deficiency Anemia

-Diagnostics

A
  1. Low serum Iron
  2. Elevated Total Iron Binding Capacity (TIBC)

-Indicate Iron-deficiency anemia

57
Q

Vitamin C and Iron

A
  1. Vitamin C may increase oral iron absorption

Nursing 3 Test 1 (5 decks)

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