Anemia: General Flashcards
What is Anemia?
A deficiency in the number of o Erythrocytes (RBCs) o Hemoglobin (\<9 issue) o Volume of packed RBCs (HCT)
MCV refers to a RBCs…
• Size
MCH refers to a RBCs…
• Color (due to Hgb)
A normocytic, normochromic RBC has MCV and MCH values of…
- MCV: 80-100
- MCH: 26-34
A microcytic, hypochromic RBC has MCV and MCH values of…
- MCV: <80
- MCH: <27
A macrocytic, normochromic RBC has MCV and MCH values of…
- MCH: >100
- MCH: >34
Normocytic, normochromic RBCs may be associated w/ what causes/types of anemia?
- Acute blood loss
- Hemolysis
- Chronic kidney disease
- Aplastic anemia
- Sickle cell anemia
- Pregnancy
Microcytic, hypochromic RBCs may be associated w/ what causes/types of anemia?
- Iron deficiency anemia
- Thalassemia
- Lead poisoning
Macrocytic, normochromic RBCs may be associated w/ what causes/types of anemia?
- Cobalamin (Vit B12) deficiency
- Liver disease (alcohol abuse)
- Post splenectomy
What are the 3 states of anemia?
- Mild
- Moderate
- Severe
What s/s may be seen with mild anemia?
• Asymptomatic or slight s/s of low energy, circulation, oxygenation
What s/s may be seen with moderate anemia?
- Cardiopulmonary symptoms are increased, and the patient may experience them while resting, as well as with activity.
- Associated low energy/o2 s/s will be elevated as well
What s/s may be seen with severe anemia?
- Fatigue, circulation, and oxygenation clinical manifestations will be more intense and involve multiple body systems
- Immunity system reaction will be decreased as well
What are for common s/s of substantial anemia progression?
- Skin pallor
- Jaundice
- Pruritus
- Cardiopulmonary manifestations
What may skin pallor indicate in regard to anemia?
- ↓ Hgb
- ↓ blood flow to skin
What may jaundice indicate in regard to anemia?
- Concentration of serum bilirubin (liver issues)
- Helps reflect integumentary changes for dark skinned peeps
What may pruritis indicate in regard to anemia?
• ↑ serum and skin bile salt concentrations
All clinical symptoms of anemia are due to
• Tissue hypoxia
Anemic hypoxia to the heart can lead to
- Heart failure, MI
- Cardiomegaly
- Pulmonary and systemic congestion
- Ascites
- Peripheral edema
Why can anemia be difficult to dx w/ older patients?
• Because many of the s/s are commonly associated w/ the ageing process
What are the general s/s of anemia that are shared w/ the ageing process?
- Pallor
- Confusion
- Ataxia
- Fatigue
- Worsening angina, heart failure
When obtaining a H&H w/ possible anemia, what are some key points to ask?
- Recent blood loss
- Any underlying disease problems involving kidney, liver, endocrine system , Crohn’s disease
- Smoking, exposure to toxins
- Recent travel suggesting exposure to infection
- Angina history
What elimination patterns should be assessed w/ suspected anemia?
- Hematuria
- Diarrhea
- Tarry stools
What hx of medication use should be inquired about for a pt suspected of anemia?
• Iron supplements
• Vitamins
• Aspirin
• Anticoagulants
• Antiseizures
o Phenobarbitol
o Phenytoin
What are the nursing management goals when treating a patient w/ anemia?
- Normal ADL function
- Maintain nutrition
- Develop no complications due to anemia
What are some ways that anemia may be corrected?
- Blood transfusion (or blood products)/volume replacement
- Drug therapy: erythropoietin and vitamin supplements
- Dietary and lifestyle changes
What is MCHC in relation to RBCs?
• Hemoglobin concentration per RBC
Type of anemia: MCV less than lower limit of normal
• microcytic anemia
Type of anemia: MCV within normal range
• normocytic anemia
Type of anemia: MCV greater than upper limit of normal
• macrocytic anemia
Type of anemia: MCH less than lower limit of normal
• hypochromic anemia
Type of anemia: MCH within normal range
• normochromic anemia
Type of anemia: MCH greater than upper limit of normal
• hyperchromic anemia
What labs may be run for anemia dx?
- Hb/HCT
- MCV, MCH, MCHC
- Reticulocytes
- Serum iron
- Total Iron Binding Capacity (TIBC)
- Bilirubin
- Platelets
What other tests (not labs) may be run for anemia dx?
- Guaiac test
- Endoscopy
- Colonoscopy
- Bone marrow biopsy