ANEMIA IN PREGNANCY Flashcards
It is a condition defined as the reduction in circulating hemoglobin below the critical level.
Anemia
Normal Hemoglobin levels
12-14 g/dL
Is a protein in the RBCs that carries oxygen to the body’s organs and tissues and transports carbon dioxide from the organs and tissues back to the lungs.
Hemoglobin
Types of Anemia
- Iron-deficiency Anemia
- Folic Acid Deficiency Anemia
- Megaloblastic anemia
The most common type of anemia in pregnancy & even more common in women during the reproductive age
Iron-deficiency anemia
Why is IDA considered the most common type of anemia during pregnancy?
Because during pregnancy, the volume of blood in the body increases and so does the amount of iron needed. The body uses iron to make more blood to supply oxygen to both mother and fetus
Characteristics of IDA
- Microcytic
- Hypochromic
Means the RBCs are small in size
Microcytic
Means RBCs are less in color
Hypochromic
Causes of IDA
- Diet low in iron
- Heay menstrual periods / Postpartum bleeding
- Unwise weight-reducing programs
- Successive pregnancies
- Low socioeconomic status
- Excessive vomiting due to morning sickness
Common tests used to diagnose IDA
- CBC
- Serum Ferritin
- Serum Iron
- Total Iron- Binding Capacity
One of the key indicators of anemia , reflects the oxygen-carrying capacity of RBCs
Low Hemoglobin
The percentage of blood volume made up of RBCs, which can be low in anemia.
Low Hematocrit
This measures the average size of RBCs, and in IDA it is often low
Low Mean Corpuscular Volume
Most specific test for iron deficiency, as it reflects the body’s iron stores
Serum Ferritin is a protein that stores iron
Serum Ferritin
Measures the level of iron in the blood
Serum Iron
Measures how much transferrin is available to bind iron.
Total Iron-Binding Capacity
Elevated TIBC of over …?
Over 400 micrograms/ dL
SIGNS & SYMPTOMS OF IDA
- Skin / mucous membrane pallor
- Extreme fatigue
- Poor exercise tolerance, shortness of breath, dizziness
- Pica
- RLS (Restless Leg Syndome)
Compulsive craving & eating of substances with little or no nutritional value in pregnant women.
Pica
Why does Pica happen?
Body recognizes need for more nutrients
Itchy, crawly, tingling sensation that urges you to move legs
Restless Leg Syndrome
How can IDA be prevented
- Prenatal vitamins containing 27 mg of Fe & folic acid as prophylactic therapy
- Eating Iron- Rich Foods
- Women with heavy periods may need iron supplements
- Continue supplements post-deliver to restore iron levels
- Educate on Pica
Prescribed dosage of elemental iron if woman develops IDA
120-200 mg/day
Nursing Interventions
- Promote adequate nutrition
- Iron Supplementation
- Monitor hematologic parametes
- Manage symptoms
- Collaboration with healthcare
Is an Intravenous iron formation used to treat IDA in specific situations where oral iron is insufficient, ineffective or contraindicated
Iron Sucrose
Indicated in anemia when the severity of the condition compromises oxygen delivery to tissues and cannot be adequately corrected with other treatments
PRBC transfusion
For pregnant women, transfusion is indicated for
Severe anemia (hb: 7 ug/dL)
Most common type of anemia in multiple pregnancies, with hemolytic disease, inadequate dietary intake & poor gastric absorption, woman taking hydantoin
Folic-Acid Deficiency Anemia
**
Is an anticonvulsant that interferes with FA absorption
Hydantoin
Necessary for the formation of RBCs
- associated in preventing NTDs
Folic Acid
Synthetic form of Vitamin B9 sold as supplements/tablets
Folic Acid
Natural source found in foods
Folate
Abnormally Large & Immature RBCs
Megaloblastic anemia
Laboratory findings for Megaloblastic anemia
- Low Hemoglobin & Low hematocrit
- Elevated Mean Corpuscular Volume
Prevents / Interventions of Megaloblastic anemia
- FA supplements at least one month
- Encourage women to take FA supplements
- FA rich diet
- FA fortified foods
- Encouarage regular prenatal check ups
- Educate patient: antiseuzire drugs, methotroxate and sulfasalazine
A nurse instructor is preparing to administer a vitamin K injection to a newborn, and a student nurse asks about the purpose of the injection. What is the most appropriate response?
A. “Vitamin K provides active immunity.”
B. “Vitamin K will help prevent hyperbilirubinemia.”
C. “Vitamin K will protect the newborn from bleeding.”
D. “Vitamin K will offer protection against jaundice and anemia.”
C. “Vitamin K will protect the newborn from bleeding.”
Nurse Kelly is educating a new mother who has just received Rho(D) immune globulin (RhoGAM) after delivery. How does Nurse Kelly know the patient understands the purpose of the medication when the patient states it will protect her baby from which of the following?
A. Developing Rh incompatibility.
B. Having Rh-positive blood.
C. Developing pernicious anemia.
D. Contracting German Measles.
A. Developing Rh incompatibility.
Nurse Jenna is discussing iron supplementation with a pregnant patient who is curious about the increased need for iron during pregnancy. What is the primary reason for this increased requirement?
A. The mother might experience anemia because of a reduced appetite.
B. The fetus requires more red blood cells, which the mother needs to provide.
C. The mother may develop physiologic anemia due to the need for increased red blood cell mass, while the fetus requires about 350-400 mg of iron for growth.
D. The mother may have digestion issues due to pica.
C. The mother may develop physiologic anemia due to the need for increased red blood cell mass, while the fetus requires about 350-400 mg of iron for growth
Nurse Rachel is caring for a child newly diagnosed with acute lymphocytic leukemia (ALL). What should be the initial priority in her care plan?
A. Implementing infection control precautions.
B. Supporting the child and family in coping with a chronic illness.
C. Promoting the consumption of iron-rich foods.
D. Administering prescribed medications via intramuscular injections.
A. Implementing infection control precautions.
Nurse Leah is reviewing common conditions that occur during the second trimester of pregnancy with a group of expectant mothers. Which of the following conditions should she mention as being typical during this stage?
A. Respiratory acidosis
B. Physiologic anemia
C. Metabolic alkalosis
D. Mastitis
B. Physiologic anemia
Nurse Maria is assessing a pregnant client admitted to the labor room. After noting the client’s low hemoglobin and hematocrit levels, which indicate anemia, Nurse Maria determines that the client is at risk for which of the following?
A. Preterm labor
B. Hypertension
C. Postpartum hemorrhage
D. Gestational diabetes
C. Postpartum hemorrhage
Nurse Jenna is providing prenatal education to a client who has been diagnosed with iron-deficiency anemia during pregnancy. Which statement by the client indicates a correct understanding of how to manage this condition?
A. “I’ll drink a glass of milk with my iron supplement to increase absorption.”
B. “I’ll take my iron supplement right before bed, even if I’ve eaten recently.”
C. “I should take my iron supplement on an empty stomach.”
D. “It’s best to take my iron supplement with a calcium-rich food like yogurt.
C. “I should take my iron supplement on an empty stomach.”
A pregnant client at 28 weeks gestation is diagnosed with anemia. Nurse Lisa reviews the client’s laboratory results, which show a hemoglobin level of 9 g/dL. Which of the following complications should the nurse monitor for as a priority?
A. Polyhydramnios
B. Preeclampsia
C. Fetal macrosomia
D. Preterm delivery
D. Preterm delivery
