Anemias Flashcards
What is anemia?
Lower than normal hemoglobin levels
What are the 3 classifications of anemia?
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- Hypoproliferation: not making enough RBCs
- Hemolytic: destruction of RBCs
- Blood Loss
What is hypoproliferative anemia?
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not making enough RBCs (defect in production of RBCs)
Examples:
* Iron deficiency anemia, B12, or folate deficiency
Causes:
Gastritis, GI tumors, pregnancy, GI bleed
S/S and treatment of Hyperproliferative Amenia
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S/S:
* rigid nails
* Low MCV (size of RBCs)
* smooth, sore tongue
Signs & Symptoms of Anemia
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- Fatigue
- Weakness
- Pallor or jaundice
- Cardiac & Respiratoyr symptoms
- Tongue changes
- Nail changes (rigid nails)
- PICA
- Angular chelosis
What is hemolytic anemia?
excess destruction of RBCs
Types of Hyperproliferative Anemia
- Iron deficiency
- Anemia in renal disease
- Anemia of chronic disease
- Aplastic anemia
- Megaloblastic anemia
What is the most common type of anemia among all age groups?
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Iron Deficiency Anemia
Manifestations / Signs & Symptoms of Iron Deficeincy Anemia
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- Fatigue
- Weakness
- Fluid Volume Deficit (FVD)
- Tongue Changes (smooth, sore tongue)
- Riged nails
- Angular Cheilosis
- PICA
- Increased RR & HR
- SOB
What is the treatment for Amenia in Renal Disease?
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Recumbent (synthetic) Erythropoietin (Epoetin Alfa also known as Epogen, Procrit, or Aranesp)
What is Anemia in Renal Disease and when does it occur?
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- Occurs in association of serum Creatinine level > 3 mg / 100 mL
As kidenys fail, less erythropoietin is produced
What classification of anemia is sickle cell anemia under?
Hemolytic anemia
What classification are Iron deficiency anemia, anemia in renal disease, & sickle cell anemia part of?
Iron deficiency & anemia in renal disease = hypoproliferative amenia
- Sickle Cell Anemia = hemolytic anemia
A patient with renal fialure has decreased erythrocyte production. Upon analysis of the patient’s CBC, the nurse will expect which of the following results?
a.) Increased hemoglobin & decreased hematocrit
b.) A decreased hemoglobin & hematocrit
c.) A decreased mean corpuscular volume (MCV) & red cell distribution (RDW)
d.) An increased mean corpuscular volume (MCV) & red cell distribution (RCD)
b.) A decreased hemoglobin & hematocrit
A patient with a hemoglobin of 7.7 g/dL has 2 units of PRBCs ordered for transfuion. Which intervention(s) should the nurse implement? (Select all that apply)
a.) Obtain signed consent
b.) Initiate a 22 g IV
c.) Assess the patient’s lungs
d.) Check for allergies
e.) Hang a keep open IV of D5W
a.) Obtain signed consent
c.) Assess the client’s lungs (to check for fluid volume status)
d.) Check for allergies
The patient receiving a unit of PRBCs begins to chill & develops hives. Which action should be the nurse’s first response?
a.) Notify the laboratory & HCP
b.) Administer the histamin-1 blocker
c.) Assess the patient for further complications
d.) Stop the transfusion & change the tubing at the hub
d.) Stop the transfusion & change the tubing at the hub
What type of inheritance is sickle cell anemia?
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Autosomal recessive trait
What are triggers of sickle cell anemia crisis?
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- cold
- dehydrated
- increased stress or exercise
- high altitutdes
What diagnostic tests are used in the diagnosis of anemia?
- Hemoglobin
- Hematocrit
- Reticulite Cell Count (immature RBCs)
- Iron Studies
- Bilirubin
- Mean Corpuscular Volume (MCV)
- Bone Marrow Aspiration
What findings are associated in geriatric patients who have anemia?
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- Confusion
- Injury due to falls
- Vertigo & Dizziness
- Depressed mood (due to fatigue)
- Fatigue
- Hypoxia
Management of Iron Deficiency Anemia
- Diet Counseling
- Iron Supplements
Clinical Manifestations of Sickle Cell Anemia
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- tired or fatigued
- Respiratory Problems / SOB (from activities that shouldn’t normally cause SOB)
- Pale or jaundice
- Pain (from thrombosis / sticking of RBCs)
- Kidney Failure
- Dizziness or lightheadedness
- Chronic coolness in hands & feet
- Frequent headaches
cells only last 10-20 days instead of 120 days like RBCs should
Acute Chest = increased RR, SOB (looks like pneumonia & CXR looks like pneumonia)
What complications are patients with Sickle Cell Anemia at increased risk for?
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- Stroke (clots)
- Anxiety & Depression
- Infections
- Retinopathy & in some cases blindness
Medical Management of Sickle Cell Anemia
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- Folate (increases RBC turnover)
- Penicillins (until age 5 when pt’s can get vaccines)
- Vaccinations
- Bone Marrow Transplants (can “cure” in some cases, but are very risky)
- Pain: NSAIDs, Analgesics, Opiods, etc.
- Hydroxyurea (creates fetal hemoglobin which reduces sickling from occuring & can reduce # of sickle cell crises)