Anemias

Question 1

What is anemia?

Answer 1

Lower than normal hemoglobin levels

Question 2

What are the 3 classifications of anemia?

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Answer 2

• Hypoproliferation: not making enough RBCs
• Hemolytic: destruction of RBCs
• Blood Loss

Question 3

What is hypoproliferative anemia?

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Answer 3

not making enough RBCs (defect in production of RBCs)

Examples:
* Iron deficiency anemia, B12, or folate deficiency

Causes:
Gastritis, GI tumors, pregnancy, GI bleed

Question 4

S/S and treatment of Hyperproliferative Amenia

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Answer 4

S/S:
* rigid nails
* Low MCV (size of RBCs)
* smooth, sore tongue

Question 5

Signs & Symptoms of Anemia

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Answer 5

• Fatigue
• Weakness
• Pallor or jaundice
• Cardiac & Respiratoyr symptoms
• Tongue changes
• Nail changes (rigid nails)
• PICA
• Angular chelosis

Question 6

What is hemolytic anemia?

Answer 6

excess destruction of RBCs

Question 7

Types of Hyperproliferative Anemia

Answer 7

• Iron deficiency
• Anemia in renal disease
• Anemia of chronic disease
• Aplastic anemia
• Megaloblastic anemia

Question 8

What is the most common type of anemia among all age groups?

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Answer 8

Iron Deficiency Anemia

Question 9

Manifestations / Signs & Symptoms of Iron Deficeincy Anemia

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Answer 9

• Fatigue
• Weakness
• Fluid Volume Deficit (FVD)
• Tongue Changes (smooth, sore tongue)
• Riged nails
• Angular Cheilosis
• PICA
• Increased RR & HR
• SOB

Question 10

What is the treatment for Amenia in Renal Disease?

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Answer 10

Recumbent (synthetic) Erythropoietin (Epoetin Alfa also known as Epogen, Procrit, or Aranesp)

Question 11

What is Anemia in Renal Disease and when does it occur?

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Answer 11

• Occurs in association of serum Creatinine level > 3 mg / 100 mL

As kidenys fail, less erythropoietin is produced

Question 12

What classification of anemia is sickle cell anemia under?

Answer 12

Hemolytic anemia

Question 13

What classification are Iron deficiency anemia, anemia in renal disease, & sickle cell anemia part of?

Answer 13

Iron deficiency & anemia in renal disease = hypoproliferative amenia

• Sickle Cell Anemia = hemolytic anemia

Question 14

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)

Answer 14

b.) A decreased hemoglobin & hematocrit

Question 15

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

Answer 15

a.) Obtain signed consent
c.) Assess the client’s lungs (to check for fluid volume status)
d.) Check for allergies

Question 16

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

Answer 16

d.) Stop the transfusion & change the tubing at the hub

Question 17

What type of inheritance is sickle cell anemia?

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Answer 17

Autosomal recessive trait

Question 18

What are triggers of sickle cell anemia crisis?

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Answer 18

• cold
• dehydrated
• increased stress or exercise
• high altitutdes

Question 19

What diagnostic tests are used in the diagnosis of anemia?

Answer 19

• Hemoglobin
• Hematocrit
• Reticulite Cell Count (immature RBCs)
• Iron Studies
• Bilirubin
• Mean Corpuscular Volume (MCV)
• Bone Marrow Aspiration

Question 20

What findings are associated in geriatric patients who have anemia?

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Answer 20

• Confusion
• Injury due to falls
• Vertigo & Dizziness
• Depressed mood (due to fatigue)
• Fatigue
• Hypoxia

Question 21

Management of Iron Deficiency Anemia

Answer 21

• Diet Counseling
• Iron Supplements

Question 22

Clinical Manifestations of Sickle Cell Anemia

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Answer 22

• 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)

Question 23

What complications are patients with Sickle Cell Anemia at increased risk for?

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Answer 23

• Stroke (clots)
• Anxiety & Depression
• Infections
• Retinopathy & in some cases blindness

Question 24

Medical Management of Sickle Cell Anemia

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Answer 24

• 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)