Exam 3 HEME Flashcards
deficiency of erythrocytes (RBCs) reflected by a decreased Hct <4x10^12
anemia
pallor (ears and nailbeds, palmar crease, conjunctiva esp)
fatigue, exercise intolerance, lethargy, orthostatic hypotension
tachycardia, heart murmurs, HR
Bleeding (hematuria, melena, menorrhagia)
Dyspnea
irritability, diff concentrating
cool skin, cold intolerance
assessment with anemic patient
which meds may cause anemia?
salicylates, thiazides, and diuretics
what dietary factors may contribute to anemia?
decreased iron, folate, or Vit B12
when does cardiac output increased to compensate for anemia?
when hgb <7
red meats, organ meats, whole wheat products, spinich, carrots
food high in iron
green veg, liver, citrus fruits
foods high in folic acid
glandular meats, yeast, green lieafy veg, milk and cheese
foods high in vit B12
how do you administer Iron?
use z track method
use air bubble to avoid w/d medication into SC tissue
DONT USE DELTOID
DONT MASSAGE
when do you take iron?
empty stomach one hour before meals or two hours after meals and give vit C to enhance iron absorption
what should you tell patients who take iron?
may turn stool black and may stain skin if given IM (that why we use Ztrack). take liquid iron through a straw and brush teeth afterward to avoid staining teeth
malignant neoplasm of blood forming organs
abnormal overproduction of immature forms of leukocytes and decreased RBC and platelets
leukemia
why does immunosupression occur in leukemia
large number of immature WBC and profound neutropenia
why does hemorrhage occur in leukemia?
thrombocytopenia
how is leukemia diagnosed?
biopsy, bone marrow aspiration, lumbar puncture, and frequent blood counts
type of leukemia where leukocytes are unable to mature
acute myelogenous leukemia: prognosis is poor
type of leukemai characterized by abnormal production of granulocytic cells
Chronic myelogenous leukemia: a biphasic disease with chronic stage of 3 years and acute stage only 2-3 months
hydroxyurea, interferon, imatinib mesylate
tx for chronic myelogenous leukemia
type of leukemia characterized by abnormal leukocytes in blood forming tissue and is the most common cause of childhood cancer
Acute lymphocytic leukemia: prognosis is favorable
type of leukemia characterized by increased production of leukocytes and lymphocytes and porliferation of cells within the bone marrow, spleen and liver. Occurs after age 35
Chronic lymphocytic leukemia
decreased H&H, decreased plt, altered/high WBC
acute myelogenous leukemia
TX: prevent infection, prevent and control bleeding
high protein, high calorie diet, assist with ADL, drug therapy
use immediately after reconstitution avoid vapors in eyes vesicant hydrate well before and during treatment with IV fluids and mannitol monitor hearing and vision
cytophosphamide
leucorvian rescue
leucorvian + methotrexate tp prevent toxic rxn
which chemo drug would you give with alloprinol to increase potency and avoid folic acid?
methoxtrexate