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NURS 232 > Hematological Conditions > Flashcards

Hematological Conditions Flashcards

1
Q

Anemia

A

Deficiency in the…

of RBCs
Quantity or quality of hemoglobin
Volume of packed RBCs (hematocrit)

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2
Q

Anemia caused by…

A 
Decreased RBC production (iron deficiency)
Blood loss (acute and chronic)
Increased RBC destruction - intrinsic (abnormal Hgb), extrinsic (physical trauma from dialysis)
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3
Q

RBC function

A

Transport oxygen from lungs to tissues

Carry CO2 form tissues to lungs

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4
Q

Anemia Classification

A

Morphological (cellular characteristics)

Etiological (underlying cause)

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5
Q

Anemia - Clinical Manifestations

A

Mild (Hb 100-120) - palpations, dyspnea and mild fatigue

Moderate Anemia (60-100) - cardiopulmonary symptoms

Severe Anemia (Hb<60) - symptoms involving multiple body systems

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6
Q

Anemia - Skin Manifestations

A

Pallor
Jaundice (increased concentration of serum bilirubin)
Pruritus (increased serum and skin bile salt)

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7
Q

Anemia- cardiopulmonary Manifestations

A

Increased HR and stroke volume

MI, HF

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8
Q

Anemia Management

A

Goals:

  • assume normal ADLs
  • Maintain adequate nutrition
  • develop no complications related to anemia
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9
Q

Anemia Implementation

A 
Blood transfusions
Drug therapy
Volume replacement
Dietary and lifestyle changes
Oxygen therapy
Client teaching (nutrition intake)
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10
Q

Lifespan of RBC

A

120 days

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11
Q

Alteration in erythropoiesis may decrease RBC production

A
  1. decreased hemoglobin synthesis
  2. Defective DNA synthesis in RBCs
  3. Diminished availability of erythrocyte precursors
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12
Q

Most susceptible people for iron deficiency anemia

A

very young
poor diets
women in reproductive years

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13
Q

Iron-deficiency anemia etiology

A

inadequate dietary intake
Malabsorption
blood loss
hemolysis

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14
Q

Iron-deficiency anemia - Manifestations

A

Pallor
Glossitis (inflammation of the tongue)
Cheilitis (inflammation of the lips)

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15
Q

Iron-deficiency anemia - collaborative care

A

GOAL: treat underlying disease

increase intake of iron
nutritional therapy
oral/parenteral iron supplements
Transfusion of packed RBCs

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16
Q

How iron is best absorbed

A

duodenum and proximal jejunum

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17
Q

When Iron should be taken

A

an hour before meals (acidic environment)

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18
Q

Anemia of Chronic Disease (decreased # of RBC precursors)

A

underproduction of RBCs

mild shortening of RBC survival

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19
Q

Anemia of chronic disease - cause

A

renal disease
chronic liver disease
inflammatory, autoimmune, infectious or malignant disease

20
Q

Anemia of chronic disease findings

A

increased serum ferritin
increased iron stores
normal folate and cobalamin levels

21
Q

Causes of Anemia

A

Decreased Erythrocyte production
Acute Blood loss
increased RBC Destruction

22
Q

Acute blood loss

A

result of sudden hemorrhage from:
trauma
complications of surgery
disrupted vascular integrity

23
Q

Concerns of acute blood loss

A

hypovolemic shock

reduced plasma volume

24
Q

Acute blood loss - manifestations

A

pain

  • internal hemorrhage
  • retroperitoneal bleeding (abd pain and distention)
  • shock
25
Q

Acute Blood loss - Collaborative Care

A 
Replacing blood volume to prevent shock
Identifying the source of hemorrhage 
Stopping blood loss
Correcting RBC loss
Providing supplemental Iron
26
Q

Blood transfusions

A

The body needs 2-5 days to manufacture more RBCs in response to increased erythropoietin

27
Q

IV fluids used in blood loss emergencies

A

dextran, hetastarch, albumin, crystalloid (lactated ringers)

28
Q

Sources of Chronic Blood Loss

A

Bleeding ulcer
Hemorrhoids
Menstraul and postmenopausal blood loss

29
Q

Chronic blood loss- management

A

Identify Source
Stop bleeding
Use supplemental iron

30
Q

Hemolytic Anemia

A

Destruction or hemolysis of RBCs at a rate that exceeds production

31
Q

Intrinsic hemolytic anemia

A

Abnormal hemoglobin
enzyme deficiencies
RBC membrane abnormalities

Hereditary

32
Q

Extrinsic hemolytic anemia

A

More common than intrinsic
Acquired
Damage caused by external factors

33
Q

Hemolytic Anemia - manifestations

A

Jaundice (increased bilirubin)

Enlarged spleen and liver (hyperactive w macrophage phagocytosis of defective RBCs)

34
Q

Hemolytic Anemia can cause…

A

Accumulation of hemoglobin molecules that obstruct renal tubules = tubular necrosis

35
Q

Example of Intrinsic hemolytic anemia

A

Sickle cell disease

36
Q

Sickle Cell disease

A

Group of inherited, autosomal recessive disorders
Presence of an abnormal form of hemoglobin in the erythrocyte (Hemoglobin S)
Incurable and fatal

37
Q

HbS in SCD

A

Causes RBC to stiffen and elongate (decreased O2 levels)

Causes vascular occlusion leading to acute or chronic tissue injury

38
Q

Types of SCD

A

Sickle Cell Anemia (most severe)
Sickle cell-thalassemia
Sickle cell-HbC disease
Sickle cell trait

39
Q

SCD - Manifestations

A

Sickling episodes - from low oxygen or infection, dehydration

Sickle cell crisis - severe pain from vaso-occlusive crisis

pain and swelling
pallor
jaundice

40
Q

SCD complications

A

Pnuemonia
Other body systems (spleen, lungs, kidneys, brain)
Acute chest syndrome

41
Q

SCD - Management

A

Alleviate symptoms of disease complications
minimize end target-organ damage
No specific treatment
client teaching (avoid high altitudes, maintain fluid intake, treat infections, pain control)\
O2 for hypoxia
Blood transfusions
Stem cell transplant

42
Q

Antisickling agent

A

Hydroxyuria

43
Q

Acute chest syndrome management

A

Antibiotics
O2 therapy
Fluid therapy
Transfusion

44
Q

Acquired Hemolytic Anemia (extrinsic)

A

Physical factors
Immune reactions
Infectious agents and toxins

45
Q

Iron storage

A

Bone marrow, liver, spleen, macrophages

NURS 232 (19 decks)

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