Hematological Dysfunction

Question 1

What are the 4 most common types of anemia in adults?

Answer 1

Fe Deficiency (IDA)
Pernicious
Folic Acid
Aplastic

Question 2

What is anemia?

Answer 2

decrease in the number of RBC, the quantity of Hgb, and volume of packed RBC (Hct)

Question 3

T or F. Anemia is not a disease but a manifestation.

Answer 3

True

Question 4

What is iron deficiency anemia (IDA)?

Answer 4

inadequate supply of Fe to synthesize Hgb

Fe in the ‘heme’ in hemoglobin

Question 5

Cause of IDA?

Answer 5

inadequate dietary intake
acute/chronic blood loss
GI blood loss
menstrual bleeding

Question 6

2mL of blood contains ___ mg of Fe

Answer 6

1 mg

Question 7

What is Fe primarily absorbed?

Answer 7

the duodenum

Question 8

Labs for IDA

Answer 8

H&H

RBC

Question 9

clinical s/x of IDA

Answer 9

pallor skin and mucous membranes
glossitis
fatigue
palpitations/tachy
dyspnea upon exertion

Question 10

Foods high in iron

Answer 10

Organ meats
dark green, leafy veggies
dried fruit
whole grain bread/cereal
foods high in Vitamin C

Question 11

Education measures for a pt taking Fe supplements

Answer 11

take 1 hour before meals
take with foods high in vitamin C
Dilute liquid prep
Drink liquid prep through straw to avoid teeth staining
Dark colored stools
constipation

Question 12

Method to administer IM Fe

Answer 12

Z track

Leave 0.5 mL of air in syringe

Question 13

What is pernicious anemia?

Answer 13

Vitamin b12 deficiency d/t absence of intrinsic factor

Question 14

Cause of pernicious anemia

Answer 14

hereditary

failure of intrinsic factor s/p gastrectomy or small bowel resection

Question 15

pernicious anemia labs

Answer 15

RBC

H&H

Question 16

s/sx pernicious anemia

Answer 16

paraesthesia
ataxia
altered structure and function of peripheral nerves, spinal cord, and brain

Question 17

T or F. Vitamin b12 injections are for life with pernicious anemia

Answer 17

True

Question 18

What is folic acid deficiency?

Answer 18

insufficient folic acid

folic acid is essential for DNA synthesis and RBC maturation

Question 19

Cause of folic acid deficiency

Answer 19

dietary deficiency (usually r/t alcoholism)
malabsorption syndromes
medications (anticonvulsants, anti-metabolics, oral contraceptives)

Question 20

folic acid deficiency labs

Answer 20

RBC

H&H

Question 21

foods high in folic acid

Answer 21

green, leafy veggies
liver
meat
fish
legumes
whole grains

Question 22

What is aplastic anemia?

Answer 22

hypo plastic bone marrow resulting in anemia, leukopenia, and thrombocytopenia

aka pancytopenia

Question 23

Cause of aplastic anemia

Answer 23

idiopathic
exposure to chemicals, toxins, radiation, viral infections
medications (anti-neoplastics used in treatment of cancer and Chloromycetin)

Question 24

Aplastic anemia labs

Answer 24

RBC
WBC
H&H
Platelets

—CBC!

Question 25

s/sx of aplastic anemia

Answer 25

s/sx of infection

bleeding (r/t thrombocytopenia)

Question 26

aplastic anemia interventions

Answer 26

DC causative agents
education on possible bone marrow transplant
prevent infection
educate on good personal hygiene
avoid ASA and ASA products
avoid Valsalva's maneuver
use an electric razor
avoid rectal temps
avoid IM or SQ injections if possible (if not, hold pressure for 5-10 minutes after needle is removed)