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Health Promotion > Hematology > Flashcards

Hematology Flashcards

1
Q

What Is anemia

A

Anemia is a condition in which the hemoglobin concentration is lower than normal; it reflects the presence of fewer than the normal number of erythrocytes within the circulation.

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2
Q

What is a hypoproliferative anemia?

A

In hypoproliferative anemias, the marrow cannot produce adequate numbers of erythrocytes. Decreased erythrocyte production is reflected by an inappropriately normal or low reticulocyte count. Inadequate production of erythrocytes may result from marrow damage due to medications (eg, chloramphenicol) or chemicals (eg, benzene) or from a lack of factors (eg, iron, vitamin B12, folic acid, erythropoietin) necessary for erythrocyte formation.

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3
Q

What is a Hemolytic Anemia

A

In hemolytic anemias, premature destruction of erythrocytes results in the liberation of hemoglobin from the erythrocytes into the plasma; the released Hemoglobin is converted in large part to bilirubin and therefore, the bilirubin concentration rises.

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4
Q

What can Cause Hemolysis

A

Hemolysis can result from an abnormality within the erythrocyte itself (eg, sickle cell anemia, glucose-6-phosphate dehydrogenase [G-6-PD] deficiency) or within the plasma (eg, immune hemolytic anemias), or from direct injury to the erythrocyte within the circulation (eg, hemolysis caused by mechanical heart valve)

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5
Q

Normal Levels Hemoglobin Women (Hgb)

A

12-16 g/dl

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6
Q

Normal Levels Hemoglobin Males (Hgb)

A

13-18g/dl

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7
Q

Biggest cause of Hypoxemia related to Anemia

A

Decreased Hemoglobin, reduces O2 carrying capacity in blood resulting in Hypoxemia

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8
Q

Erythrocytes are

A

Red Blood Cells

Average life span of 120 days

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9
Q

Normal Levels of Erythrocytes in Males

A

4,600,000 (4.6x106)cu mm to 6,200,000 (6.2x106) cu mm

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10
Q

Normal Levels of Erythrocytes in Females

A

4,200,000 (4.2x106)cu mm to 5,400,000 (5.4x106) cu mm

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11
Q

What are the two types of Iron Obtained from Food

A

Heme is from animal sources

Non-Heme From plant sources

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12
Q

Transferin does what

A

Transport Iron in the blood

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13
Q

Name five sources of Non-Heme Iron

A

Fortified Cereals

Dried Beans(Kidney Beans, Chick peas)

Peas

Sweet Potates

Green leafy Veggies(Spinach, Kale)

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14
Q

Name Three Sources of Heme Iron

A

Muscle Meats (Beef, Pork, Dark meat chicken)

Tounge(Tripe)

Organ Meats (Liver, Kidneys)

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15
Q

Eating Both Heme and Non-Heme Sources of Iron have a Synergestic effect with absortion.

TRUE OR FALSE

A

True. If you eat at least 10% Non-Heme sources with Heme there is a synergistic effect increasing the absorption of the Iron.

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16
Q

Normal Values Of Hematocrit For Males

A

40-52 %

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17
Q

Normal Values Of Hematocrit for Females

A

36-48%

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18
Q

What are Reticulocytes

A

Imature RBC’s

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19
Q

What are Reticulocytes Used to monitor

A

Reticulocytes are utilized to montior for Bone marrow failure.

An Increase in Reticulocytes after Iron treatment for anemia shows treatment is working

No increase or lack of production indicates a bone marrow disorder

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20
Q

Hyprolifitive anemia

A

Defect in production of RBCs due to Iron, Vitamin B12, or Folate Deficiancy.

Also From Decreased Erythorpoietin production and cancers

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21
Q

Hemolytic Anemia

A

Results from Excessive Destruction of RBCs

SLE( Systemic Lupus Erythropoesis)

Hyperspleenism

Altered Erythropoisis(cell Shape)

May also be caused by blood loss

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22
Q

MCV (Mean Corpuscular Volume)

A

The measure of the average size of a single RBC

Macrocytic (large)

Microcytic (small)

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23
Q

MCHC (Mean corpuscular Hemoglobin Concentration)

A

Measure of the average percent of hemoglobin on a single RBC

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24
Q

RDW

A

Red cell distribution- essentially and indication of the degree of abnormal variation in sizes of RBCs

Assists in determining type of anemmia present or causes

25
Q

Macro cytic disorders indicate

A

B-12 issues

26
Q

Micro Cytic indicate

A

Iron disorders

27
Q

Clinical Manifestations of Anemia

A
  • Fatigue, weakness, mailase(most common)
  • Palor and Jaundice(Hemolytic only due to increased BilliRubin)
  • Cardiac and Respiratory (due to increase vascular Rates)
  • Tounge changes (iron = Smooth Red, B12/Folate = Red Beefy)
  • Nail Changes
  • Angular Cheilosis (Mouth edges Split)
  • PICA (ice chewers= anemia)
28
Q

Erythropoetin is?

A

A hormone from the kidney that increases RBC production.

29
Q

What is the relationship to of the kidneys with anemias?

A

95% of anemias can lead to Kidney disorders and concerns. With anemia be sure to monitor for kidney fucntion

30
Q

Assessment is Key

What parts of assessment are VIP

A
  • Health hx and Physical exam- ETOH Decreases Absorbtion of Folic acid, also heredity is a good indicator of anemia
  • Lab Datas
  • Nutrition and Meds- Strict Vegitarian diet can decrease B12
  • Recent blood lossess( Menses or GI bleeds)
  • Nero- B12 Defiicits can cause Delirium
31
Q

Priority for managing fatigue R/T anemia

A

Assisting the patient to prioritize activities and establish a balance between activity and rest is very important because it has the largest effect on the quality of life of an anemic patient.

it is very important as a nurse not to cluster your care like you normally would to avoid overwhelming the patient.

provide breaks between tasks such as bathing, toileting, and ambulation programs

32
Q

What Are some diagnoses for Patients with anemia

A
  • Fatigue R/T Decrease Hgb and decreased O2 Carrying capacity of the blood
  • Imbalanced nutrition less than body requiremets r/t B12,, Folic Acid, or Iron Deficiencey
  • Ineffective tissue perfusion r/t decreased RBC’s
  • Noncompliance with Prescribed medicine therapys
33
Q

What is the best treatment for anemias

A

Proper nutrition

34
Q

Problems with Compliance include

A
  • Need to understand the purpose of the med
  • Undesireable S/E
    • GI constipation
    • cost inhibitive
35
Q

Potential Complications from Anemia

A
  • Heart failure
  • angina
  • paresthesia
  • confusion
  • injury r/t falls
  • Depressed mood
36
Q

Hyporoliferative anemia

Iron Deficiency Anemia

A

Most Common of all ages and all the world

Hypochromic(poor color) Micro Cytic( Small Cells)

Low Reticulicytes, Iron, Ferritin, MCV and Increased TIBC(transferin)

37
Q

Hyporoliferative anemia

Iron Deficiency Anemia

Most Common Cause

A

Dietary Concerns

Not enough Dietary Iron

Sometimes related to Increased blood loss from Menses or GI Bleed

38
Q

TIBC

A

Total Iron Binding capacity

39
Q

Iron Supplements

care and Concerns?

A

GIve 1hr before or two hours after meals

Avoid giving with H2 blockers, Antacids, calcium, coffee/tea, fiber and some phospate sodas(colas)

Best absorbed on an empty stomach with vit c, (orange Juices)

Iron dextrane only used if oral Ferrous Sulfate is not tolerated.

Given as liquid to children with straw to avoid teeth staining.

40
Q

Pernicious Anemia- Missing Intrinsic Factor

A

Must be treated by injections of B12 Oral will not help. The body does not absorb B-12

Can be hereditary, but is primarily a disorder of the elderly

41
Q

Dietary concerns for Pericious Anemia

A

Soft food because of Beefy Tounge.

42
Q

B12 Deficiency causes

A

Vegitarians who consume no meat or dairy

poor absorbtion (chrones, bariatric surgery)

43
Q

S/S of Both Hyproproliferative Anemia’s(B12-Pernicous)

A

Nero symptoms

Confusion

Numbness tingling in Hands/Feet

Poor Balance(rombergs sign)

Trouble walking

Burning tounge

44
Q

What is rombergs Sign

A

When patient closes their eyes and waivers while standing with thier feet together

45
Q

What is Schilings test and how is it done

A

Evaluates the bodies ability to absorb B-12

Large dose given to

Pt fasting given radioactive b-12 and then an 24 hour urine is collected.

If radioctive is in urine body absorbed. if not then no absorbtion through GI tract

46
Q

Folate Deficency anemia

A

Normochromatic and macrocytic

Rapid Onset mimics B-12

Decerase in Folate levels

People who rarely eat raw or uncooked veggis

ETOH, Preggers, pts with chronic Heolytic anemia

Nutrition considerations- Foods high in Folic Acid

Green Leafy veggies, organ meats, whole grains, enriched cereals

47
Q

Management of anemias

A

B-12 : Veggies can take oral supplements or fortified soy mild

Perncious anemia- Monthy IM injections of B-12

Folic- Increasing Folic acid Intake in diet or supplement 1mg folic acid daily

***Folic acid is not used to treat until others are ruled out****

48
Q

Aplastic Anemia

A

Normochromatic, Normocytic

Idyooathic

Is a decrease in precursor cells of the bone marrow

believed associated supstances- cytotoxic agents, anti thyroids, antimicrobials, inorganic arsenic, Benzene, pesticides, plutonium and radon

Essentially STEM CELLS FROM THE BODY Attack T-CElls from Bone marrow

49
Q

S/S of Aplastic Anemia

A

Gradual Onset, weakness, pallor, Dysnea on exertion

Abnormal Bleeding on 1/3 of patients

sepsis

Treatment

Hemapoietic stem cell transplant

Immunosupresives

Generally not treated for pts over 60 Due to poor tx response

50
Q

How do Hypoproliferate anemias affect renal disorders

A

They decrease Erythropoetin levels and increase creatinine levels.

Treated with Epogen, or Procrit

51
Q

Hemolytic Anemias

A

altered erthyposis of cell- resulted in fragmented RBCs increased reticulocyte levels and billirubin

body destroys RBC’s monitor labs,

52
Q

Sickle Cell Anemia

A

Inherited, RBCs Scikle when body dehydrates and there is poor perfusion.

Low O2 causes sickles, Increases Pain and swelling from poor perfusion

Treated with Oxygen and fluids

53
Q

Clinical Manifestations of SCA

A

Hgb Levels of 7-10 are normal

Jaundice

Bone marrow expands in children

Dysrythmias in adults

Children can have enlargement of flat bones of face

Adults can have and enlarged heart

54
Q

Types of SCA Crisis

A

Acute Vaso-Occlusive- Entrapment of Cells due to clumping and lack of venous space

Sequestiration- Results when other organs such as spleen pool blood

55
Q

thalassemia

A

is a group of hereditary disorders that are associated with defective hemoglobin chain synthesis. Comes in two groups Alpha and Beta

56
Q

Alpha Thalassemia Occurs Mainly in?

A

People form Asia and the middle East

This is the milder form

57
Q

Beta Thalassemia occurs mostly in

A

People from the mediterainian regions and may also occur in asian or middle easterns

58
Q

Complications of thalassemia are

A

Iron overload

infection due to splenic removal

enlarged spleen from RBC over load

slower growth rates

Heart problems

59
Q
A

Health Promotion (14 decks)

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