Hematology in depth Flashcards
(195 cards)
Go look at slide 1/45
types of anemia (morphology, examples, lab values expected)
Classification of anemia: hypoproliferative
iron
vit b12 deficiency
cancer/inflammation
results from the inability of bone marrow to produce adequate numbers of red blood cells
Classification of anemia: bleeding
GI, trauma, genitourinary, epistaxis
Classification of anemia: hemolytic
Altered erythropoiesis Hypersplenism Drug-induced anemia Autoimmune anemia Mech health valve
Red blood cells are destroyed faster than they can be replaced
Describe iron deficiency anemia:
Body’s iron stores are depleted an no iron available for hemoglobin synthesis.
Describe microlytic anemia
transferrin saturation is below 20% and ferritin is below 30
happens when your red blood cells are smaller than usual because they don’t have enough hemoglobi
What are general manifestations of anemia?
tachycardia SOB dyspnea chest pain muscle pain or cramping pallor
What labs are evaluated when determining is someone has anemia?
Hbg/Hct Retiulocyte count RBC Iron studies – TIBC, % saturation, ferritin Vitamin B12 Folate Haptogloin – if hemolysis is suspected) Erythropoietin
What are factors that can influence the development of anemia-associated symptoms?
- The rapididy with which anemia has developed
- The duration of the anemia
- The metabolic requirements of the patient
- Other concurrent disorders or disabilities (i.e., cardiopulmonary dx)
Anemia assessment: general
Weakness, fatigue
Dizziness
Pica (craving unusual items including - ice, starch, or dirt)
Anemia assessment: neurological
Numbness and tingling (paresthesias), irritability
Weakness
Headache
Poor coordination, confusion
Gait disturbances
Reflex abnormalities
Loss of position (proprioception) and vibration sense
Spasticity
Roaring, rushing, ringing, or pounding sensation in the ears
Anemia assessment: respiratory
Dyspnea
Orthopnea
Tachypnea
Anemia assessment: GI
Anorexia, nausea, vomiting Dysphagia Abdominal pain Flatulence Diarrhea Hepatomegaly Splenomegaly
Anemia assessment: musculoskeletal
Muscle pain (claudication)
Anemia assessment: integumentary
Pallor of the skin and mucous membranes
Jaundice (hemolytic anemia)
Brittle, ridged, concave nails
Impaired wound healing
Loss of elasticity
Early thinning and graying of hair
Dry skin
Painful mouth sores
Beefy red, sore tongue (megaloblastic anemia)
Smooth and red tongue (iron deficiency anemia)
Ulcerated corners of the mouth (angular cheilitis)
Anemia assessment: cardiovascular
Palpitations Chest pain Tachycardia Hypotension Peripheral edema Murmurs
Medical and nursing management for anemia
- Correct or control cause
- manage fatigue
- maintain adequate nutrition
- maintain adequate perfusion
What can decrease the severity of fatigue in patients with anemia?
short periods of daily exercise can decrease the severity of fatigue
What should clients with anemia keep in mind about their nutrition?
Iron, vitamin b12, folic acid are essential
- avoid alc
- culturally centered food and food preferences
- dietary supplements may be needed
Iron deficiency anemia: causes
Blood low
Low iron in diet
Heavy menstruation
Iron deficiency anemia: s/s
SOB Fatigue Increased workload of the heart Tachycardia Dizziness
Iron deficiency anemia: dx
MCV < 90fL
Stool for occult blood
Colonoscopy
mean corpuscular volume. An MCV blood test measures the average size of your red blood cells
Iron deficiency anemia: tx
Iron
Transfussion
What are things to keep in mind about iron transfusions?
Hemoglobin rise after 1 week – full 1-2g/dL 4-8 weeks