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Advanced Med Surg > Hemo > Flashcards

Hemo Flashcards

1
Q

low levels of hgb

A

anemia

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2
Q

too much hgb

A

polycythemia

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3
Q

s/sx of anemia

A
  • pallor
  • weakness/fatigue
  • malaise
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4
Q

normal value of MCV (size of RBC)

A

81-96

<81= too small
>96= too big
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5
Q

normal value of MCHC (amount of hbg)

A

33-36

<33= hypochromic
>36= hyperchromic
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6
Q

priority nursing diagnosis for anemia

A

ineffective tissue perfusion

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7
Q

iron deficiency anemia is most common among

A
  • menstruating and pregnant women

- third world countries

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8
Q

s/sx of iron deficiency anemia

A
  • pallor
  • dizziness
  • fatigue
  • tachycardia
  • elevated reticulocytes
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9
Q

when pt is taking iron what should you ask

A

what is the color of your stool?

-black stool is the side effect of iron

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10
Q

labs for iron deficiency anemia

A

-microcytic, hypochromic

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11
Q

clinical manifestations of iron deficiency anemia

A
  • weakness/fatigue
  • brittle, rigid nails
  • smooth, red atrophic tongue
  • angular cheilosis (cracking of the lips)
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12
Q

foods rich in iron

A
  • animal meats, organ meats (beef, chicken, liver)
  • black beans
  • leafy green vegetables
  • raisins
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13
Q

how is iron BEST absorbed?

A

acidic environments/ empty stomach

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14
Q

medication treatment for iron deficiency

A

-ferrous sulfate, ferrous gluconate, fumarate

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15
Q

what instructions/ pt teaching do you give to the pt for iron deficiency anemia

A
  • eat foods high in fiber
  • take medications together with meals
  • vitamin c will enhance absorption
  • stools will become dark in color
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16
Q

when should you do blood transfusion (in relation to hgb)?

A

when the hgb is 7 and below

17
Q

chemicals causing anemia

A

-cytokines, and inadequate secretion of erythropoetin

18
Q

pathophysiology of anemia

A

-if kidneys fail they can produce erythropoetin so you can not stimulate the bone marrow to make RBCs

19
Q

labs for anemia of inflammation

A
  • normocytic, normochromic

* low hemoglobin

20
Q

which anemia is caused by disorders in the heme moeity (portion) of hemoglobin?

A

sideroblastic anemias (ringed siderblasts)

21
Q

two types of sideroblastic anemias

A

-hereditary and acquired

22
Q

common cause of acquired sideroblastic anemia

A

-more common than hereditary type
-common causes: Lead, alcohol, isoniazid
-

23
Q

characterize hereditary sideroblastic anemia

A

X linked condition due to adbormality in pyridoxine metabolism
Congenital defect in the enzyme
(d-aminolevulinic acid (ALA) synthetase)

24
Q

describe thalassemia

A

Diminished synthesis of globin chain of Hgb

RBCs are more rigid leading to early destruction

Characterized by severe microcytosis and hypochromia

25
Q

describe a-thalassemia (Bart’s Hbg)

A
  • Deficient a-chain synthesis, usually due to deletion of gene
  • Most prevalent among Asians and middle Easterns

-Milder than beta forms and can occur without symptoms
→ may live normal life span

26
Q

describe b-thalassemia (HbF)

A
  • Due to malfunction of B-globin chain caused by B-gene abnormality
  • Common among African descent
  • Severe anemia, marked hemolysis, ineffective erythropoiesis

-Can be fatal within the few years of life
With early regular transfusion therapy growth and development through childhood are facilitated

27
Q

megaloblastic anemia

A

Characterized by RBC that exceed 100 um in size
Defective DNA synthesis (main characteristic of megaloblastic anemia) RBC cannot produce nucleic acid → nuclear maturation arrested → cytoplasmic maturation arrest→ cytoplasmic maturation proceeds→ abnormally large cells

28
Q

deficiencies for megaloblastic anemia

A
  • folic acid deficiency

- vitamin b12 deficiency

29
Q

clinical manifestations of megaloblastic anemia

A
  • Weakness, fatigue, pallor, jaundice, smooth sore, red atrophic tongue
  • Mild diarrhea, angular cheilosis
  • Vitiligo, premature graying of hair often seen in pernicious anemia
  • Paresthesias (numbing sensation) in the extremities, ataxia (B12)
  • Schilling’s test (test for presence of intrinsic factor and intestinal function to determine cause of vit. B12
  • High methylmalonic and homocysteine levels more sensitive vit B12 deficiency
30
Q

describe aplastic anemia

A

-Damage to the marrow with replacement by fat (aplasia)
→ markedly reduced hematopoiesis
-Can be congenital or acquired
Infections, medications, chemical or radiation can cause the disease
Pancytopenia

31
Q

clinical manifestations of aplastic anemia

A

fatigue , pallor, dyspnea
Bleeding tendencies: Purpura, bruising
Repeated infections such as sore throat, cervical lymphadenopathies
Retinal hemorrhage (bleeding behind eye)
Bone marrow biopsy: aplastic marrow replaced with fat

32
Q

interventions for aplastic anemia

A
  • Assess for signs of bleeding, anemic and infections
  • Offending agent should be discontinued
  • Prepare client for possible BMT or PBSCT
  • Prepare client for immunosuppressive therapy (antithymocyte globulin and cyclosporine)
  • Place client on isolation room

Advanced Med Surg (2 decks)

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