Medsurg hesi 5 cardiac Flashcards
The goal of anemia treatment is to restore adequate ___ ___
tissue oxygenation
the most common cause of anemia in children, adolescents, and pregnant women.
Iron-deficiency anemia due to inadequate intake
Aplastic anemia results in a decreased number of RBCs as well as decreased platelets and
WBCs
Anemia may be misdiagnosed as ___ or debilitation in older adult clients
depression
vitamin B12 deficiency: tongue
smooth and bright red
Hct
percentage of RBCs in relation to the total blood volume.
indicates Hgb amount relative to the size of the cell
Mean corpuscular Hgb concentration (MCHC)
Possible causes of decreased MCV, MCH, MCHC (RBC indices)
Iron-deficiency anemia
Possible causes of increased MCV (RBC indices)
Vitamin B12 deficiency
Folic acid deficiency
Hgb electrophoresis separates normal Hgb from abnormal. It is used to detect
sickle-cell disease
A ____ test measures vitamin B12 absorption with and without intrinsic factor. It is used to differentiate between malabsorption and pernicious anemia.
Schilling
A Schilling test measures vitamin B12 absorption with and without intrinsic factor. It is used to differentiate between malabsorption and
pernicious anemia.
Bone-marrow aspiration/biopsy is used to diagnose
aplastic anemia
Parenteral iron supplements (iron dextran) are only given for
severe anemia
Administer parenteral iron using the
Z-track method
Vitamin __ may increase oral iron absorption.
C
Instruct the client to take iron supplements ___ meals to increase absorption, if tolerated.
between
Monitor for a cardiovascular event if Hgb increases too rapidly (greater than __ g/dL in 2 weeks).
1
All cells rely on folic acid for ___ production.
DNA
if B12 deficiency is due to lack of intrinsic factor being produced by the parietal cells of the stomach or malabsorption syndrome, it must be administered
parenterally or intranasally to be absorbed.
Large doses of folic acid may mask
vitamin B12 deficiency
Large doses of folic acid will turn the client’s urine
dark yellow.
In some cases, the development of microemboli in the circulatory system paradoxically “uses up” the clotting factors that cause
hemorrhages to occur at the same time intravascular clotting occurs.
A coagulopathy that is an autoimmune disorder in which the life span of platelets is decreased by antiplatelet antibodies although platelet production is normal
Idiopathic thrombocytopenic purpura (ITP)
Idiopathic thrombocytopenic purpura (ITP): A coagulopathy that is an autoimmune disorder in which the life span of platelets is decreased by antiplatelet antibodies although
platelet production is normal
Idiopathic thrombocytopenic purpura (ITP) can result in
severe hemorrhage following a cesarean birth or lacerations.
A life-threatening coagulopathy in which clotting and anticlotting mechanisms occur at the same time.
Disseminated intravascular coagulation (DIC)
Unusual spontaneous bleeding from the client’s gums and nose (epistaxis) can be a finding of
coagulopathy
Prothrombin time ____ with DIC
increased
D-dimer time ____ with DIC
increased
Nursing interventions for DIC initially focus on assessing for and correcting
the underlying cause (sepsis, hemorrhage)
Nursing interventions for DIC initially focus on assessing for and correcting the underlying cause (sepsis, hemorrhage). The focus then turns to preventing organ damage secondary to microemboli and
replacing the blood’s clotting components.
DIC and ITP: avoid use of
NSAIDs
Medications for ITP
Corticosteroids and immunosuppressants
Medications for DIC
Anticoagulants
DIC – Anticoagulants (heparin) May be used to decrease microclots from forming and
using up clotting factors
ITP – ____ may be performed by the provider if client does not respond to medical management.
Splenectomy
