Unit 3 ANEMIAS Powerpoint & Powerpoint lecture Flashcards
What is the primary function of erythrocytes?
respiration
What is the life span of a RBC
120 days
What is anemia?
A deficiency in the number of erythrocytes RBCs
A deficiency in the quantity of Hemoglobin volume of the packed RBCs
What is the function of the RBC?
Transport oxygen from the lungs to systemic tissues
Carry carbon dioxide from the tissue to the lungs
What are the causes of anemia?
Decreased RBC Production
Blood Loss
Increased RBC Destruction
Anemia can be classified as (2)
Morphologic
etiologic
What are the integumentary (skin) manifestations of anemia
Pallor= low hemoglobin & blood flow to the skin
Jaundice= high concentration of serum bilirubin
Pruritus= high serum and skin bile salt concentration
What are the two cardiopulmonary manifestations of anemia
Results from additional attempts by heart and lungs to provide adequate O2 to the tissues
Cardiac output maintained by increasing the heart rate and stoke volume
Wich anemia is one of the most common chronic hematological disorders?
Iron-deficiency anemia
What accounts for 2/3 of the bodies iron?
heme
What is the most prevalent nutritional deficiency in the world
Iron deficiency anemia
What does every living cell contain?
Iron
What is essential to the formation of the hemoglobin molecules on RBCs?
Iron
What causes iron deficiency anemia? (2)
Inadequate dietary intake
Malabsorption
Blood loss
Hemolysis
pregnancy
Where does iron absorption occur?
In the duodenum
What anemia has these manifestations?
Decreased hemoglobin levels
Pallor
Glossitis
Cheilitis
Iron deficiency anemia
Which anemia has this management?
Diagnosis through blood test
Adjust diet?
Iron deficiency anemia
Which anemia has these diagnostic studies?
Laboratory findings
Stool guac test
Endoscopy
Colonoscopy
Bone marrow biopsy
Iron deficiency anemia
Which anemia has these at risk groups?
Premenopausal woman
Pregnant woman
Persons from low socioeconomic backgrounds
Older adults
Individuals experiencing blood loss
Iron deficiency anemia
Which anemia has these management?
Diet teaching
Supplemental iron
Discuss diagnostic studies
Emphasize compliance
Iron therapy for 2-3 months after hemoglobin levels return to normal
Iron deficiency anemia
Which anemia has this collaborative care?
Goal is to treat the underlying disease causing reduced intake or absorption of iron
Efforts are aimed at replacing iron
Nutritional therapy
Oral/parental iron supplements
Transfusion packed RBCs
IDA (Iron Deficiency Anemia)
Which anemia has this drug therapy?
Oral iron
IDA
Which anemia has these complications?
Heart failure
Renal failure
Impaired thermoregulation
Impaired immune function
Psychomotor and cognitive impairment
IDA
Which anemia is a group of disorders
Caused by impaired DNA synthesis
Megaloblastic anemia
Wich anemia is a result form a deficiency in
Colbalam (Vitamin b12)
Folic acid?
Megaloblastic anemia
Which anemia is also called cobalamin?
Vit B12 anemia
Vit B12 anemia
Which anemia occurs when the body has inadequate sources of vit. B12 or malabsorption disorders?
Megaloblastic anemia
What is a coenzyme in the DNA synthesis of RBC and myelin sheath in the nervous system
Vit B12
Vit B12
Which anemia has these as risk factors?
Older adults
GI restrictions
Autoimmune disorders
Crohn’s disease
Celiac disease
Long-term use of medication that decease gastric acids
V B12 Anemia
What is necessary for DNA synthesis of RBC?
Vit. B12
Which anemia has these clinical manifestations?
Spinal cord degeneration
Peripheral neuropathy
Altered mental status, depression
Visual changes
Tachycardia
Shortness of breath
Dizziness
Fatigue
Vit. B12
Wich anemia has the complication of impaired functional ability?
Vit B12 Anemia
Which anemia has this assessment & analysis
Anemia s/s is related to decreased RBC production
Neurologic s/s related to impaired DNA syntheses for maintenance of myelin, neurotransmitters, phospholipids
Vit. B12 Anemia
Which anemia has this diagnoses?
Inadequate tissue perfusion
Activity intolerance
Chronic pain
Vit B 12 anemia
Which anemia has this intervention assessment?
Fatigue, pallor, shortness of breath
Numbness, tingling, burning of heads and feet
Decreased hemoglobin & hematocrit
Fall risk
Intake & output
Vit. B12
Wich anemia has these interventions actions?
Ensure adequate “blank “ intake
Administer “blank” therapy
Monitor use of nitrous oxide
Assess pain and activity levels
Vit. B12. Anemia
Which anemia has this intervention teaching?
Dietary sources
Need for supplementation
Report clinical manifestations
Prenatal teaching
Radiation for advanced cancers
Actions of acid reducing medication
Vit B 12 anemia
Wich anemia has these evaluating care outcomes
Decreased fatigue, pallor, shortness of breath
Normal heart rate and raspatory rate
Normal lab values
Vit B12 anemia
Vit B12 anemia
Which anemia has these as risk factors?
Older adults
Chronic illness
Alcohol abuse
Extreme diets
Folic acid Deficiency
What is necessary for cell maturation and replication?
Folate
Which anemia has this manifestation
Pallor, tachypnea, dizziness, fatigue
Increase risk of bleeding
Folic acid Deficiency
What anemia has this treatment
Folate intake
Supplementation
Folic acid Deficiency
Wich anemia has these complications?
Confusion
Disorientation
Folic acid Deficiency
Wich anemia has this assessment & analyses
s/s related to decreased hemoglobin
Folic acid Deficiency
Which anemia has this nursing diagnosis
Inadequate tissue perfusion
Activity intolerance
Risk for delayed development
Folic acid Deficiency
Wich anemia has this intervention assessments?
Fatigue pallor, shortness of breath
Confusion, disorientation
Laboratory test
Folic acid Deficiency
Which anemia has this intervention action?
Ensure adequate intake
Administer supplements
Folic acid Deficiency
Wich anemia has these intervention teachings
Dietary source
Report s/s
Prenatal teaching
Need for supplementation
Folic acid Deficiency
Which anemia has this evaluating care outcomes
Increased hemoglobin level
Resolved fatigue and shortness of breath
Folic acid Deficiency
Which anemia has
Damage to the bone marrow
Decreased production of red blood cells
Aplastic anemia
Which anemia has these manifestations?
Bleeding
Susceptibility to infections
Headache
Dizzy
Pallor
tachycardia
SoB
Fatigue
Aplastic anemia
Aplastic anemia
Which anemia has these diagnosis
Laboratory test
CBC Coagulation studies
Iron levels
Bone marrow biopsy
Aplastic anemia
Wich anemia has this treatment?
Blood transfusion
Bone marrow transplant
Aplastic anemia
Which anemia has these as medications
Filgranstim
Epoetin-alfa
Aplastic anemia
Which anemia has these complications
Decreased cellular and tissue perfusion
Hemorrhage
Severe infection
Aplastic anemia
Which anemia has this assessment and analysis?
Patients as risk for decreased oxygen-carrying capacity
Infection
Bleeding
Aplastic anemia
Which anemia has this diagnosis
Activity intolerance
Risk for injury
Risk for infection
Aplastic anemia
Which anemia has this intervention assessments
Oxygen saturation
Signs of bleeding
Lab test
Fatigue and pallor
Dizziness and headache
Viral signs
Aplastic anemia
Which anemia has these intervention actions?
Provide supplemental oxygen
Administer blood products
Implement bleeding precautions
Protect from injury
Aplastic anemia
Aplastic anemia
Wich anemia has this intervention teaching
Avoid exposure to infection
Report temperature elevation
Avoid activities with potential for injury
Clinical manifestations of anemia
Nutritional intake
Aplastic anemia
Wich anemia has these outcomes?
Stable ABC & platelets
Absence of infection
Absence of bleeding
Aplastic anemia
Which anemia has this epidemiology?
Greater in blacks and men
10-14% of african americans males in the u.s have it
G6PD
Which anemia had this pathophysiology?
Premature breakdown of RBCs
G6PD
Which anemia has these manifestations?
Enlarged spleen
Jaundice
Dark urine
SoB
Tachycardia
Pallor
Fatigue
G6PD
Which anemia has this diagnosis
Smear for Heinz bodies
Reticulocyte count
CBC
G6PD
G6PD
Which anemia has this pathophysiology?
Hyperviscosity- thick blood
Increased production of RBCs
Polycythemia Vera
Which anemia has these manifestations
Blurred vision
Splenomegaly
Difficulty breathing when lying flat
Headache
Weakness
Dizziness
SoB
Polycythemia Vera
Which anemia has this diagnosis
Genetic testing
Bone marrow biopsy
Lab test
Polycythemia Vera
Which anemia had this treatment
Prevent hemorrhage
Reduce hyperviscosity
Polycythemia vera
Which anemia has these complications?
Thrombosis
Hemorrhage
Polycythemia vera
Which anemia has these NM assessment and analysis
s/s related to
Hyperviscosity
Hypovolemia
Engorgement of capillaries
Polycythemia vera
Which anemia has this diagnosis
Ineffective tissue perfusion
Activity intolerance
Risk for ineffective coping
Polycythemia Vera
What anemia has these intervention assessments?
Vision problems
Bone marrow biopsy
Generalized pruritis
Flush of the face
Feeling of fullness in the upper abdomen
Weight loss
Sob, Headache, Dizzy, Fatigue, Vital signs
Polycythemia Vera
Which anemia has these intervention actions?
Obtain routine CBCs
Increase fluid intake
Ensure adequate rest
Elevate lower extremities when sitting
Modify cardiovascular risk factors
Polycythemia Vera
Which anemia has this teaching
Clinical manifestations of severe thromboembolic event
Rationale for aggressive hydration
Eat small frequent meals
Observe bleeding precautions
Routine moderate exercise
Regular lab test
Avoid
Tight, restrictive clothing Extreme temperatures
Polycythemia vera
Which anemia has this outcome
Prevented or delayed complications
Prevention of major thromboembolic events
Prevention of hemorrhage
Polycythemia vera
Which anemia has these risk Factors
Malignancy
Infection
Medications
Autoimmune conditions
DIC
Thrombocytopenia
Which anemia has this pathophysiology
Idiopathic thrombocytopenia purpura
Hemophilia
Heparin-induced thrombocytopenia
Thrombocytopenia
What is hemophilia
It’s a deficiency of factor VIII or factor IX
Thrombocytopenia
What is a heparin induced thrombocytopenia
It is a immune response to heparin
When does a idiopathic thrombocytopenia purpura occur
It occurs Following viral infection or immunization in children
Which anemia has this manifestation?
Decreased platelets
Easy bruising
Petechiae
Bleeding
Thrombocytopenia
Which anemia has this diagnosis?
Coagulation studies
CBC w/ manual differential
Bone marrow biopsy
Thrombocytopenia
Which anemia has this as Treatment
Resolution of underlying condition
Replacement of clotting factors
Discontinue heparin
Thrombocytopenia
Which anemia has this complication?
Hemorrhage
Thrombocytopenia
Which anemia has this assessment and analysis
a/a of low platelets
Thrombocytopenia
Which anemia has this diagnosis?
Risk for injury
Risk for ineffective therapeutic regimen
Fear
Thrombocytopenia
Which anemia has this intervention assessment?
Platelet count
Ecchymosis
Petechiae/ purpura
Frank bleeding
Thrombocytopenia
Which anemia has these Actions
Implement bleeding precautions
Minimize blood loss
Avoid intramuscular injections
Avoid rectal temperatures
Provide safe environment
Use minimal inflation with blood pressure
Minimize blood draws
Thrombocytopenia
Which anemia has this intervention Teaching
Instruct patient/family on bleeding precautions
Avoid sexual intercourse when platelet count is < 50,000
Necessity of frequent laboratory tests
Thrombocytopenia
Which anemia has this outcomes
Prevention of hemorrhage
Minimize risk of bleeding
Thrombocytopenia
What is the normal value for a female
Hemoglobin
Hematocrit
Hemoglobin= 11.7-15.5
Hematocrit= 36-48%
What is the normal value for a male
Hemoglobin
Hematocrit
Hemoglobin= 14-17.3
Hematocrit= 42-52% in male
What is the oxygen carrying component of your RBC?
Heme
What is hemoglobin made up of?
Heme
Iron
What contains iron?
Heme
What does the iron bind with?
Oxygen
Every heme molecule has what in the center?
iron
What Three alterations in erythropoiesis decrease RBC production?
Decreased hemoglobin synthesis
Defective DNA synthesis in RBCs
Diminished availability of erythrocyte precursors
What is anemia?
Anemia is a decreased number of red blood cells
What is hemoglobin
Hemoglobin= the number of red blood cells
What is hematocrit
Hematocrit= volume, how much, of red blood cells
What is Anemia is caused by?
Decreased rbc production
* Deficient nutrients * Decreased erythropoietin
*Decreased iron availability
Blood loss
Increased RBC destruction
What is mild, moderate, & severe anemia?
What is mild, moderate, & severe anemia?
Mild 10-12
*fatigue
Moderate 6-10
*Cardio pulmonary
Severe less than 6
*Multi systems manifestations
What does a person with anemia look like?
Pallor
Jaundice
Pruritus – itching of the skin
*Bilirubin of the liver breaks down of your red blood cell.
Bilirubin travels to the liver or the gall bladder before its excreted. With anemia you have increased concentration of the serum bilirubin
Increased destruction of red blood cells causes the increased bilirubin
Where does iron get absorbed?
Duodenum
What can contribute to iron deficiency anemia?
Surgery
Remove part of the gut
In which anemia does the body not have enough hemoglobin to carry the oxygen to meet the needs of our body
Iron deficiency anemia
WHAT IS TARRY STOOLS
what causes it?
BLACK STOOLS
IRON SUPPLEMIENTS MAKE POOP BLACK
BLOOD IN THE POOP MAKE IT BLACK
WHAT FOOD CONTAINS VITAMIN B 12
MEAT
EGGS
DAIRY PRODUCTS
SEAFOOD
WHAT FOOD CONTAINS FOLIC ACID
NUTS
BRAN
YEAST
what are the normal values of
RBC
HNH
WBS
SErum iron
Feratin
Tbc= total iron body capacity
Platelets
Pt (bleeding time)
RBC
HNH
WBS
SErum iron
Feratin
Tbc= total iron body capacity
Platelets
Pt (bleeding time)
Where is iron absorbed?
Duodenum
Jejunum
what anemia has these complications?
Hear failure
Renal failure
Impaired immune/ thermoregulation
Psychomotor and cognitive impairment
iron deficiency anemia
What is a megaloblastic anemia?
a B12 Anemia
WHAT IS PERNICIOUS ANMEIA
A LACK OF INTRENSIC FACTOR
PA IS AN AUTO IMMUNE DESEASE THAT LEATS TO THE B12 DEFICIENCY, BUT ITS NOT THE SAME THING!
ON TEST
PERNICIOUS ANMEIA A IS AN AUTO IMMUNE DESEASE THAT LEATS TO THE B12 DEFICIENCY, BUT ITS NOT THE SAME THING!
PERNICIOUS ANMEIA A IS AN AUTO IMMUNE DESEASE THAT LEATS TO THE B12 DEFICIENCY, BUT ITS NOT THE SAME THING!
WHAT KIND OF CELLS LINE OUR STOMACH?
PERIATAL CELLS
PERIATAL CELLS
WHAT SECRESTS INTRINSIC FACTOR?
PARIATAL CELLS
PARIATAL CELLS
WHAT ALLOWS FOR IRON ABSORPTION IN THE SMALL INTESTINE?
WHEN INTRINSIC FATOR BINDS WITH B12
How do periatal cells work?
PERIATAL CELLS LINE OUR STOMACH AND THE SECRESTE INTINNSIC FACTOR. THE INTRINSIC FATOR INDS WITH THE B12 AND THIS ALLOWS OFR BASORPTION IN THE SMALL INTESTIN
What is important for the nervous system function (myelin sheath)
B12
BEFORE GIVING B12 WHAT SHOULD YOU MONITOR?
MONITOR FOLIC ACID
WHERE IS INTRINSIC FACTOR PRODUCED AND WHY IS IT NEEDED?
INTRINSIC FACTOR IS PRODUCED BY PERTIATAL CELLS IN THE STOMACH AND IS NEEDED FOR B 12 ABSORPTION
What is necessary for the maturation of cells?
like New embryos
Folic acid
WHAT IS PANCYTOPENIA?
WHEN ALL BLOOD CELL INDICES ARE LOW= PATIENT WILL BE AT RISK FOR BRUSING AND BLEEDING BECUASE THE PLATE LETS ARE LOW
What is in charge of neurological manifestations?
B12 is in charge neurological manifestations
WHAT IS ANOTHER NAME FOR APLASTIC ANEMIA
HYPOPLASTICANEMIA=
what anemia has this etiology?
THEY HAVE IT BECAUSE BONE MARROW DEPRESION leads to cellular immune response
INFECTION
HEPITITES
CHEMO
aplastic anemia
WHAT IS PANCYTOPENIA ?
where do you usualy see it?
WHEN EVRYTHING IS LOW
aplastic anemia
Aplastic anemia is a decrease of
Decreased RBC= pallor tachycardia
Decreased in white blood cells= susceptibility to infection
what kind of cells do you see in aplastic anemia
Fat cells. They are going to be high
In what anemia if the patients gets to many blood transfusions it puts them at risk for bone marrow transplantation rejection because the transfusion have sensitized that person
aplastic anemia
WHAT STIMULATES THE BONE MARROW
Filgrastin
Epoetin-alfa
WHO IS TO BE KEPT AWAY FROM OTHER PEOPLE THAT HAVE INFECTIONS
A person with pancytopenia or aplastic anemia
what anemia has these S/S
Bleeding
Brusing
aplastic
what anemia
Protects rbcs from oxidative stressors that lead to rbc destruction
G6PD
WHAT CAN A PERSON WHO HAS G6PD NOT EAT
FAVA BEANS
who is protected against malaria?
G6PD patients
WHAT IS HEINZ BODIES
G6PD anmeia
SMEAR ANALYSIS
THIS IS WHAT THEY WILL SEE WHEN THE LOOK AT CBC IT IS AN ACUMILATION OF BROKEN HEMO GLOBIN IN THE RBC’s
HOW DO YOU ASSES JAUNDICE IN DARK SKIN PEARSON
MUCUS MEMBRAINS
CONJENTIBA
WHAT HEREDITARY DISORDER LYCES RBC
G6PD
what anemia is also called
erythrocytosis
Polycythemia
Why does blood thicken in polycythemia
Increased of rbc’s
Increase in wbs
Increased in platelets
a person with this anemia is prone to forming clots
Polycythemia Vera
What is a Complication of polycythemia Vera
Thrombosis
——Because of this blood
Hemorrhage
——Because of low platelets
The main concerns in polycythemia are
Thrombase- because high viscosity the person is at risk for a thrombosis
Hemorrhage - low platelets
What anemia interferes with clotting/ platelets?
thrombocytopenia aka hemophilia
in what anemia is hemorrhaging the problem?
thrombocytopenia
What anemia is inherited from the female but its present in the male
thrombocytopenia
In what anemia are platelets are destroyed within hours
thrombocytopenia
What is Hemophilia
A
B
what is its treatment?
A -Def in factor8
B -Def in factor 9
Iv treatment for treatment
What is the treatment used on thrombocytopenia
use corticosteroids
What can cause gangrene in people with thrombocytopenia
warfin
WHAT CAN GIVE YOU TARRY STOOLS?
Iron supplements
Bleeding in the bowl or bleeding in the gut (from thrombocytopenia)
What should patients that have thrombocytopenia avoid?
IM injections
Douching
rectal thermometer
what should be checked SHOULD BE CHECKED TO MONITOR THROMBOCYTOPENIA
cbc