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NURS 416 > Week 4 > Flashcards

Week 4 Flashcards

1
Q

what is the main stimulus for erythropoises?

A

hypoxia

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2
Q

what is the prototype drug for anemia associated with renal failure?

A

Epoiten Alfa (Epogen, Eprex)

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3
Q

what are the serious adverse effects of Epoiten Alfa (Epogen, Eprex)?

A

Thromboembolic events, hypertension, pure red cell aplasia and seizures

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4
Q

what are the indications of the prototype drug Filgrastim (Neupogen, Grastofil)

A

neutropenia, severe bacterial and fungal infections, and AIDS related immunosuppression

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5
Q

what is the normal RBC count for Men?

A

4.7 - 6.1 million mcL

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6
Q

What is the normal RBC count for women?

A

4.2 - 5.4 million mcL

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7
Q

what is the normal Hb level for women?

A

> 120g/L

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8
Q

What is the normal Hb level for men?

A

> 140g/L

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9
Q

What is the normal hematocrit level for women?

A

37% - 47%

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10
Q

What is the normal hematocrit level for men?

A

40% - 54%

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11
Q

Why might the hematocrit be deceptive?

A

because it varies with the quantity of extracellular fluid, so it rises with dehydration and falls with overexpansion of extra cellular fluid volume

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12
Q

Normal ferritin levels for males?

A

12 - 300 ng/mL

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13
Q

Normal ferritin levels for females?

A

12 - 150 ng/mL

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14
Q

what are some adverse effects of Epoiten?

A

nausea, diarrhea, headache, fever, edema

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15
Q

Mechanism of action of Epoiten?

A

binds erythropoiten receptor of stem cells in the bone marrow, promoting growth and maturation of RBCs

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16
Q

what are colony stimulating factors?

A

they increase the production of leukocytes

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17
Q

what are the indications of colony stimulating factors?

A

chemo or radiation therapy, certain malignancies, and patients receiving transplants

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18
Q

what are the indications of oprelvekin?

A

to increase platelet counts following cancer chemotherapy

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19
Q

nuclear neonatal jaundice

A

newborn brain damage due to the cytotoxic effect of high concentrations of bilirubin

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20
Q

what happens with bilirubin in liver failure?

A

the liver cannot convert bilirubin from unconjugated to conjugated. Unconjugated bilirubin builds up.

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21
Q

what occurs in liver disease and bile duct disorder?

A

conjugated bilirubin is higher than unconjugated

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22
Q

intravascular hemolysis

A

occurs as a result of complement fixation in transfusion reactions, mechanical injury or toxic factors

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23
Q

bilirubin

A

a product of RBC breakdown and will be elevated if breakdown is accelerated

24
Q

anemia

A

abnormally low number of circulating RBCs or level of Hb or both

25
what results due to increased bone marrow production?
bone pain
26
If anemia is caused by hemorrhage, what results?
bruising or petechiae
27
If anemia is hemolytic, what results?
increased bilirubin leading to jaundice
28
if anemia is aplastic, what results?
petechiae and pupura which are the results of decreased platelet function
29
causes of iron deficiency anemia?
low iron intake or bleeding
30
free iron is?
toxic
31
How is free iron transported?
Bound to ferritin, hemosiderin and transferrin
32
what is a good indicator of the amount of iron stored in the body?
serum ferritin
33
When is serum ferritin increased?
in inflammation or metabolic syndrome
34
Hemorrhagic anemia is due to?
severe blood loss
35
gestational anemia is caused by?
a disproportionate increase in plasma volume resulting in hemodilution
36
Extreme fatigue, weakness, pale skin, chest pain, tachycardia, SOB, headache, dizziness, lightheadedness, cold hands and feet, inflammation of the tongue, brittle nails, unusual cravings for non-nutritive substances, and poor appetite (especially in children)
Iron deficiency anemia
37
indication of ferrous sulphate
iron deficiency anemia
38
adverse effects of ferrous sulphate?
darkened stools, nausea, vomiting, constipation and brown stains on teeth if taken orally
39
Interventions for iron administration:
- administer on an empty stomach | - use a straw if patient taking liquid iron
40
pernicious anemia is caused by:
vitamin B12 deficiency
41
lack of B12 causes the formation of:
large, fragile, megaloblastic RBCs
42
what is a common initial sign of B12 deficiency anemia
red, sore tongue
43
dyspnea, palpations, dysrhythmias, fatigue, muscle weakness, sodium retention and hypokalemia are adverse effects of which drug?
Vitamin B12
44
why must pregnant women get enough folic acid?
folic acid is necessary for development of the fetus's brain and spinal cord. Folate deficiency can lead to neural tube defects
45
Folic acid is required for?
DNA synthesis and RBC maturation
46
what are some of the main causes of folate deficiency?
- decreased dietary intake: old age, chronic diseases, alcoholism - malabsorption: tropical sprue, gluten-sensitive enteropathy - Increased requirements: pregnancy, infancy, malignancy - Drugs: methotrexate, oral contraceptives
47
sickle cell disease
an inherited disorder in which an abnormal hemoglobin leads to chronic hemolytic anemia, pain and organ failure
48
thalassemias
group of inherited disorders of hemoglobin synthesis leading to a decreased synthesis of Hb
49
what can occur in thalassemia?
enlargement of the spleen or liver resulting from extramedullary hematopoises and increased red cell destruction
50
what are two risk factors for a G6PD deficiency?
aspirin and fava beans
51
causes of aplastic anemia
exposure of high doses of radiation, chemicals and toxins that suppress hematopoises directly or through immune mechanisms
52
polycythemia
a condition in which the RBC mass is increased
53
relative polycythemia
results from a loss of vascular fluid and is corrected by replacing the fluid
54
primary polycythemia
a proliferative disease of bone marrow with an absolute increase in total RBC mass accompanied by elevated white cell and platelet counts
55
Secondary polycythemia
results from increased erythropoiten levels caused by hypoxic conditions such as chronic heart and lung disease

NURS 416 (17 decks)

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