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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
Q

what results due to increased bone marrow production?

A

bone pain

26
Q

If anemia is caused by hemorrhage, what results?

A

bruising or petechiae

27
Q

If anemia is hemolytic, what results?

A

increased bilirubin leading to jaundice

28
Q

if anemia is aplastic, what results?

A

petechiae and pupura which are the results of decreased platelet function

29
Q

causes of iron deficiency anemia?

A

low iron intake or bleeding

30
Q

free iron is?

A

toxic

31
Q

How is free iron transported?

A

Bound to ferritin, hemosiderin and transferrin

32
Q

what is a good indicator of the amount of iron stored in the body?

A

serum ferritin

33
Q

When is serum ferritin increased?

A

in inflammation or metabolic syndrome

34
Q

Hemorrhagic anemia is due to?

A

severe blood loss

35
Q

gestational anemia is caused by?

A

a disproportionate increase in plasma volume resulting in hemodilution

36
Q

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)

A

Iron deficiency anemia

37
Q

indication of ferrous sulphate

A

iron deficiency anemia

38
Q

adverse effects of ferrous sulphate?

A

darkened stools, nausea, vomiting, constipation and brown stains on teeth if taken orally

39
Q

Interventions for iron administration:

A
  • administer on an empty stomach

- use a straw if patient taking liquid iron

40
Q

pernicious anemia is caused by:

A

vitamin B12 deficiency

41
Q

lack of B12 causes the formation of:

A

large, fragile, megaloblastic RBCs

42
Q

what is a common initial sign of B12 deficiency anemia

A

red, sore tongue

43
Q

dyspnea, palpations, dysrhythmias, fatigue, muscle weakness, sodium retention and hypokalemia are adverse effects of which drug?

A

Vitamin B12

44
Q

why must pregnant women get enough folic acid?

A

folic acid is necessary for development of the fetus’s brain and spinal cord. Folate deficiency can lead to neural tube defects

45
Q

Folic acid is required for?

A

DNA synthesis and RBC maturation

46
Q

what are some of the main causes of folate deficiency?

A
  • decreased dietary intake: old age, chronic diseases, alcoholism
  • malabsorption: tropical sprue, gluten-sensitive enteropathy
  • Increased requirements: pregnancy, infancy, malignancy
  • Drugs: methotrexate, oral contraceptives
47
Q

sickle cell disease

A

an inherited disorder in which an abnormal hemoglobin leads to chronic hemolytic anemia, pain and organ failure

48
Q

thalassemias

A

group of inherited disorders of hemoglobin synthesis leading to a decreased synthesis of Hb

49
Q

what can occur in thalassemia?

A

enlargement of the spleen or liver resulting from extramedullary hematopoises and increased red cell destruction

50
Q

what are two risk factors for a G6PD deficiency?

A

aspirin and fava beans

51
Q

causes of aplastic anemia

A

exposure of high doses of radiation, chemicals and toxins that suppress hematopoises directly or through immune mechanisms

52
Q

polycythemia

A

a condition in which the RBC mass is increased

53
Q

relative polycythemia

A

results from a loss of vascular fluid and is corrected by replacing the fluid

54
Q

primary polycythemia

A

a proliferative disease of bone marrow with an absolute increase in total RBC mass accompanied by elevated white cell and platelet counts

55
Q

Secondary polycythemia

A

results from increased erythropoiten levels caused by hypoxic conditions such as chronic heart and lung disease

NURS 416 (17 decks)

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