Wk 2 Nursing Care of the Anemic Patient Flashcards
What is the difference between activity intolerance and fatigue?
Fatigue means you are tired, even when you are lying in bed
One of the most common complications associated with anemia?
Activity intolerance
What are 3 nursing problems for the anemic patient?
Activity intolerance/fatigue
Altered nutrition/malabsorption
Risk for infection, bleeding, and fatigue
If the anemia is due to blood loss…
Find and treat the source of bleeding, such as hemoccult or scoping
What vitamins and minerals might you give a patient with anemia?
Iron
Folate
B12
What medication might you give an anemic patient who has kidney failure?
epoetin alfa (Epogen)
Iron supplementation is most often given…
PO TID/QID (newer evidence says that once a day is acceptable)
Iron supplement medication
ferrous sulfate
Why do we not give EC or ER ferrous sulfate?
Because it is absorbed in the duodenum
Why do we tell patients to take their iron supplements one hour before meals (if possible)?
Because it is best absorbed in an acidic environment
What is the patient education for taking iron supplements?
Take with food at first and then try taking it without and see if you can tolerate it
Why should a patient use a straw when drinking liquid iron?
It will stain their teeth
Why should you use z track method for IM injections of iron?
It will stain the skin
What are the GI side effects of ferrous sulfate?
Heartburn
Constipation
Diarrhea
What is the most common GI side effect of iron?
Constipation
A notable side effect of iron supplementation is…
Black stool (not melena)
What is melena?
Dark, sticky stool containing partially digested blood
A patient receiving IV dextran (iron supplementation) is at risk for what?
Fatal anaphylaxis, start out slow!!
What routes can b12 be given?
IM
SQ
PO
Intranasal
When is the IM route preferred for a patient with b12 deficiency?
If deficiency is severe or presence of neurological symptoms
b12: Evidence shows that oral and IM routes have similar effects if…
1) some IF present
2) megadoses are given
If a megadose of cobalamin is given (1000mcg), about how much will be absorbed?
2.4mcg (1-4%)
A patient with b12 deficiency, especially pernicious anemia must be…
treated for life
Folic acid tablets should be taken…
Usually 0900 meds and don’t have adverse side effects
What is epoetin?
Synthetic erythropoietin
Epoetin is often given concurrently with __
iron
How is epoetin given?
IM/SQ three times a week
Epoetin has many…
adverse effects and black box warnings, provider should weigh advantages with disadvantages
When should epoetin be held and why?
If hgb greater than 10 because of increased risk for cardiovascular problems
What are foods rich in iron?
Liver Eggs Dried fruits Legumes Potatoes Dark green leafy vegetables Whole grain/enriched breads and cereals
What vitamin helps iron absorb more efficiently?
Vitamin C
Vitamin b12 is only found in…
Animal products
Foods rich in b12
Red meats Enriched grains Milk and dairy Fish Eggs
What foods are good sources of folic acid?
Green leafy vegetables Legumes Whole grains Orange juice Nuts
What should you monitor in a patient with anemia?
Labs
VS
Hypoxemia
Neuro status changes
What are four nursing interventions for anemia?
O2 therapy
Provide rest periods
Keep warm
Blood transfusion
Why should you not use heating pads?
Risk for parasthesia
