Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
NUR 112
Anemia
| Question | Answer |
|---|---|
| what is anemia? | A condition when the body can not delivery enough oxygen due to: ↓ volume of healthy Red Blood Cells (RBCs) ↓ amount of oxygen carrying component in RBCs |
| hematocrit measures | volume of healthy RBCs |
| hemoglobin measures | amount of oxygen carrying molecules on RBCs |
| normal hematocrit | 36-54% |
| normal hemoglobin | 12-18 g/dL |
| normal red blood cells | 4-6 million/ microliter |
| what is blood loss anemia | decreased amount of RBCs flowing through the circulatory system |
| what is nutritional anemia | deficient amount of vitamins and minerals needed to form normal RBC’s |
| what is hemolytic anemia | destruction of RBCs from inside (intrinsic) or outside (extrinsic) causes |
| what is aplastic anemia | decline in production of healthy RBC’s |
| Non-mod risk factors for anemia | -older adults and infants/ teens -females (menstruation and pregnancy) -Family Hx (parent to child) -renal disease |
| modifiable risk factors for anemia | -renal disease -excessive alcohol use -antibiotic use -poor diet -vegetarians/ vegans |
| acute blood loss anemia occurrence | a sudden drop in RBCs, most often by hemorrhage. |
| acute blood loss anemia rate and volume | quickly loses large volumes of blood |
| acute blood loss anemia key symptoms | hypovolemia = low BP = dizziness |
| acute blood loss anemia RBC, HBG, HCT levels | all decreased |
| acute blood loss anemia response to maintain blood volume | ↑ HR, peripheral vasoconstriction, shifting fluids from interstitial tissues into the blood vessels -Kidneys sense decrease in RBCs, release EPO to stimulate bone marrow production of more RBC |
| hemodilution | more fluid than RBCs in the blood vessel leading to decreased amount of RBC’s reflective in decreased Hbg and Hct levels |
| when does body recover from acute BLA | the body uses stored iron to restore normal levels by producing normocytic RBC within 3-4 weeks |
| Chronic Blood Loss Anemia occurrence | gradual drop in RBCs, some causes include nutritional deficiencies, chronic diseases and other conditions. |
| Chronic Blood Loss Anemia examples | Ex. Iron deficiency anemia, colon cancer, peptic ulcer disease, menorrhagia-heavy menstrual periods |
| Chronic Blood Loss Anemia rate and volume | Client slowly loses small volumes of blood,- *blood loss is significantly less volume than acute |
| Chronic Blood Loss Anemia key symptoms | chronic fatigue |
| Chronic Blood Loss Anemia RBC, HBG, HCT levels | all decreased |
| Chronic Blood Loss Anemia response | ↑ HR, peripheral vasoconstriction, shifting fluids from interstitial tissues into the blood vessels -Kidneys sense decrease in RBCs, release EPO to stimulate bone marrow production of more RBC |
| when does body recover from chronic BLA | Client would need cause of blood loss treated and take iron supplements- can take up to 6 months to restore iron reserves |
| foods high in iron | meat such as liver, beef, chicken, fish and shellfish (heme-animal source) whole grains, oatmeal, bran flakes, beans (non-heme- plant source) |
| foods high in vitamin b12 | meat such as liver, beef, chicken, fish and shellfish eggs and dairy products, mushrooms |
| foods high in folate or folic acid | green leafy vegetables (“think” foliage) broccoli liver |
| what vitamin is folate | vitamin b9 |
| dietary causes of nutritional anemias | decreased intake of Fe, B12, and B9 |
| GI causes of nutritional anemias | impaired vitamin absorption, effects on villi of the intestines, lack of intrinsic factor (protein needed for GI absorption in intestine) |
| examples of GI causes of nutritional anemias | Inflammation Autoimmune Disorders Surgery Tapeworm Drugs- Alcohol, Chemotherapy- kill GI cells, cause diarrhea |
| bleeding causes of nutritional anemia | loss of blood causing depletion of Fe and vitamins needed to make healthy RBCs |
| Menorrhagia | heavy menstruation |
| characteristics of RBC during iron deficiency anemia | microcytic, Hypochromic, Malformed (abnormal shape) |
| what does microcytic mean | small |
| what does hypochromic mean | pale from decreased Hbg |
| what does macrocytic mean | large |
| characteristics of RBC during vitamin b12 deficiency anemia | Macrocytic, oval, immature |
| what does vitamin b12 do in the body | required for DNA synthesis and normal maturation of RBCs. Also important for nerve cell development. |
| another name for vitamin b12 deficiency anemia | megaloblastic anemia |
| what is Pernicious Anemia | specific type of vitamin b12 deficiency anemia, where pts do not have intrinsic factor to absorb Vitamin B12 |
| what does iron do in the body? | needed to produce hemoglobin. Also helps with cell development of skin, hair and nails. |
| what aids in the absorption of iron | hydrochloric acid (HCL) in the stomach and Vitamin C (Ascorbic acid) helps absorb non-heme iron in the GI tract |
| what does folate do in the body | required for DNA synthesis and normal maturation of RBCs. Also involved in specific nerve cell development |
| another term for folic acid deficiency anemia | megaloblastic anemia |
| characteristics of RBC during folic acid deficiency anemia | Macrocytic, oval, immature |
| S/S of anemia related to skin | Pallor and Intolerance of cold- decreased oxygen to peripheral tissue, blood is sent to more internal organs, blood is warm, extremities feel cold |
| Neuro S/S of anemia | Dizziness, HA, Disorientated- decreased oxygen to brain |
| Respiratory S/S of anemia | Tachypnea- lungs trying to bring more oxygen into the body Dyspnea- lack of oxygen to lung tissue |
| Cardiac S/S of anemia | Tachycardia- heart trying to circulate more oxygen throughout the body Palpitations, Chest pain- lack of oxygen to heart tissue and greater oxygen demand on the heart and lungs |
| MS S/S of anemia | Fatigue and Weakness- decreased oxygen which is energy for the body |
| special S/S of anemia | spoon shaped/ brittle nails, Pica, Cheilosis, glossitis |
| what is cheilosis | cracks at corners of the mouth, can lead to bleeding and discomfort, caused by lack of oxygen, vitamins and skin irritation |
| what is glossitis | smooth and sore tongue, caused by inflammation from lack of oxygen and vitamins |
| S/S specific to vitamin b12 deficiency anemia | GI problems/ upset Paresthesia in the extremities Proprioception problems (cause balance issues) Mood Changes |
| what can Proprioception problems lead to | irreversible spinal cord damage if not diagnosed in time |
| S/S specific to folate deficiency anemia | Causes neural tube defects -Spina Bifida -Anencephaly |
| when do birth defects with folate deficiency anemia occur | during the first month of pregnancy |
| interventions for nutritional anemias | dietary intake, supplements, blood transfusions |
| common side effects of oral iron supplements | constipation, nausea and heartburn, turns stools dark or black Liquid iron can stain the teeth |
| Nursing education for liquid iron | drink with a straw or mix with water or juice to help avoid this |
| PO iron medication name | ferrous Sulfate (Slow FE, Iron) |
| IM iron medication name | Iron Dextran |
| caution with IM iron | Allergic reaction when administering is rare BUT life-threatening reaction; nurse must monitor client closely for signs and symptoms of adverse reaction |
| S/S of allergic reaction | hives, difficulty breathing, swelling of the face, lips, tongue and throat, low blood pressure |
| why would someone receive IM vitamin b12? | oral B12 supplements would not be absorbed it due to lack of intrinsic factor |
| IM vitamin b12 name | Cyanocobalamin |
| how often to receive IM vitamin b12 | once a month to every 3-4 months. Clients who don’t produce intrinsic factor- Pernicious anemia must take IM route- oral B12 supplements would not be absorbed it due to lack of intrinsic factor |
| what are some hemolytic anemias? | Thalassemia Acquired Hemolytic Glucose 6 Phosphate Dehydrogenase (G6PD) |
| intrinsic causes of hemolytic anemias | occurring within the RBC -Cell membrane defects -Hgb defects in the structure and function -Enzyme deficiencies needed to produce healthy RBC’s |
| extrinsic causes of hemolytic anemias | occurring outside of the RBC -Toxins -Trauma -Drugs -Microorganisms |
| what is thalassemia | -Decreased production of hemoglobin due to missing or defective alpha or beta chains that help form Hgb |
| cause of thalassemia | Intrinsic Factors -Inherited defect within the RBC from genes passed on from parents to children |
| RF for thalassemia | Ethnicity: Asian Descent Middle East Descent Mediterranean Descent African Descent |
| Characteristics of RBC for thalassemia | Microcytic- small Hypochromic- pale Malformed- abnormal shaped- oval (egg-shaped) or tear drops or bull’s eye |
| result of thalassemia | production of unhealthy RBC’s that are filtered and destroyed by the spleen, then sent to liver to be broken down further. The body can get overwhelmed by having to replace so many RBCs |
| what is acquired hemolytic anemia | Body makes normal red blood cells, but they are later destroyed by factors outside the body |
| causes of acquired hemolytic anemia | Extrinsic Factors- Autoimmune Disorders Infections Medicines Toxins Trauma |
| characteristics of RBC in acquired hemolytic anemia | Normocytic, Normochromic |
| result of acquired hemolytic anemia | production of healthy RBCs that are destroyed by the extrinsic factors, filtered out by the spleen, then sent to liver to be broken down further. The body can get overwhelmed by having to replace so many damaged RBCs. |
| what is glucose 6 phosphate dehydrogenase anemia (G6PD) | Decreased production of G6PD (enzyme that keeps RBC’s healthy with a normal lifespan) due to defective X-recessive chromosome. |
| causes of glucose 6 phosphate dehydrogenase anemia (G6PD) | Intrinsic -Inherited defect within the RBC’s from genes passed on from parents to children. Highest risk in males than females because it is on a X-recessive chromosome. |
| RF for G6PD | Ethnicity- many different variants Asian Descent Middle East Descent Mediterranean Descent African Descent (highest) |
| Characteristics of RBC’s during G6PD | -Abnormal RBCs from lack of G6PD in the presence of oxidative stress causes damage to the cell membrane -Destruction of the RBCs by the spleen can be identified specifically by appearance under microscope (Bite cells) |
| what is oxidative stress | when body has imbalance of free radicals and antioxidants (drugs like Aspirin, chemicals, infections, ingestion of fava beans and certain legumes, Diabetic Ketoacidosis) |
| result of G6PD | production of unhealthy RBC’s that respond to specific stresses that leads to damaged membranes, that are then filtered and destroyed by the spleen, then sent to liver to be broken down further |
| S/S specific to hemolytic anemia | Hemoglobinuria Bone Marrow Hyperplasia / Bone fractures Bronze color skin or Jaundice, Hyperbilirubinemia Hepatomegaly and Splenomegaly Heart Failure Folate Deficiency |
| pt education for hemolytic anemias | Avoiding known triggers, do not consume certain foods, alcohol or use certain meds like ASA Stress Reduction Infection Prevention Diabetes management Genetic counseling Thalassemia and G6PD Anemia |
| medications for hemolytic anemias | Corticosteroids and Immunosuppressants folic acid supplements |
| how do Corticosteroids and Immunosuppressants help with hemolytic anemias | decrease inflammation and the immune response. For those with Acquired Hemolytic Anemeia (ex. Autoimmune Disorders) and G6PD Anemia |
| how do folic acid supplements help with hemolytic anemias | replaces the depleted folate from the body. For those with All hemolytic Anemias |
| procedures for hemolytic anemias | splenectomy, blood transfusions, and intravenous immune globulin (IVIG) infusions |
| purpose of splenectomy for hemolytic anemias | surgical removal of spleen which filters out RBCs to be destroy, only works in some severe cases, tries to slow down damaging effects of the hyperbilirubinemia, For those with All Hemolytic Anemias |
| purpose of blood transfusions for hemolytic anemias | IV infusion that replaces unhealthy RBCs, for those with All Hemolytic Anemias |
| purpose of IVIG infusions for hemolytic anemias | IV infusion of antibodies that help strengthen the immune system. For those with Acquired Hemolytic Anemia (ex. Autoimmune Disorders) |
| aplastic anemia occurs when | Stem cells in the bone marrow fails to produce all types of blood cells called Pancytopenia and Bone marrow is either empty (aplastic) or contains few blood cells. Replaced by fat cells |
| Pancytopenia | low: Red Blood Cells (RBC) White Blood Cells (WBC) and Platelets (Plt) |
| Characteristics of RBCs for aplastic anemia | Normocytic / Normochromic |
| Anemia classification | low RBC, less than 4 million/ microliter |
| Leukopenia classification | low WBC, less than 5000 microliter |
| Thrombocytopenia classification | low platelets, less than 150,000 microliter |
| S/S specific to aplastic anemia | Infections- due to low WBCs --> neutropenic precautions Bleeding problems- Due to low Platelets. --> can cause petechiae and purpura |
| neutropenic precaustions | minimize blood sticks no fresh fruit or flowers wear mask |
| what is petechiae | red or purple; pinpoint or dots |
| what is purpura | larger red or purple; spots or blotches |
| pt education for aplastic anemia | Teach client about need to withdraw from causative agent Avoid prolong and excessive contact with specific chemicals and toxins- wear PPE’s if occupation environment exposes them. Infection Control Fall and Bleeding Precautions |
| medications for aplastic anemia | oral or parenteral iron and vitamin supplements Epogen SQ injection Antibiotics, anti-inflammatories immunosuppressants |
| what does Epogen SQ injection do | helps rebuild RBCs |
| procedures for aplastic anemia | Blood transfusions (Red blood cells and Platelets) Bone marrow transplant or Stem cell transplant |
| what is the only cure for aplastic anemia | Bone marrow transplant or Stem cell transplant. |
| what are the 10 diagnostic tests for anemia diagnosis | CBC (complete blood count) HBG (hemoglobin) HCT (hematocrit) IRON (Fe) FERRITIN TIBC (total iron-binding capacity) B12 FOLATE G6PD Bone marrow aspiration |
| CBC of someone with anemia will show: | low RBC, PLT and WBC levels |
| HBG of someone with anemia will show: | dysfunctional RBCs |
| HCT of someone with anemia will show: | low % of healthy RBCs in the blood |
| Iron (Fe) of someone with anemia will show: | low iron levels. Iron is transported by transferrin to the liver where it is stored with ferritin. (Iron is a free radical and must be “chaperoned” or with a protein or it can damage other cells) |
| FERRITIN of someone with anemia will show: | low storage of iron in the liver |
| TIBC (total iron-binding capacity) of someone with anemia will show: | low available iron to use and attach to Transferrin |
| B12 of someone with anemia will show: | low b12 |
| Folate of someone with anemia will show: | low b9 |
| G6PD of someone with anemia will show: | lack of RBC protecting enzyme |
| Neuro S/S of hypovolemic shock | restless, anxious, irritable, confused early, altered level of consciousness, drowsy, lethargic, unconscious (late) |
| Skin S/S of hypovolemic shock | pale or cyanotic, gray, cool and clammy- sweating, decrease peripheral perfusion- blood flow to internal vital organs |
| Cardiac S/S of hypovolemic shock | tachycardia (early), bradycardia, cardiac arrest (late) |
| respiratory S/S of hypovolemic shock | tachypnea (early), bradypnea, respiratory arrest (late) |
| GI S/S of hypovolemic shock | nausea and vomiting, excessive thirst (due to decrease fluid volume- like in dehydration) |
| urinary S/S of hypovolemic shock | oliguria- little urine output- due to decrease fluid volume, kidneys not working - like in dehydration |
| MS S/S of hypovolemic shock | weakness – decreased oxygenation throughout the body, which is energy for cells |
| key interventions for hypovolemic shock | 1. stop the bleeding 2. oxygenation 3. fluid replacement 4. blood transfusion |
| types of blood products | Most common- Packed Red Blood Cells (PRBCs), Fresh Frozen Plasma (FFP), Platelets, Also Granulocytes and Cryoprecipitate (fibrogen) |
| Nurse role pre-procedure for blood transfusion | -consent -type & cross -obtain IV access (20 gage or larger) -premedicate with benadryl or tylenol |
| type and cross; type purpose | checks type of blood client has (A,B, AB, O) and Rh negative or Rh positive (protein found on RBCs) |
| type and cross; crossmatch purpose | checks the interaction between donor and recipient’s blood |
| universal blood donor | type O |
| Nurse role during procedure for blood transfusion | -start transfusion within 30 minutes of receiving bag -set up infusion -double verify w another nurse -obtain baseline VS and 15 mins after starting blood -start flow rate slow, if no problems, increase rate |
| Hemolytic reactions to blood transfusion | common symptoms include, fever, chills and more serious symptoms of chest and lower back pain, dark urine or oliguria, other s/s of bleeding like hypotension |
| non-hemolytic reactions to blood transfusion | common symptoms of fever, chills, pruritus, rash, hives and nausea |
Created by:
ginnyfoscue
Popular Nursing sets