hematology

Question 1

hemorrhagic anemia

Answer 1

mosy common type

Question 2

nutritional anemia

Answer 2

most common type worldwise
iron deficiency (microcytic)
folic deficiency (megaloblastic)
B12 deficiency (pernicious)

Question 3

hypoproliferative anemia

Answer 3

underproduction of RBCs by the bone marrow
marrow unable to produce
adequate amount of RBCs

Question 4

hemolytic anemia

Answer 4

increased destruction of circulating RBCs
RES destroys RBC

Question 5

anemia clinical manifestations

Answer 5

chronic: asymptomatic, fatigue
mild: (hgb 10-12) asymptomatic fatigue
moderate (hgb 6-10) fatigue, dyspnea, palpitation, tachycardia, diaphoresis on exertion
severe: chronic fatigue, severe symptoms, peripheral edema

Question 6

anemia diagnostics

Answer 6

history and physical
CBC
reticulocyte count
coagulation screening (INR, PT, PTT)
bone marrow aspiration

Question 7

iron deficiency microcytic (small rbc)

Answer 7

most common type worldwide
total body iron content
decreased

Question 8

microcytic anemia risk factors

Answer 8

blood loss
hemorrhoids
menstruating and pregnant
adolescents children infants

Question 9

microcytic anemia nursing care

Answer 9

diet rich in eggs, meat, leafy greens, liver (best source), vit c mineral milk, fiber, soy, coffee, tea
supplemental iron (rinse, straws)
Z track injections
monitor for dark tarry stools (can indicate internal bleeding)
avoid antacids

Question 10

folate deficiency anemia (megaloblastic)

Answer 10

abnormally large RBC with altered shape, size, function- cannot carry O3
does not effect nervous system
risk factors” alcohol, seizure prevention meds, genetics chron’s, celiac disease) infants

Question 11

megaloblastic treatment/ diet

Answer 11

oral dietary supplements (folic acid from diet, vit b)
treat underlying condition
decrease alcohol and increase folic acid

Question 12

megaloblastic symptoms

Answer 12

decreased appetite, irritable, fatigue, diarrhea, glossitis, pallor

Question 13

b12 deficiency (pernicious anemia) diet

Answer 13

diet of meat, fish, fortified cereal, tofu

Question 14

pernicious anemia risk factors

Answer 14

decreased b12 malabsorption
ileal resection
chrohns disease
gastrectomy
hereditary lack of intrinsic factor
vegans
autoimmune
anything harming gastric lining

Question 15

pernicious anemia symptoms

Answer 15

slow onset
decreased mental status
peripheral neuropathy
glossitis (beefy red tongue)
mood swings
decreased CO
decreased RBC, hgb Hct
vitiligo and greying hair

Question 16

pernicious diagnosis

Answer 16

schilling test
PO administration, small dose of radioactive vit B12
if urine is radioactive, B12 is successfully absorbed in the body and the patient does not have an issue

Question 17

pernicious management care

Answer 17

Vit B12 injections
never orally if caused by gastrectomy
cyanocobalamin (IM or nasal spray), monthly, response within 24-48 hr, within 72 hr RBC and reticulocyte count increases
iron supplements
O2 administration
blood transfusion
erythropoietin injection twice a week until iron stores are replenished

Question 18

aplastic anemia

Answer 18

rare normocytic, normochromic erythrocytes (normal size, heme content, insufficient in number)
bone marrow hypoplasia- incomplete RBC development
bone marrow aplasia lack of RBC development
pancytopenia BM suppression, decreased RBC, WBC, and platelet count

Question 19

aplastic anemia risk factors

Answer 19

congenital
idiopathic (without cause, 50% of cases)
idiosyncratic (drug reaction)
acquired (myelotoxins)
autoimmune
infections Epstein barr virus (mono)

Question 20

aplastic anemia causes

Answer 20

altered stem cell- inhibit division
altered marrow- BM replaced by fat

Question 21

aplastic anemia signs and symptoms

Answer 21

pancytopenia
petechia- low platelets, purple/ red spots
purpura (bleeding under skin)
retinal hemorrhage
hypoxia
anemia signs and symptoms