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Nursing Theory IV > Anemia > Flashcards

Anemia Flashcards

1
Q

Anemia: Goals

A
  • Assume normal activities of daily living
  • Maintain adequate nutrition
  • Develop no complications related to anemia
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2
Q

Anemia: Nursing Assessment

A
  • Inquire about bruising easily, bleeding for an unusually long time, or chronic fatigue
  • Note any history of blood transfusions
  • Medications used or recent change in medication
  • PMH & FH
  • Systems & Diagnostics review
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3
Q

Anemia: Nursing Implementation

A
  • Dietary and lifestyle changes
  • Blood or blood product transfusions
  • Drug therapy
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4
Q

Anemia: Nursing Diagnoses

A 
Activity intolerance
• Vital signs
• Rest periods
• Energy conservation 
• Smoking cessation
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5
Q

Anemia: Potential Complication

A

Hypoxemia
• Monitor vitals
• Oxygen prn
• Rest

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6
Q

Anemia: Ineffective Therapeutic Regimen Management

A
  • Ineffective therapeutic regimen management
  • Teach medication compliance
  • Dietary replacement
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7
Q

Anemia: Nursing Diagnoses; Imbalanced Nutrition

A
  • Imbalanced nutrition: less than body requirements
  • Collaboration with dietitian •Keep a food diary
  • Monitor recorded intake
  • Encourage increased intake of protein, iron, and vitamin C to provide nutrients needed for hematopoiesis.
  • Small, frequent meals with snacks
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8
Q

Anemia: Nursing Care; Self-Care Deficit

A
  • Assist with ADLs
  • Rest periods
  • Concerns about self-care
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9
Q

Anemia: Nursing Care; Impaired Oral Mucous Membranes

A
  • Assess lips and tongue
  • Mouthwash
  • Frequent oral hygiene
  • Avoid alcohol-based mouthwashes
  • Petroleum jelly for lips
  • Avoid spicy foods
  • Encourage soft bland foods
  • Small high-protein balanced meals each day
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10
Q

Anemia: Nursing Care; Continuing Care and Teaching

A
  • Types of anemia
  • Diet
  • Medications
  • Genetic counseling
  • Follow-up appointments
  • Support groups
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11
Q

Anemia: Gerontologic Considerations

A
  • Common in older adults
  • Chronic disease
  • Nutritional deficiencies
  • Signs and symptoms may go unrecognized or mistaken for normal aging changes
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12
Q

Iron-Deficiency Anemia: Collaborative Care; Goals

A
  • ↑ Intake of iron
  • Nutritional therapy
  • Replacement therapy
  • Transfusion of packed RBCs
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13
Q

Iron-Deficiency Anemia: Nursing Management; At-risk groups

A
  • Premenopausal women
  • Pregnant women
  • Persons from low socio-economic backgrounds
  • Older adults
  • Individuals experiencing blood loss
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14
Q

Iron-Deficiency Anemia: Nursing Management

A
  • Diet teaching
  • Supplemental iron
  • Discuss diagnostic studies
  • Emphasize compliance
  • Iron therapy for 2-3 months after the hemoglobin levels return to normal
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15
Q

Iron-Deficiency Anemia: Drug Therapy

A
  • Oral iron
  • Inexpensive
  • Convenient
  • Factors to consider
  • Best absorbed as ferrous sulfate in an acidic environment
  • Liquid iron should be diluted and ingested through a straw
  • Side effects- Heartburn, constipation, diarrhea
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16
Q

Cobalamin Deficiency: Collaborative Care

A
  • Parenteral administration of cobalamin
  • ↑ Dietary cobalamin does not correct the anemia
  • Still important to emphasize adequate dietary intake
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17
Q

Cobalamin Deficiency: Nursing Management

A
  • Familial disposition
  • Ensure injuries are not sustained due to the client’s diminished sensations to heat and pain
  • Ensure client compliance with treatment
  • Evaluate client for gastric carcinoma frequently
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18
Q

Folate Deficiency: Nursing Management

A
  • Assess for risk
  • Replacement orally
  • Nutrition therapy
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19
Q

Aplastic Anemia: Nursing Management

A
  • Preventing complications from infection and hemorrhage
  • Untreated prognosis is poor
  • 75% fatal
  • Treatment options
  • Bone marrow transplantation
  • Immunosuppressive therapy
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20
Q

Acute Blood Loss: Collaborative Care

A
  • Replacing blood volume to prevent shock
  • Identifying the source of the hemorrhage
  • Stopping blood loss
  • Correcting RBC loss
  • Infection control
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21
Q

Acute Blood Loss: Nursing Management

A

May be impossible to prevent if caused by trauma
Post-operative clients
• Monitor blood loss
No need for long-term treatment

22
Q

Chronic Blood Loss: Management

A
  • Identify source
  • Stop bleeding
  • Possible use of supplemental iron
23
Q

Sickle Cell Disease (SCD): Nursing Management

A
  • Alleviate symptoms of disease complications
  • Minimize end target-organ damage
  • No specific treatment for SCD
  • Client teaching
  • Avoid high altitudes, maintain fluid intake, treat infections, pain control
24
Q

Sickle Cell Disease: Nursing Management

A
  • O2 for hypoxia and to control sickling
  • Pain management
  • Acute chest syndrome
  • Antibiotics
  • O2 therapy
  • Fluid therapy
  • Folic acid daily supplements
25
Q

Sickle Cell Disease: Nursing Management

A 
Blood transfusions in crisis
Hydroxyurea: anti-sickling agent
• Erythropoietin in clients unresponsive to hydroxyurea
Bone marrow transplant
• Can cure some clients with SCD
26
Q

Leukemia: Collaborative Care; Goals

A
  • attain remission

* maintain optimal blood counts (hemoglobin, platelet) during and after completion of treatment

27
Q

Leukemia: Collaborative Care; Chemotherapeutic treatment

A
  • Induction therapy
  • Intensification therapy
  • Consolidation therapy
  • Maintenance therapy
28
Q

Leukemia: Chemotherapy Regimen; Combination chemotherapy

A

Combination chemotherapy:
• Mainstay treatment
• 3 purposes
• ↓ drug resistance
• ↓ drug toxicity to the client by using multiple drugs with varying toxicities
• Interrupt cell growth at multiple points in the cell cycle

29
Q

Leukemia: Bone Marrow and Stem Cell Transplantation; Goal

A

Totally eliminate leukemic cells from the body using combinations of chemotherapy with or without total body irradiation

30
Q

Leukemia: Bone Marrow and Stem Cell Transplantation

A 
Eradicates client’s hematopoietic stem cells
Replaced with those of an HLA-matched 
• Sibling
• Volunteer
• Identical twin
• Client’s own stem cells removed before
31
Q

Leukemia: Nursing Management; Overall goals

A
  • Understand and cooperate with the treatment plan
  • Experience minimal side effects and complications of disease and treatment
  • Feel hopeful and supported during the periods of treatment, relapse, and remission
32
Q

Leukemia: Nursing Management

A
  • Ongoing care is necessary to monitor for signs and symptoms of disease control or relapse
  • Teach client and significant other
  • Diligence in disease management
  • Need for follow-up care
  • When to seek medical attention
33
Q

Leukemia: Nursing Care; Risk for Infection

A
  • Infection precautions
  • Avoid invasive procedures
  • Report evidence of infection
  • Monitor vital signs
  • Report lab values
  • Explain precautions and restrictions
34
Q

Leukemia: Nursing Care; Imbalanced Nutrition

A

Less than Body Requirements
• Monitor weight
• Promote food and fluid intake
• Avoid procedures around meals

35
Q

Leukemia: Nursing Care; Impaired oral Mucous Membranes

A
  • Assess mouth
  • 1:1 solution saline/peroxide as mouthwash
  • Soft-bristle toothbrush
  • Medications for infection, pain
  • Avoid alcohol-based mouthwashes
36
Q

Leukemia: Nursing Care; Ineffective Protection

A
  • Monitor LOC
  • Report manifestations of bleeding
  • Avoid invasive procedures
  • Apply pressure to puncture sites
  • Avoid straining with bowel movement
37
Q

Leukemia: Nursing Care; Anticipatory Grieving

A
  • Therapeutic communication
  • Manage stressful situations
  • Support groups for the grieving process
38
Q

Leukemia: Nursing Care; Teaching

A
  • Diagnosis, treatment, bone marrow, complications
  • Cancer as a chronic illness
  • Balance activity with rest
  • Maintain weight and nutrition
  • Hydration
  • Prevent infection
  • Oral hygiene
39
Q

Leukemia: Nursing Care

A
  • Avoid crowds, sick people
  • Avoid immunizations
  • Reduce risk of bleeding or injury
  • Avoid OTC medications that can cause bleeding
  • Refer to social services, support groups, home health
40
Q

Leukemia: Nursing Management; Evaluation

A
  • Cope effectively with diagnosis, treatment regimen, and prognosis
  • Attain and maintain adequate nutrition
  • Experience no complications
  • Feel comfortable and supported
41
Q

Hodgkin’s Disease: Nursing and Collaborative Management

A
  • Using diagnostic studies, a stage of disease is determined
  • Disease may be localized or diffused
  • Treatment depends on the nature and extent of the disease
42
Q

Stages of Hodgkin’s Disease

A
  • Stage I- involvement of a single node
  • Stage II- involvement of 2 or more nodes on the same side of the diaphragm
  • Stage III- involvement of additional lymph node regions, organs or extralympathic
  • Stage IV- widely spread disease
  • A or B
43
Q

Hodgkin’s Disease: Nursing and Collaborative Management

A

Management focuses on selecting a treatment plan
Least amount of treatment to achieve a cure
• Minimize short- and long-term complications

44
Q

Hodgkin’s Disease: Nursing and Collaborative Management; Chemo/ Radiation

A 
Chemotherapy
• Combination
• Remission in >75%
Radiation
• Used for both
• Combined with chemotherapy
45
Q

Hodgkin’s Disease: Nursing and Collaborative Management; Radiation/ Combination Chemo

A

Radiation therapy
• 95% of stage I or stage II clients cured with 4 to 6 weeks of radiation therapy
Combination chemotherapy
• Resistant disease or high risk of relapse

46
Q

Hodgkin’s Disease: Nursing and Collaborative Management

A
  • Skin in radiation field needs attention
  • Psychosocial considerations
  • Fertility issues
  • Long-term evaluation of client
  • Consequences may not be apparent for many years
47
Q

Hodgkin’s Disease: Nursing and Collaborative Management; Risk of secondary malignancies

A
  • 18% risk of secondary cancer at 15 years after treatment
  • Most common
  • Acute non-lymphoblastic leukemia
  • Non-Hodgkin’s lymphoma
  • Solid tumours
48
Q

Non-Hodgkin’s Disease: Treatment

A 
Treatment
• Radiation therapy 
• Chemotherapy
More aggressive lymphomas are more responsive to treatment
• More likely to be cured
49
Q

Non-Hodgkin’s Disease: Nursing Care; Impaired Skin Integrity/ Nausea

A 
Risk for Impaired Skin Integrity 
• Measures to reduce itching
Nausea
• Antiemetics
• Measures to relieve/reduce nausea
50
Q

Non-Hodgkin’s Disease: Nursing Care; Fatigue

A
  • Assess malaise
  • Encourage talking about disease
  • Quiet activities
  • Rest periods
  • High-carbohydrate diet
  • Fluids
51
Q

Non-Hodgkin’s Disease: Nursing Care; Disturbed Body Image

A
  • Body image assessment
  • Objective signs of altered body image
  • Coping with alopecia
  • Effects of illness on sexuality
  • Support groups
52
Q

Non-Hodgkin’s Disease: Nursing Care; Teaching

A
  • Treatment and effects of treatment
  • Skin care
  • New symptoms
  • Complementary pain management strategies
  • Rest and exercise
  • Diet
  • Canadian Cancer Society referral

Nursing Theory IV (12 decks)

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