Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

kol- Med Surg 320 Spring > Anemia > Flashcards

Anemia Flashcards

1
Q

Why is anemia a disease of perfusion?

A

> > there aren’t enough RBC’s to carry adequate oxygen to tissue
-manifestation of something else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anemai for men vs women

A
  • Hg < 12 g/dL in women

- Hg < 13.5 g/dL in men (or 14 g/dL, per Iggy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

anemia a manifestation of

A

something else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

anemia is temporary or permanent

A

either

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

labs for anemia

A
  • CBC
  • RBC’s (4-6 M cells/mcL)
  • Hemoglobin (14-18g/dL/ 12-16 g/dL)
  • Hematocrit (42-52%/ 37-47%)
  • *Reticulocytes (0.5 – 2%)
  • MCV (Mean Corpuscular Volume) (80-95)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

normal HGB ranges

A

14-18g/dL/ 12-16 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

normal hematocrit

A

42-52%/ 37-47%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

normal reticulocytes

A

0.5 – 2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Normal RBC

A

4-6 M cells/mcL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is a reticulocyte

A

immature RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why do I care about reticulocytes in relation to anemia

A

-Insight into whether the problem is production (low reticulocytes) or destruction (high- don’t have enough time to mature)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does MCV stand for and what is the normal range

A

Mean Corpuscular Volume 80-95

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Microcytic anemia is problem with

A

not having enough iron, RBC are too small

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Macrocytic anemia is problem with

A

DNA synthesis, doesn’t have enough Folic Acid

–>cell continues to grow b/c DNA synthesis is slow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 types of hemolytic anemia

A
  1. Sickle Cell Disease
  2. Glucose 6-Phosphate Dehydrogenase Deficiency Anemia
  3. Immunohemolytic Anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

hemolytic anemia is characterized by

A

increased destruction of RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

3 types of anemia that are a decreased production of RBC

A
  1. Normocytic Anemia
    - ->Anemia of Chronic Disease
  2. Macrocytic Anemias (DNA issue)
    - ->Vitamin B12 deficiency anemia
    - -> Folic acid deficiency anemia
    - ->Aplastic Anemia
  3. Microcytic Anemias (Hemoglobin issue)
    - ->Iron Deficiency anemia ***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

anemia risk factors

A 
Blood Loss (Acute or Chronic)
GI bleeding
Hemorrhage
Trauma
Operative
Menorrhagia
Increased destruction of RBC’s
Defective RBC’s
Immune issue
G6PD deficient
Age
Nutritional Issues
GI Bleeding
Dietary intake issue or Malabsorption
Iron deficient
B12 deficient
Folic acid deficient
Bone Marrow Suppression 
Radiation 
Chemicals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

anemia assessment

A 
Fatigue
Pallor
Jaundice
Dysrhythmias
Tachycardia
Dyspnea
Shortness of breath
Syncope
Dizziness
Headache
Chest Pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Nursing Interventions for anemia

A

Largely depend on the cause
Situationally, think:
Dyspnea Low SpO2- Elevate HOB , put oxygen on
Increased fatigue- rest periods
Intolerance of cold temperature- warm blanket
Orthostatic Hypotension- education about getting up slowly
Chest Pain - 12 lead EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Indication for Blood Transfusion=

A

When Hg < 7 g/dL OR your patient is anemic and symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

causes of iron deficiency anemia

A

Poor diet
Blood loss
Poor GI absorption- common in elderly due to poor GI absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

most common type of anemia?

A

iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what do RBCs look like with iron anemia

A

Small RBC’s (microcytic/ low MCV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

iron deficiency anemia labs

A

Serum ferritin <10-12 ng/mL

Serum Iron < 60-80 mcg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

mouth fissures with what kind of anemia?

A

iron deficiency

*will not heal until anemia is better!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

diet changes for iron deficiency anemia

A 
Red meat & Liver
Legumes
Leafy greens
Shellfish
-Oral Supplements-constipation/stool dark color 
May cause GI distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

IV iron infusions = Only for ? and why?

A

severe iron deficiency, anaphylaxis risk!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Anemia of chronic disease common

A

elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

severity of anemia of chronic disease?

A

mild to moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

RBC appearance w/ anemia of chronic disease?

A

normocyctic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

another name of anemia of chronic disease

A

anemia of inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

common causes of anemia of chronic disease

A 
Kidney Disease
	Infection
	Cancer
	Inflammatory Bowel Disease
	Diabetes
34
Q

how do we treat anemia of chronic disease?

A

treat the underlying causes

35
Q

Vit b12 deficiency anemia result in what with RBC

A

macrocytic RBC

–>cell continues to grow b/c DNA synthesis is slow

36
Q

causes of b12 anemia

A
  • Dietary
  • Chronic diarrhea
  • Pernicious anemia - not able to absorb b12
37
Q

b12 anemia s/s

A

-Pallor
-Fatigue
-Jaundice
-Weight loss
-Glossitis
Parasthesias –> nerves involved!

38
Q

folic acid anemia causes

A
  • Diet
  • Malabsorption
  • Drugs
  • Alcoholism
39
Q

folic acid anemia s/s

A
  • Pallor
  • Fatigue
  • Jaundice
  • Weight loss
  • Glossitis

*same as b12 but no nerve stuff

40
Q

how we treat B12 anemia?

A

Dietary changes
Oral supplements
B12 injections

41
Q

Folic acid anemia interventions

A 
Screening for:
	Older adults
	Poor nutrition
	Alcoholics
Dietary Changes
Supplement
42
Q

What is sickle cell disease (patho)

A

-Autosomal recessive genetic disorder
-Causes mutation that results in HbS (vs HbA which is what most people have)
-HbS is sensitive to low O2
-Low O2 = Sickling of RBC’s
> Sickled cells clump together
>Create vaso-occlusive event (VOE)

43
Q

HbS vs HbA

A

HbA = 2 alpha and 2 beta chains in cell
HbS = 1 of beta chains has alternation in amino acid causing changes in certain environments
—> in low O2 environment that beta chain loses is structure and causes entire HgB to sickle

44
Q

carriers of sickle cell diesease

A

inherited 1 normal and 1 HbS allele

-people who are carriers have mild sxs!

45
Q

Life span of HbS vs HbA RBC

A 
HbA = normal =120 
HbS = sickle = 20 days (sickled or not) = anemia = increased reticulocytes
46
Q

Concern w/ VOE from Sickle cell crisis

A 
-long term damage to tissue/organs organ failure
	Spleen
	Liver
	Heart
	Kidney
	Brain
	Bones & Joints
	Retina
	Lungs - acute chest syndrome = #1 people with sickle cell disease die
47
Q

1 cause of death in Sickle Cell patients?

A

acute chest syndrome

48
Q

conditions that cause sickling

A
  • Pregnancy
  • Hypoxia
  • Dehydration > decrease blood flow
  • Infection
  • Venous stasis > immobility
  • Alcohol
  • High Altitudes
  • Extreme temperatures
  • Acidosis > DKA, infection
  • Exercise >lactic acid build up
  • Stress
  • Anesthesia
49
Q

sickle cell assessment

A

Signs of poor perfusion!

**Pain** - acute and chronic --> long term opioids 
Fatigue
Pallor
Jaundice
Cyanosis
Lower Extremity  ulcers
Joint pain > deformed joints > limited range of motion > swelling
SHOB
Pallor
Jugular vein distension
Capillary Refill > 2 seconds
Diminished pulses
Cool
Tachycardia
Cognitive changes -memory/clarity issues 
Coping
Understanding of SCD
Support System
50
Q

complications of sickle cell

A
  • Crisis
  • Organ Failure
  • Priapism- erection that doesnt go away , medical emergency, cannot urinate!
  • Pneumonia
  • **Acute Chest Syndrome **
51
Q

Assessing for acute chest syndrome

A

-caused by VOE in pulmonary bed
-looks like PNA :
Cough
SHOB
Infiltrate on chest x-ray

52
Q

Diagnostics for sickle cell

A
  • # 1 diagnosis: Family history + Hemoglobin electrophoresis
  • Low Hematocrit (new normal = 20-30% for SCD)
  • High Bilirubin (May be high >1.2 mg/dL)
  • High Reticulocytes (> 2%)
  • High WBC’s (> 10 9 cells/L)
53
Q

hematocrit sickle cell vs regular

A

sickle = 20-30 %

normal =(42-52%/ 37-47%)

54
Q

interventions for sickle cell crisis

A
  • *Oxygen (if Hypoxic) - oxygen can slow prdxn of RBC > only give if hypoxic! give minimum amt
  • *Pain management
  • *Hydration
  • D5 1/2NS
  • Promote Circulation
  • Prevention of infection
  • Early detection of infection> report fever to provider!
  • Temperature adjustments to environment
  • Blood transfusions > rarely indicated, only if really need them
  • Crisis prevention > recognize triggers
  • Hydroxurea (medication)
55
Q

consideration for giving O2 during sickle cell crisis

A

oxygen can slow prdxn of RBC > only give if hypoxic! give minimum am

56
Q

when are we using packed red blood cells

A

Hg < 7g/dL OR low with symptoms of anemia

57
Q

when use washed PRBC

A

history of allergies or allergic reaction to blood products

58
Q

when transfuse platelets?

A

Platelets < 20,000 OR < 50,000 with active bleeding

59
Q

-platelets <20,000 = risk of

A

spontaneous bleed especially in brain!

60
Q

this type of transfusion does not require type/cross

A

platelets

61
Q

when use fresh frozen plasma

A
  • Elevated PT / INR (with or without bleeding) - trouble with clotting
  • Reversal of coumadin (in emergency)
  • For patients who have received multiple PRBC transfusions
62
Q

universal donor =

universal recipients =

A
  • O- = universal donor

* AB+ = universal recipient

63
Q

1st thing to do when giving blood?

A

-Verify order* & consent* - if another nurse says they got consent YOU still need to verify consent

64
Q

After consent for blood make sure you have a _______ from w/in 3 days

A

type and cross

65
Q

iv access for blood?

A

large bore - 18/19/20

66
Q

how soon to start blood once it comes from blood bank?

A

w/in 15 minutes

67
Q

the unit of blood should be administered within ____ hours

A

4

68
Q

tubing for blood?

A

filter!

69
Q

stay w/ patient for the first _____ minutes

A

15

70
Q

transfusion reaction types

A
  1. febrile
  2. hemolytic
  3. allergic
  4. bacterial
  5. TRALI
  6. circulatory overload
  7. Graft vs host
71
Q

febrile transfusion reaction

A

(fever, chills, tachycardia, low BP, tachypnea- occurs within 4 hours)

72
Q

hemolytic transfusion reaction

A

(fever, chills, low back pain, chest pain, anxiety, low BP, tachycardia, tachypnea)

73
Q

allergic transfusion reaction

A

(itching, urticaria)

74
Q

bacterial transfusion reaction

A

(tachycardia, low BP, fever, chills)

75
Q

TRALI

A

(dyspnea, hypoxia)

76
Q

circulatory overload transfusion reaction

A

(hypertension, bounding pulse, JVD, anxiety) - give diuretics

77
Q

Transfusion associated graft versus host disease

A

(thrombocytopenia, nausea, vomiting, weight loss, infection)

78
Q

which transfusion reactions are acute?

A 
Mild allergic
Anaphylactic
Acute Hemolytic
Febrile non-hemolytic
Bacterial
Circulatory overload
79
Q

which transfusion reactions are delayed?

A

Delayed Hemolytic

Transfusion-associated graft-versus -host

80
Q

transfusion reaction interventions

A
  • !Stop transfusion
  • Remove blood tubing
  • Notify charge nurse or Rapid response
  • Do not flush unless you have no other IV access
  • Apply oxygen
  • Administer Benadryl
  • Proceed appropriately (monitor, administer other medications…)

kol- Med Surg 320 Spring (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions