ANEMIA

Question 1

a condition in which there is
lack of enough healthy red blood
cells in the body to carry
adequate oxygen to the body’s
tissues

Answer 1

anemia

Question 2

Most common anemia of pregnancy
- A microcytic, hypochromic anemia
- hematocrit : <33%
- hemoglobin : <11g/dl

Answer 2

iron deficiency anemia

Question 3

iron deficiency anemia is confirmed by

Answer 3

low serum iron <30 ug/cl and high iron binding capacity

Question 4

• Associated with LBW & preterm births
• Some women develop pica

Answer 4

iron deficiency anemia

Question 5

causes of iron deficiency anemia

Answer 5

• low iron stones
• inadequate vit b6, b12, ascorbic acid, copper, and zinc

Question 6

• S/Sx: pallor, fatigue, lethargy & headache
• Clinical findings: inflammation of the lips & tongue

Answer 6

IDA

Question 7

iron deficiency:

• Mean corpuscular hgb. concentration (MCHC) –
  < ___ g/dL

Answer 7

30

Question 8

iron deficiency:

___ and ___ are low

Answer 8

plasma iron and serum ferritin

Question 9

iron deficiency:

Total iron binding capacity is higher than normal; over ___ ug/dl

Answer 9

400

Question 10

maternal:

• Tires easily
• More susceptible to infection
• Has increased chance of preeclampsia-eclampsia &
  postpartal hemorrhage
• Cannot tolerate even minimal blood loss during birth
• Episiotomy healing may be delayed

Answer 10

IDA

Question 11

fetus:

• Reduced red cell volume, hemoglobin & iron stores
• Reduction in fetal oxygen supply
• Risk of lbw, prematurity, stillbirth & neonatal death increases w/
  severe IDA (Hb <6g/dl)

Answer 11

IDA

Question 12

Iron is best absorbed in an ___ medium

Answer 12

acid

Question 13

Iron absorption is higher for ___ products than ___ products

Answer 13

animal; vegetable

Question 14

true or false: Iron supplements may cause constipation &
the stool will turn black & more formed

Answer 14

true

Question 15

true or false: Oral iron supplements should be
ingested w/ milk or milk products,
coffee, tea & egg

Answer 15

false

Question 16

Daily supplement of ___ mg elemental iron
is recommended by many caregivers (ferrous gluconate, ferrous fumarate, or
ferrous sulfate)

Answer 16

30

Question 17

w/ IDA – ___ mg elemental iron/day

Answer 17

120-200

Question 18

___ - intramuscular or intravenous iron dextran can be prescribed

Answer 18

severe anemia

Question 19

necessary for the
normal formation of RBCs in the mother as well as being associated with preventing neural tube & abdominal wall
defects in the fetus

Answer 19

folic acid

Question 20

example of NTD

Answer 20

myelomeningocele (spina bifida cystica), anencephaly

Question 21

• Most common cause of megaloblastic anemia
• Occurs most often in women with:
• Multiple pregnancies
• Secondary hemolytic illness
• Hydantoin use
• Oral contraceptive use

Answer 21

folic acid deficiency anemia

Question 22

Associated with increased risk for:
* Spontaneous abortion
* Abruptio placenta
* Fetal anomalies

Answer 22

FDA

Question 23

causes:

• Poor diet
• Cooking w/ large volumes of water
• Increased alcohol use
• Use of certain medications - phenytoin [Dilantin],
  methotrexate, sulfasalazine, triamterene, pyrimethamine,
  trimethoprim-sulfamethoxazole, barbiturates, & oral
  contraceptives

Answer 23

FDA

Question 24

assessment of FDA

Answer 24

measuring the average RBC volume (mean corpuscular volume)

Question 25

Deficiency manifestations may take a number of weeks to develop, it primarily becomes apparent during the ___ trimester of pregnancy

Answer 25

second

Question 26

s/sx: ▪ Pallor ▪ Fatigue ▪ Headache ▪ Lethargy ▪ Glossitis ▪ Skin roughness

Answer 26

FDA

Question 27

Women expecting to become pregnant should take a supplement of ___ µg folic acid daily in addition to eating folacin-rich foods

Answer 27

400

Question 28

During pregnancy, folic acid requirement increases to ___ µg/day.

Answer 28

600

Question 29

* Recessively inherited hemolytic anemia caused by an abnormal amino acid in the beta chain of hemoglobin * Majority of RBCs are irregular or sickleshaped

Answer 29

sickle cell anemia

Question 30

Recessively inherited hemolytic anemia caused by an abnormal amino acid in the beta chain of hemoglobin

Answer 30

sickle cell anemia

Question 31

* If abnormal amino acid replaces amino acid ___ – HbS results (sickling)

Answer 31

valine

Question 32

* If abnormal amino acid replaces amino acid ___ – HbC results (non-sickling)

Answer 32

lysine

Question 33

If an individual is heterozygous (HbAS) – has sickle cell ___

Answer 33

trait

Question 34

* If an individual is homozygous (HbSS) – has sickle cell ___

Answer 34

disease

Question 35

* Characterized by sickling of the RBCs in the presence of decreased oxygenation * Condition may be marked by crisis with profound anemia, jaundice, high temperature, infarction, & acute pain.

Answer 35

SCA

Question 36

* Painful episode that occurs in people who have sickle cell anemia * happens when sickle-shaped red blood cells block the blood vessels * Blood & oxygen cannot flow to the tissues causing pain

Answer 36

sickle cell crisis

Question 37

All ___ women who have not been previously tested should be screened for sickle cell anemia at first prenatal visit

Answer 37

african-american

Question 38

SCA: ___ levels for all women with sickle cell disease should be obtained throughout pregnancy

Answer 38

hemoglobin

Question 39

true or false: in SCA There is accompanying rise in her indirect bilirubin.

Answer 39

true

Question 40

A woman with sickle cell disease may normally have a hemoglobin level of ___ mg/ 100 mL; hemoglobin level can fall ___ mg/ 100 mL

Answer 40

6-8; 5-6

Question 41

SCA: Assess a woman’s lower extremities for ___ of blood in leg veins

Answer 41

varicosities or pooling

Question 42

* Fetal health is usually monitored during pregnancy by an ultrasound examination at ___ weeks & by weekly nonstress or ultrasound examinations beginning at about ___ weeks

Answer 42

16-24 weeks; 30

Question 43

if a crisis occurs, control pain, administer ___ as needed, & increase the ___ of the circulatory system to lower viscosity

Answer 43

oxygen; fluid volume

Question 44

SCA: Administer IV fluid: ___ solution

Answer 44

hypotonic

Question 45

If the woman has the disease & her partner has the trait, the chances that the child will be born with the disease are ___

Answer 45

50%

Question 46

true or false: If both parents have the disease, all their children will also have the disease

Answer 46

true

Question 47

true or false: as a rule, women with sickle cell disease are given an iron supplement during pregnancy.

Answer 47

false - they are NOT given

Question 48

SCA: ___ of RBCs obtained during fetal life by percutaneous umbilical blood sampling or amniocentesis

Answer 48

electrophoresis