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Flashcards in Anemia Deck (52)
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1

Anemia: Goals

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

2

Anemia: Nursing Assessment

• 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

3

Anemia: Nursing Implementation

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

4

Anemia: Nursing Diagnoses

Activity intolerance
• Vital signs
• Rest periods
• Energy conservation
• Smoking cessation

5

Anemia: Potential Complication

Hypoxemia
• Monitor vitals
• Oxygen prn
• Rest

6

Anemia: Ineffective Therapeutic Regimen Management

• Ineffective therapeutic regimen management
• Teach medication compliance
• Dietary replacement

7

Anemia: Nursing Diagnoses; Imbalanced Nutrition

• 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

8

Anemia: Nursing Care; Self-Care Deficit

• Assist with ADLs
• Rest periods
• Concerns about self-care

9

Anemia: Nursing Care; Impaired Oral Mucous Membranes

• 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

10

Anemia: Nursing Care; Continuing Care and Teaching

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

11

Anemia: Gerontologic Considerations

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

12

Iron-Deficiency Anemia: Collaborative Care; Goals

• ↑ Intake of iron
• Nutritional therapy
• Replacement therapy
• Transfusion of packed RBCs

13

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

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

14

Iron-Deficiency Anemia: Nursing Management

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

15

Iron-Deficiency Anemia: Drug Therapy

• 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

16

Cobalamin Deficiency: Collaborative Care

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

17

Cobalamin Deficiency: Nursing Management

• 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

18

Folate Deficiency: Nursing Management

• Assess for risk
• Replacement orally
• Nutrition therapy

19

Aplastic Anemia: Nursing Management

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

20

Acute Blood Loss: Collaborative Care

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

21

Acute Blood Loss: Nursing Management

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

22

Chronic Blood Loss: Management

• Identify source
• Stop bleeding
• Possible use of supplemental iron

23

Sickle Cell Disease (SCD): Nursing Management

• 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

Sickle Cell Disease: Nursing Management

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

25

Sickle Cell Disease: Nursing Management

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

26

Leukemia: Collaborative Care; Goals

• attain remission
• maintain optimal blood counts (hemoglobin, platelet) during and after completion of treatment

27

Leukemia: Collaborative Care; Chemotherapeutic treatment

• Induction therapy
• Intensification therapy
• Consolidation therapy
• Maintenance therapy

28

Leukemia: Chemotherapy Regimen; Combination chemotherapy

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

Leukemia: Bone Marrow and Stem Cell Transplantation; Goal

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

30

Leukemia: Bone Marrow and Stem Cell Transplantation

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