Anemia

Question 1

Anemia

Answer 1

Condition in which red blood cells have a reduced capacity to deliver oxygen to tissues

Question 2

Anemia consider a sign of an

Answer 2

underlying disorder

Goal: identify underlying cause and treat

Question 3

Anemia causes

Answer 3

Blood loose due to hemorrhage
Increase erythrocyte destruction
Decreased erythrocyte production

Question 4

Anemia S/S

Answer 4

pallor, decrease exercise tolerance, fatigue, lethargy; dizziness or fainting; severe – heart failure

Question 5

Anemia Classified by

Answer 5

erythrocytes size and color

Question 6

sizes example

Answer 6

normal (normocytic), small (microcytic), or large (macrocytic).

Question 7

Color example

Answer 7

Color – normal red (normochromic) or light red (hypochromic).

Question 8

Macrocytic–normochromic

Description and example

Answer 8

Large, abnormally shaped erythrocytes with normal hemoglobin concentration

Question 9

Goal for anemia is

Answer 9

identify the underlying cause to treat

Question 10

Microcytic–hypochromic

example and descrption

Answer 10

Small, abnormally shaped erythrocytes with decreased hemoglobin concentration

Iron-deficiency anemia, thalassemia

Question 11

Normocytic–normochromic example and description

Answer 11

Destruction or depletion of normal erythroblasts or mature erythrocytes

Aplastic anemia, hemorrhagic anemia, sickle-cell anemia,

Question 12

Iron Deficiency Anemia

Answer 12

Cells are microcytic and hypochromic.

Question 13

Iron Deficiency Anemia caused

Answer 13

Inadequate iron absorption or consumption decreases erythropoiesis, which causes anemia.

Question 14

Conditions associated with iron-deficiency anemia include

Answer 14

Gastrointestinal (GI) bleeding (found in more than 50% of clients with this anemia)
Chronic peptic ulcer disease (PUD)
GI malignancies
Pregnancy
Blood loss during menses

Question 15

Test to determine time of anemia

Answer 15

peripheral smear

Question 16

Treatmetn of anemia varies according to

Answer 16

severity

Question 17

Mild anemia treatment

Answer 17

increased dietary intake of iron-rich foods such as fish, red meat, fortified cereal, and whole-grain bread

Question 18

Moderat anemia treatment

Answer 18

oral iron supplementation

Question 19

severe anemia treatment

Answer 19

iron supplementation; IV or IM iron therapy may be given if the client cannot tolerate oral supplements

Question 20

Most common cause of iorn deficience anemia

Answer 20

GI bleeding

Question 21

Iron preperations build

Answer 21

serum iron and iron storage in the body

Question 22

Iron preparations pharmacokinetics

Answer 22

Enhanced absorption if iron stores low
Ferrous form absorbed more readily
Food affects absorption
Eliminated via shedding of gastrointestinal (GI) mucosal cells or via bleeding

Question 23

Iron preperations precautions and contraindications

Answer 23

Hemochromatosis and hemolytic anemia

Question 24

Iron preparations ADR

Answer 24

GI symptoms (constipation, GI upset)
Acute toxicity possible, especially in children

Question 25

Iron preparations drug interacions

Answer 25

Chelation | Decreased absorption

Question 26

Iron prepartions clinical use and dosing

Answer 26

Iron-deficiency anemia Treatment for 3 to 4 months after Hgb/Hct return to normal Adults: 150 to 300 mg elemental iron daily Premature infants: 2 to 4 mg/kg/day Infants and young children: 4 to 6 mg/kg/day

Question 27

Iron preparations monitoring

Answer 27

Monitoring Reticulocyte count 5 to 10 days after starting therapy Hgb, hct, ferritin at 4 weeks, then 3 months, then annual If Hgb, Hct, and ferritin do not return to normal levels, the patient should be evaluated for a source of blood loss in other pathology.

Question 28

Iron preparations take with what to enhance absorption

Answer 28

Take with vitamin c to enhance absorption

Question 29

Pernicious Anemia

Answer 29

Vitamin B12 deficiency the result of Large, immature RBCs

Question 30

Pernicious anemia S/S

Answer 30

pallor, fatigue, lethargy, dizziness & faintness

Question 31

Vitamin B12 cannot

Answer 31

Cannot be synthesized from the body, only bacteria in the gut can Must interact with the intrinsic factor

Question 32

Deficiency in B12 can be

Answer 32

caused by inflammatory diseases of the small intestine, or by gastric resection

Question 33

Vitamin B12 supplement route

Answer 33

Vitamin B12 supplement - parental, oral. Intranasal not generally used.

Question 34

Vitamin B12 ADR

Answer 34

: uncommon but can include hypokalemia, rashes, itching & sodium retention

Question 35

The most common cause of vitamin B12 deficiency is absence of 

Answer 35

intrinsic factor, a protein secreted by stomach cells. Intrinsic factor is required for vitamin B12 to be absorbed from the intestine. The hematopoietic stem cells produce abnormally large erythrocytes that do not fully mature.

Question 36

The symptoms of pernicious anemia are often

Answer 36

nonspecific and develop slowly, sometimes over decades. Nervous system symptoms may include memory loss, confusion, unsteadiness, tingling or numbness in the limbs, delusions, mood disturbances, and even hallucinations in severe deficiencies.

Question 37

Vitamin B12 deficiency etiology

Answer 37

``` Poor intake (vegans, vegetarians) Impaired absorption caused by lack of intrinsic factor, diseases of the ilium, stasis (constipation) Gastrectomy, bariatric surgery ```

Question 38

B12 pharmacokinetics

Answer 38

IM, SC, or intranasal well absorbed | Stored in liver and excreted in urine

Question 39

B12 dose prevention

Answer 39

Pregnancy: 2.2 mcg/day, lactation 2.6 mcg/day Infants: 0.3 to 0.5 mcg/day Children age 1 to 10 years: 0.7 to 1.4 mcg/day

Question 40

B12 dose deficiency

Answer 40

1,000 mcg oral cobalamin daily for 6 to 12 weeks

Question 41

pernicious anemia B12 initial dose

Answer 41

Initial dose 1,000 mcg/day IM or SC for 7 days, then 100 to 1,000 mcg IM per week for a month

Question 42

pernicious anemia B12 maintenance dose

Answer 42

1,000 mcg IM monthly 500 mcg intranasal cyanocobalamin weekly 1,000 mcg orally daily

Question 43

pernicious anemia B12 monitoring

Answer 43

Reticulocyte counts, Hgb and Hct, iron, folic acid, and vitamin B12 serum levels prior to treatment, at 5 to 7 days of therapy, then frequently until Hgb and Hct are normal Monitor potassium levels Liver function tests every 2 to 4 weeks to monitor for hepatotoxicity