Anemias

Question 1

Why do kidney failure patients get anemia

Answer 1

due to the loss of the hormone erythropoietin

Question 2

What does erythropoietin do?

Answer 2

Signals bone marrow to produce RBC and carries iron

Question 3

Med given to kidney failure patients with anemia

Answer 3

epoetin alpha

Question 4

How does iron get administered

Answer 4

May be given IM (z track)

Question 5

What must be monitored to administer iron

Answer 5

nausea/abdominal discomfort/constipation/and or diarrhea

Question 6

Severe anemia signs and symptoms

Answer 6

Koilonchias (soft spoon shaped fingernails), Glossitis (beefy red tongue)

Question 7

Complications of severe anemia

Answer 7

No oxygen to the heart and no thermoregulation

Question 8

Anemia diet

Answer 8

High in red meat, green leafy vegtables (spinich, beets, beans and cereals, and citrus to help retain the iron (especially iron deficiency- grapefruit, orange juice)

Question 9

What is intrinsic factor

Answer 9

controls the function of CNS- you will not make new DNA or RBCs)

Question 10

Signs and symptoms of pernicious anemia

Answer 10

Vitiligo, premature graying of the hair, and glossitis

Question 11

Risk factors for pernicious anemia

Answer 11

chronic alcohol use, liver issues, chrons disease, or gastrecomies, any medications that decrease gastric acid (long term use of PPI and H2 blockers)

Question 12

s/s of B12 deficiency

Answer 12

Peripheral neuropathy, altered mental status, depression, visual disturbances, atrophy in the eyes, orthostatic hypotension

Question 13

Signs and symptoms of Folic acid deficiency

Answer 13

tachypnea (decreased O2 sat) and confusion

Question 14

What is decreased in folic acid deficiency

Answer 14

of platelets which increases the risk of bleeding

Question 15

symptoms of folic acid deficiency will continue unless you replace

Answer 15

B12

Question 16

Patients with folic acid deficiencies may experience

Answer 16

mood changes, memory difficulties, and weakness

Question 17

s/s of sicke cell crisis

Answer 17

Fatigue, pallor, SOB, vasoocclusion of blood vessels resulting in pain or swelling

Question 18

where will patients feel pain with sickle cell crisis

Answer 18

Pain will occur in- joints, bones, chest, abdomen

Question 19

What may be present with sickle cell crisis

Answer 19

Fever

Question 20

Risk factors for Sickle cell crisis

Answer 20

severe cold tempuratures, high altitude, fever, dehydration

Question 21

Treatment for sickle cell crisis

Answer 21

O2 via NC 2-3L fluid resuscitation, give morphine

Question 22

What can occur in sickle cell anemia that may cause puberty to be delayed

Answer 22

ischemia of organs

Question 23

Prevention for sickle cell crisis

Answer 23

Get immunizations (vaccines) like the flu, Good dental hygiene, Get enough oxygen, drink fluids, avoid getting over-heated or getting very cold, avoid getting infections

Question 24

aplastic anemia

Answer 24

bone marrow depression

Question 25

What does aplastic anemia result in

Answer 25

decreased production of RBC/WBC/platelets

Question 26

Why might aplstic anemia occur

Answer 26

Can occur due to hepatitis and HPV or other infectious agents or chemicals

Question 27

Treat aplastic anemia with

Answer 27

chemo and radiation

Question 28

Meds for aplastic anemia

Answer 28

epogen which induces bone marrow production

Question 29

Why does AML occur

Answer 29

Linked to exposure to radiation or benzene and causes possible alterations in bone marrow function

Question 30

What is AML more prevalent in

Answer 30

white males over the age of 60 and history of smoking

Question 31

S/S of lymphoma

Answer 31

Painless swelling of the lymph nodes in the neck, underarm, and groin; low grade fevers for no apparent reason; drenching night sweats; unexplained weight loss of more than 10% in less than 6 months; and fatigue

Question 32

S/S of lymphoma with alc

Answer 32

alcohol induced pain at site of lymph nodes

Question 33

What may be on the skin due to scratching from lymphoma

Answer 33

excoriations

Question 34

If feeling SOB or fullness with lymphoma

Answer 34

this may mean enlarging lymph nodes spread to the spleen or liver or compress the vena cava or spine

Question 35

Multiple myeloma and risk factors

Answer 35

Incurable B cell malignancy-men, age 62 and over

Question 36

Lab values for Multiple myeloma

Answer 36

Hypercalcemia, renal insufficiency (serum creatinine higher), anemia (hemoglobin low), osteopenia