Care of Patients with Anemia Flashcards
(47 cards)
Reduction in either the number of RBCs, the amount of hemoglobin, or hematocrit
Is a clinical indicator, not a specific disease process because it occurs with many health problems
Can result from
Most common reason for anemia in adults
Types or causes of anemias
Anemia
Dietary problems
Genetic disorders
Bone marrow disease/decreased func
Excessive bleeding
Can result from
GI bleeding
Most common reason for anemia in adults
Deficiency in one of the components needed to make a fully functional RBC
Decrease in RBC production
Increased in RBC destruction
RBC loss
Types or causes of anemias
Ex. Iron deficiency (most common); Folic acid deficiency; vitamin B12 deficiency
Deficiency in one of the components needed to make a fully functional RBC
Ex. aplastic anemia - exposed to toxin/med that affects func of bone marrow
Decrease in RBC production
Ex. hemolytic anemia - autoimmune process
Increased in RBC destruction
Ex. GI bleed; trauma; blood lost in trauma
RBC loss
Integumentary
Cardiovascular
Respiratory
Neurologic
Key features
Pallor
Cool to the touch
Intolerance of cold temperatures
Nails become brittle and become concave over time
Integumentary
Tachycardia - severe enough; heart trying to compensate
Murmurs and gallops when anemia is severe
Orthostatic hypotension - severe enough
Cardiovascular
Dyspnea on exertion - severe enough dyspnea
Decreased oxygen saturation levels
Respiratory
Sig Fatigue and somnolence
Headache
Neurologic
Most common anemia worldwide
Causes:
When iron deficient the stores will decrease first
A microcytic anemia (RBC will be small)
Labs:
Clinical Manifestations:
Iron deficiency anemia
More among women (menstruating), older adults, and people with poor diets
Most common anemia worldwide - Iron deficiency anemia
Blood loss
Poor GI absorption of iron
Inadequate iron in diet
Causes: - Iron deficiency anemia
Hbg/Hct & RBC decreased
Ferritin decreased < 10ng/mL (12-300 normal) (decreased iron stores)
MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin) and MCHC (mean corpuscular hemoglobin concentration) decreased
Labs: - Iron deficiency anemia
Weakness and pallor
Fatigue
Reduced exercise tolerance
Fissures at the corners of the mouth
*with chronic anemia signs and symptoms may be more mild than acute situation
Clinical Manifestations: - Iron deficiency anemia
Increase oral intake of iron from food sources
Oral iron supplements (Ferrous Sulfate)
With severe deficiency give IV infusion (lot monitoring with first dose) or IM iron solutions - very irritating and do Z track method
Iron deficiency anemia interventions
10-15 grams of iron a day
High in iron: red meat, organ meat, egg yolks, kidney beans, leafy green vegetables, raisins, dark chocolate, soy beans
5-10% of dietary iron is absorbed - eat lot iron to supplement; may need supplements
Increase oral intake of iron from food sources - Iron deficiency anemia interventions
Take between meals for better absorption and reduce GI distress
Take with vitamin C for better absorption
Expect 2 gm/dL increase in 4 weeks - not immediate improvements
Oral iron supplements (Ferrous Sulfate) - Iron deficiency anemia interventions
Ex. Iron dextran (Dexferrum) or ferumoxytol (Feraheme)
With severe deficiency give IV infusion (lot monitoring with first dose) or IM iron solutions - very irritating and do Z track method - Iron deficiency anemia interventions
Vitamin B12 plays a key role in the formation of RBCs as well as normal functioning of the nervous system - helps move folic acid
Causes:
May be mild or severe, usually develops slowly
Macrocytic anemia (large RBC) - not proper process - see in CBC
Clinical manifestations - mild to severe
Vitamin B12 Deficiency anemia
Vegan diets or diets lacking dairy products
GI disorders: small bowel resection, chronic diarrhea, diverticuli, tapeworm, overgrowth of intestinal bacteria
Anemia resulting from failure to absorb vitamin B12 (pernicious anemia) secondary to chronic gastritis
Causes: - Vitamin B12 Deficiency anemia
