Hemo

Question 1

low levels of hgb

Answer 1

anemia

Question 2

too much hgb

Answer 2

polycythemia

Question 3

s/sx of anemia

Answer 3

• pallor
• weakness/fatigue
• malaise

Question 4

normal value of MCV (size of RBC)

Answer 4

81-96

<81= too small
>96= too big

Question 5

normal value of MCHC (amount of hbg)

Answer 5

33-36

<33= hypochromic
>36= hyperchromic

Question 6

priority nursing diagnosis for anemia

Answer 6

ineffective tissue perfusion

Question 7

iron deficiency anemia is most common among

Answer 7

• menstruating and pregnant women

- third world countries

Question 8

s/sx of iron deficiency anemia

Answer 8

• pallor
• dizziness
• fatigue
• tachycardia
• elevated reticulocytes

Question 9

when pt is taking iron what should you ask

Answer 9

what is the color of your stool?

-black stool is the side effect of iron

Question 10

labs for iron deficiency anemia

Answer 10

-microcytic, hypochromic

Question 11

clinical manifestations of iron deficiency anemia

Answer 11

• weakness/fatigue
• brittle, rigid nails
• smooth, red atrophic tongue
• angular cheilosis (cracking of the lips)

Question 12

foods rich in iron

Answer 12

• animal meats, organ meats (beef, chicken, liver)
• black beans
• leafy green vegetables
• raisins

Question 13

how is iron BEST absorbed?

Answer 13

acidic environments/ empty stomach

Question 14

medication treatment for iron deficiency

Answer 14

-ferrous sulfate, ferrous gluconate, fumarate

Question 15

what instructions/ pt teaching do you give to the pt for iron deficiency anemia

Answer 15

• eat foods high in fiber
• take medications together with meals
• vitamin c will enhance absorption
• stools will become dark in color

Question 16

when should you do blood transfusion (in relation to hgb)?

Answer 16

when the hgb is 7 and below

Question 17

chemicals causing anemia

Answer 17

-cytokines, and inadequate secretion of erythropoetin

Question 18

pathophysiology of anemia

Answer 18

-if kidneys fail they can produce erythropoetin so you can not stimulate the bone marrow to make RBCs

Question 19

labs for anemia of inflammation

Answer 19

• normocytic, normochromic

* low hemoglobin

Question 20

which anemia is caused by disorders in the heme moeity (portion) of hemoglobin?

Answer 20

sideroblastic anemias (ringed siderblasts)

Question 21

two types of sideroblastic anemias

Answer 21

-hereditary and acquired

Question 22

common cause of acquired sideroblastic anemia

Answer 22

-more common than hereditary type
-common causes: Lead, alcohol, isoniazid
-

Question 23

characterize hereditary sideroblastic anemia

Answer 23

X linked condition due to adbormality in pyridoxine metabolism
Congenital defect in the enzyme
(d-aminolevulinic acid (ALA) synthetase)

Question 24

describe thalassemia

Answer 24

Diminished synthesis of globin chain of Hgb

RBCs are more rigid leading to early destruction

Characterized by severe microcytosis and hypochromia

Question 25

describe a-thalassemia (Bart's Hbg)

Answer 25

- Deficient a-chain synthesis, usually due to deletion of gene - Most prevalent among Asians and middle Easterns -Milder than beta forms and can occur without symptoms → may live normal life span

Question 26

describe b-thalassemia (HbF)

Answer 26

- Due to malfunction of B-globin chain caused by B-gene abnormality - Common among African descent - Severe anemia, marked hemolysis, ineffective erythropoiesis -Can be fatal within the few years of life With early regular transfusion therapy growth and development through childhood are facilitated

Question 27

megaloblastic anemia

Answer 27

Characterized by RBC that exceed 100 um in size Defective DNA synthesis (main characteristic of megaloblastic anemia) RBC cannot produce nucleic acid → nuclear maturation arrested → cytoplasmic maturation arrest→ cytoplasmic maturation proceeds→ abnormally large cells

Question 28

deficiencies for megaloblastic anemia

Answer 28

- folic acid deficiency | - vitamin b12 deficiency

Question 29

clinical manifestations of megaloblastic anemia

Answer 29

- Weakness, fatigue, pallor, jaundice, smooth sore, red atrophic tongue - Mild diarrhea, angular cheilosis - Vitiligo, premature graying of hair often seen in pernicious anemia - Paresthesias (numbing sensation) in the extremities, ataxia (B12) - Schilling’s test (test for presence of intrinsic factor and intestinal function to determine cause of vit. B12 - High methylmalonic and homocysteine levels more sensitive vit B12 deficiency

Question 30

describe aplastic anemia

Answer 30

-Damage to the marrow with replacement by fat (aplasia) → markedly reduced hematopoiesis -Can be congenital or acquired Infections, medications, chemical or radiation can cause the disease Pancytopenia

Question 31

clinical manifestations of aplastic anemia

Answer 31

fatigue , pallor, dyspnea Bleeding tendencies: Purpura, bruising Repeated infections such as sore throat, cervical lymphadenopathies Retinal hemorrhage (bleeding behind eye) Bone marrow biopsy: aplastic marrow replaced with fat

Question 32

interventions for aplastic anemia

Answer 32

- Assess for signs of bleeding, anemic and infections - Offending agent should be discontinued - Prepare client for possible BMT or PBSCT - Prepare client for immunosuppressive therapy (antithymocyte globulin and cyclosporine) - Place client on isolation room