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ADN002 MED SURG > Week 4 Anemia > Flashcards

Week 4 Anemia Flashcards

1
Q

Reduction in number of RBCs, HgB and therefore lowered Hct- decreased ability to carry oxygen

A

Anemia

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2
Q

Garbage disposal of the RBCs

A

Spleen

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3
Q

Mechanical Heart Valve ca cause what?

A

Physical damage to RBCs

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4
Q

What causes anemia?

A

Iron
vitamin b12
folate deficiency
decreased erythropoietin
Cancer

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5
Q

Excess destruction of RBCs

A

Hemolytic

Caused by altered erythropoiesis, or other causes such as hypersplenism, drug induced, or auto immune processes, mechanical heart valves

Also caused by blood loss

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6
Q

Defect in production in RBCs

A

Hypoproliferative

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7
Q

Anemias

A

Lower than normal hemoglobin and fewer than normal circulating erythrocytes: sign of underlying disorder

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8
Q

Chewing or eating things with no nutritional value

A

Pica

ex chewing or craving ice

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9
Q

Pagophobia

A

Associated with iron deficiency anemia

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10
Q

Manifestations of Anemia

A

Depend on the rapid development of the anemia, metabolic requirements of the patient, concurrent problems, and concomitant features

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11
Q

Fatigue
Weakness, Malaise
Pallor, Jaundice
Cardiac and Respiratory Problems
Tongue and/ or nail changes
Pica

A

Manifestations of Anemia

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12
Q

Nail changes are known as

A

Koilonychia

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13
Q

Tongue changes are known as

A

Glossitis

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14
Q

Angular Cheilitis

A
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15
Q

Diagnostic Testing for Anemia

A

HgB testing- Carries o2 and Co2 and heps maintain RBC

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16
Q

HgB conists of

A

2 Alpha- globulin chains and 2 beta- globulin chains

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17
Q

Each globulin contains a what that contains what?

A

Heme; iron

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18
Q

What is Fe responsibility?

A

Iron responsible for carrying 02 and CO2

Fe gives RBCs their color

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19
Q

Hct is

A

Volume % of RBC in the blood
Term H and H is for Hemoglobin and Hematocrit

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20
Q

Reticulocyte Count is

A

Immature RBCs

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21
Q

RBC indices are part of

A

CBC

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22
Q

MCV

A

Mean Corpuscular Volume
- avg. RBC volume- size
(Low means RBCs are small and microcytic)

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23
Q

MCH

A

Mean Corpuscular HgB
Avg. mass of HgB per RBC
-Low in hypochromic anemias

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24
Q

MCHC

A

Mean Corpuscular Hgb Concentration

  • Avg. concentration of Hbg inside a RBC

High Levels indicate macrocytic anemia- can be caused by Vit. B12 deficiency

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25
Q

Pernicious Anemia

A

Can’t absorb Vit. B12 effectively

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26
Q

Diagnostics of Anemia

A

Iron Studies- ability to carry O2
Vitamin B12- assist in formation of RBCs- enlarged and ova(macrocytic)
Folate- important for DNA synthesis- low causes macrocytic anemia
Schilling- Test for absorption of vit. b12 in intestines- test for pernicious anemias
Sickle Cell- Genetic most dominant in African Americans
Bone marrow aspiration- needed for aplastic anemia- bone marrow does not produce sufficient amount of RBCs

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27
Q

Iron Deficiency Anemia

A

Transferrin and Soluble Transferrin- Increased

Iron, Transferrin and Transferrin Saturation- Decreased

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28
Q

Anemia of Chronic Disease

A

Decrease in
Iron, Transferrin, transferrin saturation, ferritin soluble

Soluble transferring is normal- increased

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29
Q

Iron Studies used for

A

Transferrin, Ferritin, Iron

30
Q

Folates

A

Assists in production of DNA, cellular replication

31
Q

Schilling Test

A

Determines if absorbing adequate vitamin B12

32
Q

Sickle Cell

A

Misshaped RBCs

33
Q

Bone Marrow Aspiration

A

Diagnose aplastic anemia

34
Q

Medical management

A

Correct and control the cause
Transfusion of PRBCs
Tx to specific anemia
Dietary therapy
Iron or Vitamin supplementation
Transfusions
Immunosuppressive
Other

35
Q

Rightward Shift of ODC

A
36
Q

Leftward shift of ODC

A
37
Q

Assessment of Pt of Anemia

A

Health History and Physical Exam
Lab Data
Presence of symptoms and impact those symptoms on pt’s life, fatigue, weakness, malaise, pain
Nutritional Assessment
Medications
Cardiac and GI assessment
Blood Loss, menses, potential GI loss
Neurologic Assessment - Mentation changes due to lack of O2 carrying capacity

38
Q

Pt with Anemia Nursing Dx

A

Fatigue
Activity Intolerance
Altered Nutrition
Altered Tissue Perfusion
Delayed Surgical Recovery
Impaired comfort
Deficient Knowledge
Risk for injury

39
Q

Road Test Patient

A

While Patient walks or performs an activity - attach pulse oximetry and monitor SpO2

40
Q

Interventions of Pt with Anemia

A

Balance physical activity, exercise, and rest
Maintain adequate nutrition and perfusion
Pt education to promote compliance with medications and nutrition
Monitor VS and pulse oximetry, provide supplemental oxygen
Monitor potential complications

41
Q

Collaborative Problems

A

Heart Failure
Angina
Paresthesia - Tingling pins and needles
Confusion
Injury Related to Falls
Depressed Mood

42
Q

Underproduction of RBCs by the bone marrow

A

Hypo proliferative Anemia

broadly refers to anemia

43
Q

unusually large, structurally abnormal, immature RBCs

A

Megaloblastic Anemia

Megaloblasts

44
Q

Cobalamin

A

Vitamin B12

Nutrient that keeps the body’s nerve and blood cells healthy and helps make DNA

45
Q

Low iron in diet or malabsorption of nutrients

A

Iron deficiency Anemia

46
Q

Anemia in Renal Disease

A

Deficiency in erythropoietin release

47
Q

Aplastic Anemia

A

Deficiency in new RBC production

48
Q

Megaloblastic Anemia

A

Caused by folic acid deficiency

Caused vitamin B12 deficiency

49
Q

Disorder in which RBC are destroyed faster than they can be made

A

Hemolytic Anemia

Destruction of RBCs is called hemolysis

50
Q

Thalassemia

A

Abnormal Hgb
-Mutation to beta- globulin
- Hereditary

51
Q

Glucose 6- phosphate dehydrogenase deficiency

A

Enzyme protects RBCs from cell damage
- Hereditary
- Exacerbated by stress or medications

52
Q

Immune hemolytic Anemia

A

Antibodies attack RBCs

53
Q

Hereditary Hemochromatosis

A

Over absorption of Fe

Damages liver, tissues, and joints

54
Q

Beta Thalassemia

A

Reduces production of hemoglobin
RF: Race and family history

Caused by defect in beta globulin chains

S/S: Pale skin, weakness, fatigue, and iron overload symptoms

Dx; Blood work up

Tx: severe cases involve transfusion therapy, iron chelation and splenectomy

Complications: Anemia, Blood clots, and spleen enlargement

Prognosis- Depends on clinical type and nature of long term Tx

55
Q

Autoimmune Hemolytic Anemia

A

Disorder characterized by antibody production against own blood cells
- Shortening of RBC from months to few days

RF- Systemic lupus, rheumatoid arthritis, Crohns Disease, and Ulcerative Colitis

S/S: Fatigue, Pallor, breathing, dark urine, chills and backache

Dx: By blood investigation

Treated: Steroids, immunosuppression, and blood transfusion

Complications: Autoimmune disorders, weakness and spleen enlargement

Px: Worse in older adults

56
Q

Sickle Cell Anemia Manifestations

A

Sickle Cell Crisis
Acute Chest Trauma
Pulmonary HTN
Assessment and Dx findings
Overall Life Expectancy reduced by 20-30 years
Medical Management

57
Q

Pt with Sickle Cell Anemia Assessment

A

Health Hx and Physical Exam
Pain Assessment
Lab Data - S shaped Hemoglobin, Sickle Shaped RBCS

S/S- Swelling, fever, chronic pain,

Sickle Cell Crisis Assessment
- Determine how long Pt attempted to self manage symptoms

Early and aggressive hydration
Blood Loss: menses, potential GI loss

CV and Neurological Assessment- Hemodynamically stable- ability to oxygenate cells

58
Q

Major Features and Symptoms of Sickle Cell Anemia

A

Fatigue and anemia
Pain Crisis
Dactylitis- swelling and inflammation of the hands/ feets
Arthritis

Bacterial Infections
Sudden pooling of blood in the spleen and liver congestion
Lungs and Heart injury

Aseptic Necrosis and bone infarcts- Death portions of bone

Eye Damage

59
Q

Pt Sickle Cell Anemia Interventions

A

Hydration
Pain Management
Manage Fatigue
Infection Prevention
Promote Coping
Education of Disease
Monitor for Complications

60
Q

Aplastic Crisis

A

Suppression of RBCs due to infection

61
Q

Sickle Cell Tx

A

HOP

h- Hydration and Electrolytes
o- Oxygen and bed rest
p- Pain relief

62
Q

Blood and Blood Products

A

Directed- Family and Friend donated blood
Standard- one pin tof blood that goes any pat
Autologus- donated blood to self for planned surgery

63
Q

Pre Transfusion Assessment

A

Always obtain PT consent
Type and Cross match
Determine Blood type

Pt education

Transfusion Reactions

S+S

64
Q

PRBCs

A

Made from a unit of whole blood by centrifugation and removal of plasma

Leaving the unit with about 60%

Used to treat Anemia or hemorrhage

65
Q

FFP

A

Contains all factors of the soluble coagulation system

Clotting factors

66
Q

Cryoprecipitate

A

Contains all concentrated subset of FFP components including VIII coagulant, vonwillebrand factor, and factorXIII( clotting factors)

67
Q

Platlets are used to treat

A

Thrombocytopenia

68
Q

Group O can donate to

A

Anyone

69
Q

AB is the … recipient

A

Universal recipient

70
Q

Febrile Transfusion Reaction

A

1 degree in temperature change
May have chills and malaise

Tx: Acetaminophen

Most common

71
Q

Hemolytic Reaction

A

Fever, chills, and pain at the site of reaction, nausea and vomiting, shock, dark urine

Tx: Stop transfusion, lots of IV fluids +/- diuretics

Worst Reaction often blood compatibility issue

72
Q
A

ADN002 MED SURG (18 decks)

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