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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
Pernicious Anemia
Can't absorb Vit. B12 effectively
26
Diagnostics of Anemia
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
27
Iron Deficiency Anemia
Transferrin and Soluble Transferrin- Increased Iron, Transferrin and Transferrin Saturation- Decreased
28
Anemia of Chronic Disease
Decrease in Iron, Transferrin, transferrin saturation, ferritin soluble Soluble transferring is normal- increased
29
Iron Studies used for
Transferrin, Ferritin, Iron
30
Folates
Assists in production of DNA, cellular replication
31
Schilling Test
Determines if absorbing adequate vitamin B12
32
Sickle Cell
Misshaped RBCs
33
Bone Marrow Aspiration
Diagnose aplastic anemia
34
Medical management
Correct and control the cause Transfusion of PRBCs Tx to specific anemia Dietary therapy Iron or Vitamin supplementation Transfusions Immunosuppressive Other
35
Rightward Shift of ODC
36
Leftward shift of ODC
37
Assessment of Pt of Anemia
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
Pt with Anemia Nursing Dx
Fatigue Activity Intolerance Altered Nutrition Altered Tissue Perfusion Delayed Surgical Recovery Impaired comfort Deficient Knowledge Risk for injury
39
Road Test Patient
While Patient walks or performs an activity - attach pulse oximetry and monitor SpO2
40
Interventions of Pt with Anemia
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
Collaborative Problems
Heart Failure Angina Paresthesia - Tingling pins and needles Confusion Injury Related to Falls Depressed Mood
42
Underproduction of RBCs by the bone marrow
Hypo proliferative Anemia broadly refers to anemia
43
unusually large, structurally abnormal, immature RBCs
Megaloblastic Anemia Megaloblasts
44
Cobalamin
Vitamin B12 Nutrient that keeps the body's nerve and blood cells healthy and helps make DNA
45
Low iron in diet or malabsorption of nutrients
Iron deficiency Anemia
46
Anemia in Renal Disease
Deficiency in erythropoietin release
47
Aplastic Anemia
Deficiency in new RBC production
48
Megaloblastic Anemia
Caused by folic acid deficiency Caused vitamin B12 deficiency
49
Disorder in which RBC are destroyed faster than they can be made
Hemolytic Anemia Destruction of RBCs is called hemolysis
50
Thalassemia
Abnormal Hgb -Mutation to beta- globulin - Hereditary
51
Glucose 6- phosphate dehydrogenase deficiency
Enzyme protects RBCs from cell damage - Hereditary - Exacerbated by stress or medications
52
Immune hemolytic Anemia
Antibodies attack RBCs
53
Hereditary Hemochromatosis
Over absorption of Fe Damages liver, tissues, and joints
54
Beta Thalassemia
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
Autoimmune Hemolytic Anemia
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
Sickle Cell Anemia Manifestations
Sickle Cell Crisis Acute Chest Trauma Pulmonary HTN Assessment and Dx findings Overall Life Expectancy reduced by 20-30 years Medical Management
57
Pt with Sickle Cell Anemia Assessment
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
Major Features and Symptoms of Sickle Cell Anemia
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
Pt Sickle Cell Anemia Interventions
Hydration Pain Management Manage Fatigue Infection Prevention Promote Coping Education of Disease Monitor for Complications
60
Aplastic Crisis
Suppression of RBCs due to infection
61
Sickle Cell Tx
HOP h- Hydration and Electrolytes o- Oxygen and bed rest p- Pain relief
62
Blood and Blood Products
Directed- Family and Friend donated blood Standard- one pin tof blood that goes any pat Autologus- donated blood to self for planned surgery
63
Pre Transfusion Assessment
Always obtain PT consent Type and Cross match Determine Blood type Pt education Transfusion Reactions S+S
64
PRBCs
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
FFP
Contains all factors of the soluble coagulation system Clotting factors
66
Cryoprecipitate
Contains all concentrated subset of FFP components including VIII coagulant, vonwillebrand factor, and factorXIII( clotting factors)
67
Platlets are used to treat
Thrombocytopenia
68
Group O can donate to
Anyone
69
AB is the ... recipient
Universal recipient
70
Febrile Transfusion Reaction
1 degree in temperature change May have chills and malaise Tx: Acetaminophen Most common
71
Hemolytic Reaction
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

ADN002 MED SURG (18 decks)

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