Week 7: Anemia Flashcards
What is hematopoiesis?
What is heme?
Formation of new blood cells is one of the primary function of the bones
Red blood cells (RBCs): Erythropoiesis
White blood cells (WBCs): Platelets
Heme: red pigment, contains iron
Erythropoiesis-Stimulating Agents
(ESAs)
Epoetin alfa
What is it?
Why do patients receive it?
Most patients on it also need what?
Not indicated for who?
Used to stimulate production of RBCs
Biosynthetic form of the natural hormone erythropoietin
Most patients receiving epoetin alfa need to also receive an oral or intravenous (IV) iron preparation
UNCONTROLLED HYPERTENSION
HEMOGLOBIN LEVELS ABOVE 10 g/dL for cancer patients
Iron
Stored where?
Iron deficiency results in?
Essential mineral in the body
Oxygen carrier in hemoglobin and myoglobin
Stored in the liver, spleen, and bone marrow
Iron deficiency results in anemia
Iron: Adverse Effects
GI effects?
Most important GI effect?
Liquid oral preparations may do what?
N/V/D,
Constipation
Stomach cramps
Pain
BLACK TARRY STOOLS!!!!
Liquid oral preparations may stain teeth
Iron Toxicity/Overdose antidote?
Antidote is deferoxamine
PO Iron
Ferrous Sulfate
Most frequently used oral iron
Contains largest amount of iron per gram of salt consumed
Ferrous salts are contraindicated in clients with GI disorders and liver disease.
Parenteral Iron
Iron dextran (IM)
May cause what?
May cause anaphylactic reactions!!!
A test dose of 25 mg is administered before injection of the full dose, and then the remainder of dose is given after 1 hour
Parenteral Iron
Ferric gluconate (IV)
Indicated for who?
Risk?
Adverse effects???
Infuse over????
Indicated for anemic clients with chronic renal failure
Less risk for precipitating anaphylaxis than with iron dextran
***Adverse effects: hypotension (r/t infusion rates)
***Infuse over 2.5 to 3.5 hours
Folic Acid
Should not be given until?
Given during what and why?
What can cause folic acid deficiency?
Should not be used until actual cause of anemia is determined
***Given during pregnancy to promote normal fetal development
oral contraceptives, corticosteroids, and sulfonamides can cause folic acid deficiency
Cyanocobalamin (Vitamin B12)
Used to treat what?
How is it administered?
Used to treat pernicious anemia and other megaloblastic anemias
Administered orally or intranasally to treat vitamin B12 deficiency
Usually administered by deep IM injection
Nursing Considerations
PO-Liquids
How to take liquid iron?
Take through straw to avoid staining teeth
Take liquid iron preps w/ ascorbic acid (OJ) to increase absorption
Do not mix w milk or antacid products
Sit up for 15 to 30 minutes after
It will turn stool a tarry, black color; it’s expected
Nursing Considerations, Cont.
PO-pills
Administer folic acid with what?
Education for clients?
Administer oral folic acid with food
Educate clients to Keep away from children because oral forms may look like candy*!!!!!!!!
Nursing Considerations, Cont.
Parenteral and IM
Folic acid may be given how?
Iron dextran?
How to give medication IM?
Folic acid may also be given IV and added to TPN solutions
Keep epipen near
Iron dextran: a small test dose should be given
IM: administer deeply into vastus lateralis using the Z-track method
