Wk 2 Nursing Care of the Anemic Patient

Question 1

What is the difference between activity intolerance and fatigue?

Answer 1

Fatigue means you are tired, even when you are lying in bed

Question 2

One of the most common complications associated with anemia?

Answer 2

Activity intolerance

Question 3

What are 3 nursing problems for the anemic patient?

Answer 3

Activity intolerance/fatigue
Altered nutrition/malabsorption
Risk for infection, bleeding, and fatigue

Question 4

If the anemia is due to blood loss…

Answer 4

Find and treat the source of bleeding, such as hemoccult or scoping

Question 5

What vitamins and minerals might you give a patient with anemia?

Answer 5

Iron
Folate
B12

Question 6

What medication might you give an anemic patient who has kidney failure?

Answer 6

epoetin alfa (Epogen)

Question 7

Iron supplementation is most often given…

Answer 7

PO TID/QID (newer evidence says that once a day is acceptable)

Question 8

Iron supplement medication

Answer 8

ferrous sulfate

Question 9

Why do we not give EC or ER ferrous sulfate?

Answer 9

Because it is absorbed in the duodenum

Question 10

Why do we tell patients to take their iron supplements one hour before meals (if possible)?

Answer 10

Because it is best absorbed in an acidic environment

Question 11

What is the patient education for taking iron supplements?

Answer 11

Take with food at first and then try taking it without and see if you can tolerate it

Question 12

Why should a patient use a straw when drinking liquid iron?

Answer 12

It will stain their teeth

Question 13

Why should you use z track method for IM injections of iron?

Answer 13

It will stain the skin

Question 14

What are the GI side effects of ferrous sulfate?

Answer 14

Heartburn
Constipation
Diarrhea

Question 15

What is the most common GI side effect of iron?

Answer 15

Constipation

Question 16

A notable side effect of iron supplementation is…

Answer 16

Black stool (not melena)

Question 17

What is melena?

Answer 17

Dark, sticky stool containing partially digested blood

Question 18

A patient receiving IV dextran (iron supplementation) is at risk for what?

Answer 18

Fatal anaphylaxis, start out slow!!

Question 19

What routes can b12 be given?

Answer 19

IM
SQ
PO
Intranasal

Question 20

When is the IM route preferred for a patient with b12 deficiency?

Answer 20

If deficiency is severe or presence of neurological symptoms

Question 21

b12: Evidence shows that oral and IM routes have similar effects if…

Answer 21

1) some IF present

2) megadoses are given

Question 22

If a megadose of cobalamin is given (1000mcg), about how much will be absorbed?

Answer 22

2.4mcg (1-4%)

Question 23

A patient with b12 deficiency, especially pernicious anemia must be…

Answer 23

treated for life

Question 24

Folic acid tablets should be taken…

Answer 24

Usually 0900 meds and don’t have adverse side effects

Question 25

What is epoetin?

Answer 25

Synthetic erythropoietin

Question 26

Epoetin is often given concurrently with __

Answer 26

iron

Question 27

How is epoetin given?

Answer 27

IM/SQ three times a week

Question 28

Epoetin has many...

Answer 28

adverse effects and black box warnings, provider should weigh advantages with disadvantages

Question 29

When should epoetin be held and why?

Answer 29

If hgb greater than 10 because of increased risk for cardiovascular problems

Question 30

What are foods rich in iron?

Answer 30

``` Liver Eggs Dried fruits Legumes Potatoes Dark green leafy vegetables Whole grain/enriched breads and cereals ```

Question 31

What vitamin helps iron absorb more efficiently?

Answer 31

Vitamin C

Question 32

Vitamin b12 is only found in...

Answer 32

Animal products

Question 33

Foods rich in b12

Answer 33

``` Red meats Enriched grains Milk and dairy Fish Eggs ```

Question 34

What foods are good sources of folic acid?

Answer 34

``` Green leafy vegetables Legumes Whole grains Orange juice Nuts ```

Question 35

What should you monitor in a patient with anemia?

Answer 35

Labs VS Hypoxemia Neuro status changes

Question 36

What are four nursing interventions for anemia?

Answer 36

O2 therapy Provide rest periods Keep warm Blood transfusion

Question 37

Why should you not use heating pads?

Answer 37

Risk for parasthesia