Wk 2 Nursing Care of the Anemic Patient Flashcards

1
Q

What is the difference between activity intolerance and fatigue?

A

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

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2
Q

One of the most common complications associated with anemia?

A

Activity intolerance

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3
Q

What are 3 nursing problems for the anemic patient?

A

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

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4
Q

If the anemia is due to blood loss…

A

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

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5
Q

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

A

Iron
Folate
B12

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6
Q

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

A

epoetin alfa (Epogen)

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7
Q

Iron supplementation is most often given…

A

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

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8
Q

Iron supplement medication

A

ferrous sulfate

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9
Q

Why do we not give EC or ER ferrous sulfate?

A

Because it is absorbed in the duodenum

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10
Q

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

A

Because it is best absorbed in an acidic environment

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11
Q

What is the patient education for taking iron supplements?

A

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

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12
Q

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

A

It will stain their teeth

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13
Q

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

A

It will stain the skin

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14
Q

What are the GI side effects of ferrous sulfate?

A

Heartburn
Constipation
Diarrhea

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15
Q

What is the most common GI side effect of iron?

A

Constipation

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16
Q

A notable side effect of iron supplementation is…

A

Black stool (not melena)

17
Q

What is melena?

A

Dark, sticky stool containing partially digested blood

18
Q

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

A

Fatal anaphylaxis, start out slow!!

19
Q

What routes can b12 be given?

A

IM
SQ
PO
Intranasal

20
Q

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

A

If deficiency is severe or presence of neurological symptoms

21
Q

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

A

1) some IF present

2) megadoses are given

22
Q

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

A

2.4mcg (1-4%)

23
Q

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

A

treated for life

24
Q

Folic acid tablets should be taken…

A

Usually 0900 meds and don’t have adverse side effects

25
Q

What is epoetin?

A

Synthetic erythropoietin

26
Q

Epoetin is often given concurrently with __

A

iron

27
Q

How is epoetin given?

A

IM/SQ three times a week

28
Q

Epoetin has many…

A

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

29
Q

When should epoetin be held and why?

A

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

30
Q

What are foods rich in iron?

A
Liver
Eggs
Dried fruits
Legumes
Potatoes
Dark green leafy vegetables
Whole grain/enriched breads and cereals
31
Q

What vitamin helps iron absorb more efficiently?

A

Vitamin C

32
Q

Vitamin b12 is only found in…

A

Animal products

33
Q

Foods rich in b12

A
Red meats
Enriched grains
Milk and dairy
Fish 
Eggs
34
Q

What foods are good sources of folic acid?

A
Green leafy vegetables
Legumes
Whole grains
Orange juice 
Nuts
35
Q

What should you monitor in a patient with anemia?

A

Labs
VS
Hypoxemia
Neuro status changes

36
Q

What are four nursing interventions for anemia?

A

O2 therapy
Provide rest periods
Keep warm
Blood transfusion

37
Q

Why should you not use heating pads?

A

Risk for parasthesia