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72 Cards in this Set

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This is a symptom of an underlying disorder; Hgb conc < normal- reflecting <in # of RBC's circulating; therefore the tissues don't get enough 02.
Anemia
This is when marrow cannot produce sufficient #'s of RBC's therefore a low reticulocyte count.
Hypoproliferative Anemia
This is when there is a premature destruction of RBC's?
Hemolytic Anemia
This is a chronic or acute loss of RBC's?
Bleeding
Pallor, fatigue, weak, tachy, SOB, DOE, bone & joint pain, fever, pruritis, hemorrhagic tendencies, oral lesions
Signs & symptoms of anemia
Dyspnea on exertion indicates a ? blood level
Dyspnea at rest?
Heart Failure?
<7.5g/dl
3g
<2-2.5g
The quicker the Hgb decreases the more severe the symptoms.
A 30% rapid loss can cause?
How much of a gradual or rapid loss can occur before symptoms become evident?
Vascular collapse

50% GRADUAL loss
Common complications of anemia include? 4 things
heart failure, angina, paresthesia, confusion
Anemia in the elderly is considered as a general part of GI pathological disorders because?
they are less able to compensate for increased CO2 due to increased vetilations.
This occurs as a result of deficiencies of elements: iron, folic acid & B12,- ,erythropoietin produced due to kidney dysfx, cancer or inflammation, and aplastic (marrow damage/<stem cells)
Hypoproliferative Anemia
This anemia is due to a lack of intake or faulty absorption of?
Iron deficiency anemia.
This causes ulcers, gastritis, GI tumors, malignancy, inadequate in diet
Iron deficiency anemia
A BUN > than ? is indicative of kidney disease.
>10
Hct is ?% and the hct looks normal on a smear & the decreased erythropoietin shortens the life of the RBC's.
anemia in kidney disease
In dialysis, which essential element is passed into the dialysate?
Folic Acid
People with kidney disease related anemia are given supplements of? 3 things
Iron, Folic Acid, Epoetin Alpha
Chronic inflammatory diseases cause anemia that is mild & nonprogressive with a hct > ___ or a Hgb > ___?
> 25% hct or > 9g; is very seldom ever below this
Examples of chronic diseases that can cause anemia?
RA, lung abscess, osteomylitis, cancer, TB
This is a symptom of an underlying disorder; Hgb conc < normal- reflecting <in # of RBC's circulating; therefore the tissues don't get enough 02.
Anemia
This is when marrow cannot produce sufficient #'s of RBC's therefore a low reticulocyte count.
Hypoproliferative Anemia
This is when there is a premature destruction of RBC's?
Hemolytic Anemia
This is a chronic or acute loss of RBC's?
Bleeding
Pallor, fatigue, weak, tachy, SOB, DOE, bone & joint pain, fever, pruritis, hemorrhagic tendencies, oral lesions
Signs & symptoms of anemia
Dyspnea on exertion indicates a ? blood level
Dyspnea at rest?
Heart Failure?
<7.5g/dl
3g
<2-2.5g
The quicker the Hgb decreases the more severe the symptoms.
A 30% rapid loss can cause?
How much of a gradual or rapid loss can occur before symptoms become evident?
Vascular collapse

50% GRADUAL loss
Common complications of anemia include? 4 things
heart failure, angina, paresthesia, confusion
Anemia in the elderly is considered as a general part of GI pathological disorders because?
they are less able to compensate for increased CO2 due to increased vetilations.
This occurs as a result of deficiencies of elements: iron, folic acid & B12,- ,erythropoietin produced due to kidney dysfx, cancer or inflammation, and aplastic (marrow damage/<stem cells)
Hypoproliferative Anemia
This anemia is due to a lack of intake or faulty absorption of?
Iron deficiency anemia.
This causes ulcers, gastritis, GI tumors, malignancy, inadequate in diet
Iron deficiency anemia
A BUN > than ? is indicative of kidney disease.
>10
Hct is ?% and the hct looks normal on a smear & the decreased erythropoietin shortens the life of the RBC's.
anemia in kidney disease
In dialysis, which essential element is passed into the dialysate?
Folic Acid
The lab value measuring the iron "stores" are? If depleted causes the Hgb to ? and then causes the RBC's to?
Low Serum Ferritin Levels
Decrease
Decrease in # & get smaller-hypochromic
In iron deficiency anemia, the serum iron levels are low BUT as the TIBC levels are elevated. The TIBC measures?
as they need it= also called transferrin
TIBC is 230-410
The 2 MOST RELIABLE lab test evaluating iron deficiency anemia are the?
Ferritin and hemoglobin
These clinical findings are indicative of? smooth sore tongue, pica, brittle rigid nails, and cheliosis.
Iron deficiency anemia.
With HIV infected, anemia is very common due to treatment with the antiretroviral medication Zidovudine (AZT)that depresses the bone marrow- what drug should be given for the anemia?
Epoetin alpha
Medical treatment for anemia of chronic diseases include?
Elim cause, ~stool for occult blood, oral or parenteral iron supplements
What are the most commonly reported problems with solid oral supplements of iron?
nausea, abdominal pain, constipation
Solid oral iron supplements are usually made of?
Ferrous sulfate or FeSO4
Helpful tips nurse can give for solid oral iron supp?
one hr before or 2 hrs after meals b/c absorption is <, > dose gradually (if rx) and take with vit C (citrus, strawberries, tomatoes, broccoli) b/c > absorption, high fiber -NO dairy- prevents absorption
Info needed by patient if taking liquid iron?
may stain teeth & rinse mouth. Can use straw or put in back of mouth from spoon; frequent oral hygiene
When giving iron IM, what is recommended?
Z-track method, deep into large muscle. Skin test prior to test for allergy.
What is one side effect of iron supp that is particularly alarming if not informed prior?
black stool
Sources of iron rich foods?
red meat, organ meat, beans, green leafy veg, well balanced is best
Cells are large and odd shaped with some multi-nucleated.
Hyperpalsia of marrow & > precursor cells, pancytopenia in advanced cases
Megaloblastic anemia
Megaloblastic anemia can be caused by a deficiency of?
Hgb is usually?
and platelets < ?
vitamin B12 or folic acid
hgb 4-5g/dl
platelets <50,000
Decreased cellular production in marrow; pancytopenia;(3types)congenital, acquired, idiopathic
Aplastic anemia
Aplastic anemia can be caused by:(other than meds/chemicals)
infections, pregnancy, radiation
Chemicals related to causes of aplastic anemia?
Benzene, arsenic, insecticides, chemotherapy
Medications related to causes of aplastic anemia?
chloroamphenical, antidiabetics, antiseizure, antibiotics
In diagnosing aplastic anemia, using a bone marrow aspiration or biopsy the specific findings would be?
< stem cells, pancytopenia, RBC's are normachromic and normocytic, and < WBC's and platelets
The s/s's of aplastic anemia include all except:gradual o/s, weakness, pallor, vomiting, DOE, abnormal bleeding/bruising, sore throat, fever
vomiting
Select all that are tx options for apl/anem? stem cell txpl, bone marr txpl, immunosupp ther, cyclosporine & antithymocyte glob (atg), oral tyrosene kinase
all except oral tyrosene kinase- this is used for acute myelenogenous leukemia tx (CML)
If you were admin ATG for aplastic anemia, would you give it central line for 7-10d or periph IV for 10-12d
central line for 7-10
Supportive Ther for apl/anem includes RBC & platelet transfx. Why must you take extra caution and carefully monitor?
Some people have developed antibodies to RBC's.
What other support measures are necessary for apl/anem?
remove cause, monitor for infection, hypoxia, bleeding. Oral hygiene, no IM's, avoid strain w/BM, min energy expenditure
Increased destruction of RBC's defines?
Hemolytic anemia
Hemolytic anemia caused by sphere shaped RBC's is called?
Hereditary spherocytosis
Inherited hem/anem caused by conditions of abnormal hgb include 2?
sickle cell, thalassemia
Presents with > bilirubin, > reticulocyte ct, spleenomegaly, low sat & hypoxic- points to?
hemolytic anemia
Low circulating o2 = hypoxia = > erythropoietin = premature RBC's from bone marrow & when prolonged 80% heme coverts to bilirubin- describes which process?
shortened life of RBC's due to hemolytic anemia
Manifestations of spleenomegaly, elev reticulocytes & bilirubin, and decreased haptoglobin
Hemolytic anemia
Anemia caused by Folic Acid def is most often seen in ? who seldom eat raw fruits/veggies
Elderly
Alcoholics & malabsorption from small bowel have higher rate of ? def.
Folic acid
Sore tongue, megaloblastic anemia, weakness, confusion, paresthesia, spontaneous remissions, untreated=chf&death
folic acid def s/s
Labs reveal > concentration of RBC's in bone marrow and in peripheral blood, leukocytosis & thrombocytosis (rbc's >6;hgb >18)- is indicative of?
Polycythemia Vera b/c it causes hyper-proliferation of blood cells from marrow.
Presents with ruddy skin, enlarged spleen & liver, h/a, claudications, thrombophlebitis, bleeding, pruritis- you would suspect?
Polycythemia Vera
Treatment for polycythemia vera includes all except, allopurinal for > uric acid, antihistamines, phlebotomy, radioactive phos, liver enzymes, busulfan,or chemo?
All are correct except for liver enzymes b/c it occurs in bone marrow.
GI bleeding, menorrhea, epistaxis (nosebleeds), trauma, bleeding disorders (platelets, clotting factors)are all a medium for the loss of ? duh
Red blood cells
All EXCEPT ? are dx tests for anemias? Hgb, hct, red cell indices, wbc w/diff, serum iron, tibc, folate, b12, platelets, electrolytes, bleeding times, pt, ptt, bone marrow aspirate or biopsy and bilirubin
Electrolytes specifically are not tested for dx but may be tested for addnl health status info