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72 Cards in this Set
- Front
- Back
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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.
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Anemia
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This is when marrow cannot produce sufficient #'s of RBC's therefore a low reticulocyte count.
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Hypoproliferative Anemia
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This is when there is a premature destruction of RBC's?
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Hemolytic Anemia
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This is a chronic or acute loss of RBC's?
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Bleeding
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Pallor, fatigue, weak, tachy, SOB, DOE, bone & joint pain, fever, pruritis, hemorrhagic tendencies, oral lesions
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Signs & symptoms of anemia
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Dyspnea on exertion indicates a ? blood level
Dyspnea at rest? Heart Failure? |
<7.5g/dl
3g <2-2.5g |
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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 |
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Common complications of anemia include? 4 things
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heart failure, angina, paresthesia, confusion
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Anemia in the elderly is considered as a general part of GI pathological disorders because?
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they are less able to compensate for increased CO2 due to increased vetilations.
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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)
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Hypoproliferative Anemia
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This anemia is due to a lack of intake or faulty absorption of?
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Iron deficiency anemia.
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This causes ulcers, gastritis, GI tumors, malignancy, inadequate in diet
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Iron deficiency anemia
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A BUN > than ? is indicative of kidney disease.
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>10
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Hct is ?% and the hct looks normal on a smear & the decreased erythropoietin shortens the life of the RBC's.
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anemia in kidney disease
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In dialysis, which essential element is passed into the dialysate?
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Folic Acid
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People with kidney disease related anemia are given supplements of? 3 things
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Iron, Folic Acid, Epoetin Alpha
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Chronic inflammatory diseases cause anemia that is mild & nonprogressive with a hct > ___ or a Hgb > ___?
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> 25% hct or > 9g; is very seldom ever below this
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Examples of chronic diseases that can cause anemia?
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RA, lung abscess, osteomylitis, cancer, TB
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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.
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Anemia
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This is when marrow cannot produce sufficient #'s of RBC's therefore a low reticulocyte count.
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Hypoproliferative Anemia
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This is when there is a premature destruction of RBC's?
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Hemolytic Anemia
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This is a chronic or acute loss of RBC's?
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Bleeding
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Pallor, fatigue, weak, tachy, SOB, DOE, bone & joint pain, fever, pruritis, hemorrhagic tendencies, oral lesions
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Signs & symptoms of anemia
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Dyspnea on exertion indicates a ? blood level
Dyspnea at rest? Heart Failure? |
<7.5g/dl
3g <2-2.5g |
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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 |
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Common complications of anemia include? 4 things
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heart failure, angina, paresthesia, confusion
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Anemia in the elderly is considered as a general part of GI pathological disorders because?
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they are less able to compensate for increased CO2 due to increased vetilations.
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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)
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Hypoproliferative Anemia
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This anemia is due to a lack of intake or faulty absorption of?
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Iron deficiency anemia.
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This causes ulcers, gastritis, GI tumors, malignancy, inadequate in diet
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Iron deficiency anemia
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A BUN > than ? is indicative of kidney disease.
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>10
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Hct is ?% and the hct looks normal on a smear & the decreased erythropoietin shortens the life of the RBC's.
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anemia in kidney disease
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In dialysis, which essential element is passed into the dialysate?
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Folic Acid
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The lab value measuring the iron "stores" are? If depleted causes the Hgb to ? and then causes the RBC's to?
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Low Serum Ferritin Levels
Decrease Decrease in # & get smaller-hypochromic |
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In iron deficiency anemia, the serum iron levels are low BUT as the TIBC levels are elevated. The TIBC measures?
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as they need it= also called transferrin
TIBC is 230-410 |
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The 2 MOST RELIABLE lab test evaluating iron deficiency anemia are the?
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Ferritin and hemoglobin
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These clinical findings are indicative of? smooth sore tongue, pica, brittle rigid nails, and cheliosis.
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Iron deficiency anemia.
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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?
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Epoetin alpha
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Medical treatment for anemia of chronic diseases include?
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Elim cause, ~stool for occult blood, oral or parenteral iron supplements
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What are the most commonly reported problems with solid oral supplements of iron?
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nausea, abdominal pain, constipation
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Solid oral iron supplements are usually made of?
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Ferrous sulfate or FeSO4
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Helpful tips nurse can give for solid oral iron supp?
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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
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Info needed by patient if taking liquid iron?
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may stain teeth & rinse mouth. Can use straw or put in back of mouth from spoon; frequent oral hygiene
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When giving iron IM, what is recommended?
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Z-track method, deep into large muscle. Skin test prior to test for allergy.
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What is one side effect of iron supp that is particularly alarming if not informed prior?
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black stool
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Sources of iron rich foods?
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red meat, organ meat, beans, green leafy veg, well balanced is best
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Cells are large and odd shaped with some multi-nucleated.
Hyperpalsia of marrow & > precursor cells, pancytopenia in advanced cases |
Megaloblastic anemia
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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 |
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Decreased cellular production in marrow; pancytopenia;(3types)congenital, acquired, idiopathic
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Aplastic anemia
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Aplastic anemia can be caused by:(other than meds/chemicals)
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infections, pregnancy, radiation
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Chemicals related to causes of aplastic anemia?
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Benzene, arsenic, insecticides, chemotherapy
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Medications related to causes of aplastic anemia?
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chloroamphenical, antidiabetics, antiseizure, antibiotics
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In diagnosing aplastic anemia, using a bone marrow aspiration or biopsy the specific findings would be?
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< stem cells, pancytopenia, RBC's are normachromic and normocytic, and < WBC's and platelets
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The s/s's of aplastic anemia include all except:gradual o/s, weakness, pallor, vomiting, DOE, abnormal bleeding/bruising, sore throat, fever
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vomiting
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Select all that are tx options for apl/anem? stem cell txpl, bone marr txpl, immunosupp ther, cyclosporine & antithymocyte glob (atg), oral tyrosene kinase
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all except oral tyrosene kinase- this is used for acute myelenogenous leukemia tx (CML)
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If you were admin ATG for aplastic anemia, would you give it central line for 7-10d or periph IV for 10-12d
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central line for 7-10
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Supportive Ther for apl/anem includes RBC & platelet transfx. Why must you take extra caution and carefully monitor?
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Some people have developed antibodies to RBC's.
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What other support measures are necessary for apl/anem?
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remove cause, monitor for infection, hypoxia, bleeding. Oral hygiene, no IM's, avoid strain w/BM, min energy expenditure
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Increased destruction of RBC's defines?
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Hemolytic anemia
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Hemolytic anemia caused by sphere shaped RBC's is called?
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Hereditary spherocytosis
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Inherited hem/anem caused by conditions of abnormal hgb include 2?
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sickle cell, thalassemia
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Presents with > bilirubin, > reticulocyte ct, spleenomegaly, low sat & hypoxic- points to?
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hemolytic anemia
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Low circulating o2 = hypoxia = > erythropoietin = premature RBC's from bone marrow & when prolonged 80% heme coverts to bilirubin- describes which process?
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shortened life of RBC's due to hemolytic anemia
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Manifestations of spleenomegaly, elev reticulocytes & bilirubin, and decreased haptoglobin
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Hemolytic anemia
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Anemia caused by Folic Acid def is most often seen in ? who seldom eat raw fruits/veggies
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Elderly
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Alcoholics & malabsorption from small bowel have higher rate of ? def.
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Folic acid
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Sore tongue, megaloblastic anemia, weakness, confusion, paresthesia, spontaneous remissions, untreated=chf&death
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folic acid def s/s
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Labs reveal > concentration of RBC's in bone marrow and in peripheral blood, leukocytosis & thrombocytosis (rbc's >6;hgb >18)- is indicative of?
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Polycythemia Vera b/c it causes hyper-proliferation of blood cells from marrow.
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Presents with ruddy skin, enlarged spleen & liver, h/a, claudications, thrombophlebitis, bleeding, pruritis- you would suspect?
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Polycythemia Vera
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Treatment for polycythemia vera includes all except, allopurinal for > uric acid, antihistamines, phlebotomy, radioactive phos, liver enzymes, busulfan,or chemo?
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All are correct except for liver enzymes b/c it occurs in bone marrow.
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GI bleeding, menorrhea, epistaxis (nosebleeds), trauma, bleeding disorders (platelets, clotting factors)are all a medium for the loss of ? duh
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Red blood cells
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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
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Electrolytes specifically are not tested for dx but may be tested for addnl health status info
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