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71 Cards in this Set
- Front
- Back
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Cracks in the corners of a persons mouth are _________. This is commonly seen in B12 deficiency.
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angular cheilosis
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When nails become concave and ridged from being anemic, it is called _________.
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Kollonychia
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Cardiac and respiratory symptoms from being anemic include what?
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Angina, dyspnea, claudication, palpitations and dizziness, fatigue, systolic murmurs and bruits. In extreme cases MI, CHF, ascites, and peripheral edema. Cardiac output and heart rate are increased like when a person runs.
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Normal Hemoglobin in women is _______ - __________ g/dl.
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12-16 g/dl
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Normal hemoglobin in men is ___-___ g/ dl.
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13-18 g/dl
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Anemia's are considered severe if hemoglobin is less than __ which could be manifested by tachycardia, tachypnea or dyspnea.
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6
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________ or a deficiency in the concentration of dissolved oxygen in arterial blood, is a potential complication of anemia.
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hypoxemia
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The vast majority of symptoms from anemias are due to tissue ________, or abnormally low oxygen availability to the body or an organ.
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Hypoxia
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Anemia's can be caused by a decrease in _________ which is a precursor to RBC production that is made in the kidneys (90%) or the liver (10%).
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Erythropoietin
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These three types of anemias cause decreased hemoglobin synthesis.
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Iron deficiency anemia
Thalassemia Sideroblastic anemia |
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A blood loss of __-__ml per day will yield Iron deficiency anemia.
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2-4
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Iron deficiency anemia is a _______ __________ anemia.
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Microcytic Hypochromic (Small cells with reduced hemoglobin.
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People who live in __________ regions often have Thalassemia anemia.
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Mediterranean
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__________ is a hereditary anemia. It is an autosomal recessive genetic disorder that causes a decrease in erythrocyte (RBC) production due to a basic problem in globulin protein.
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Thalassemia
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There are two types of Thalassemia. In Thalassemia ______, there is one thalassemia gene and one normal gene causing no real symptoms. In Thalassemia ______, or ______ Anemia, there are two Thalassemia genes and symptoms are present.
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Minor
Major, Cooley's Anemia |
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__________ Anemia (Thalassemia ______) is life threatening. The symptoms appear in childhood causing physical and mental retardation with bone marrow hyperplasia (Expansion of bone marrow space).
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Cooley's
Major |
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To treat Thalassemia major, or Cooley's Anemia, blood transfusions with IV __________ are necessary. ________ is a chelating agent that binds with iron to prevent overload due to multiple transfusions.
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deferoxamine (Desferal)
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Megaloblastic (large cell) anemias are defective in DNA synthesis in RBC. They are due to deficiencies in __________ or ___________ or drug induced suppression of DNA synthesis.
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Cobalamin (B12)
Folic Acid |
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_______ _______ is a protein secreted by parietal cells of the gastric mucosa that helps the body absorb vitamin B12 . A lack of it leads to a condition that is called ________ anemia.
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Intrinsic factor
Pernicious |
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A lack of vitamin B12 or cobalamin deficiency is called
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Pernicious anemia
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An _____ environment is necessary for the absorption of Intrinsic factor in the GI tract. GI surgery, or long term use of H2 histamine receptor blockers or Proton Pump inhibitors can change this environment leading to a lack of b12 (Pernicous Anemia).
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Acidic
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A disease characterized by the malabsorption of cobalamin (B12) is called _______ disease.
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Crohn's
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Neuromuscular manifestations such as parasthesias, ataxia(lack of coordinated muscle movement), decreased vibratory and position senses, and impaired thought processes are unique to a deficiency in ________ (_________ anemia).
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Cobalamin
Pernicious |
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Irregular shape
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Pokilocytosis
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Irregular size
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Anisocytosis
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The recommended dose of oral iron is ____-____mg/day. It is best absorbed as _______ sulfate in an acidic environment.
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150-200
ferrous |
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Iron therapy must be continued for __-__ months after hemoglobin returns to normal.
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2-3
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Diagnositic studies used for cobalamin deficiency reveal large (macrocytic) abnormally shaped (poikilocytoisis) with a decrease in serum cobalamin levels. The other test used is called the ______ test, which involves giving radioactive cobalamin and seeing how much is secreted in urine.
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Schilling test
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To treat a cobalamin deficiency, give ____ mg of B12 daily for two weeks then every month for the remainder of life. Dietary intake does not correct the anemia.
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1000mg
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When testing for Cobalamin deficiency you must check the ______ status by checking _______ and _______ sense and ______and _______.
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Neurological
position and vibratory gait and stability. |
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Dietary intake of folate for normal RNA and DNA synthesis is __-___ micrograms/day.
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50-200
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Lack of folate leads premature ____ _____. Low serum folate leads to neural tube defects in a fetus and _____ cancer in adults
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cell death
colon |
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Folic acid deficiency can be caused by:
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Inadequate dietary intake
Alcohol abuse and anorexia drugs such as oral contraceptives, metrotrexate, and dilantin. |
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Normal serum folate is __-__mg/ml
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1.8-9
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To treat folic acid deficiency anemia, give __-__mg per day.
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1-5
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Anemias of chronic disease often reveal _____ levels of serum ferritin, _____ levels of iron stores, and ______ levels of folate and cobalamin
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increased
increased normal |
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To treat anemias of chronic disease, it is usually best to treat the underlying cause. Erythropoietin therapy is also used such as _______ or______.
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Epogen
Procrit |
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______ anemia is caused by damage to the bone marrow or stem cells.
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Aplastic
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Aplastic anemia occurs from the destruction of Bone marrow. This leads to decreased RBCs, WBCs, and platelets which is called _______.
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Pancytopenia
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Symptoms of aplastic anemia are caused by ______ _______ suppression and include fatigue, pallor, and dyspnea, chronic infections such as throat infection, cervical lymphanopathy, and splenomegaly._______ can also be caused due to platelets being destroyed.
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Bone marrow
Purpura (bruising) |
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Laboratory studies to confirm aplastic anemia should reveal _______ or decreased RBCs, WBCs (including ________, and platelets (__________).
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Pancytopenia
neutropenia thrombocytopenia |
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If untreated, aplastic anemia is fatal and usually occurs from ______ or _______. Aplastic anemia is treated by _______ therapy including corticosteroids and cyclosporin in order to prevent lymphocytes from destroying stem cells. Also with bone marrow transplant and peripheral blood stem cell transplant.
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Infection or hemorrhage
immunosuppressive |
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Anemias from acute blood loss are the result of sudden ________ including trauma, complication of surgery, and disruption of vascular integrity.
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hemorrhage
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Rapid blood loss leads to ________ _________. If blood is lossed gradually, the body will maintain blood volume by increasing ______, however, there will be a derease in O2 due to a decreased availability of RBC.
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hypovolemic
plasma |
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During acute blood loss, what are the clinical manifestations that are the body's attempt to maintain an adequate blood volume and O2?
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Tachycardia, postural hypotension, decreased blood pressure, rapid thready pulse, cold clammy skin, shock, and death.
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Laboratory data do not reflect acute blood loss for __-__ days. However, you monitor ___, _____, & _____.
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2-3
RBC, Hemoglobin, and Hematocrit |
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During acute blood loss, what should be done?
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1. Stop blood loss
2. Replace blood to prevent shock 3. Give Dextran, albumin, ringer's lactate to increase volume (this will not increase RBCs). |
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Chronic blood loss from ulcers, hemorrhoids, or menstrual or postmenopausal blood loss leads to a decrease in _____ stores.
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Iron
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To manage chronic blood loss, what three things should be done?
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1. Identify the source
2. Stop bleeding 3. supplement with iron |
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Destruction or hemolysis of RBCs at a rate that exceeds production is called _______ anemia
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hemolytic
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Hemolytic anemia manifests as ______ from destroyed RBCs causing an increase in billirubin, and enlarged ______ and _______ from hyperactivity of macrophages performing phagocytosis on the defective RBCs.
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jaundice
spleen liver |
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_______ _______ disease is a group of inherited, autosomal recessive disorders characterized by the presence o fan abnormal form of hemoglobin in the erythrocyte (Hemoglobin S- HbS).
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Sickle Cell disease
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If a person has 1 abnormal sickle cell trait, there are ____ manifestations. If two abnormal sickle cell traits are present, it is determined a person has ______ cell disease and the manifestations are severe.
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mild
sickle |
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Normal hemoglobin is 98-99 % HbA, in sickle cell disease 40% of hemoglobin are hemoglobin __, which is an abnormality of the beta chains, very sensitive to hypoxia.
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S
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In sickle cell disease, _______ causes cells to sickle and clump together which blocks blood flow in vessels. This can lead to _______.
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hypoxia
infarctions |
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Typically, patients with sickle cell disease are _______, however, during sickling episodes they have what symptoms?
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asymptomatic
pain, swelling, fever, pallor of mucus membranes, fatigue |
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When blood does not get through to organs due to sickling many organs can be affected. What are they?
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Brain-stroke
Eye-blindness lung- pulmonary embolism kidney-renal failure liver- hepatomegaly heart- MI or CHF skin- static ulcers |
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People with sickle cell disease usuall die by middle age due to ______ and ______ failure. They are prone to infections, the most common being _______.
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renal
pulmonary pneumonia |
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To diagnose sickle cell disease, a peripheral blood smear reveals a _______ cell, a ______ test is done, and electrophoresis of hemoglobin reveals a large percentage of Hemoglobin __. DNA testing, skeletal x-rays and MRIs are also done.
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sickled
sickling S |
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While there is no real treatment for Sickle Cell disease, to manage it you should do what?
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Administer O2 for hypoxia and to control sickling.
Give morphine or hydromorphone for pain. Give lots of fluids |
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As a nurse you should teach patients with sickle cell disease to avoid ___________________________________________________.
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Avoid high altitude areas , maintain fluid intake, treat infections, and pain control.
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______ transfusions are done if a patient is in sickle cell crisis. ________ transplants can cure some patients.
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blood
bone marrow |
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_______ (_______) is an antisickling agent that is effective in decreasing the permanent formation of sickled cells.
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Hydroxyurea (Hydrea)
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When helping a patient in sickle cell crisis, give ____, _____, _______. Also, remove _____ clothing and keep extremeties _________. Elevate the head of the bed and do NOT raise the knee gatch. Keep the room temp above ___ degrees. Avoid taking blood pressure with an _______ cuff and check ciruculation with pulse oximeter every ______
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oxygen, pain meds, hydration
restrictive extended 72 external hour |
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An excessive amount of RBCs in the blood is called _____________.
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Polycythemia
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Polycythemia is characterized by a hematocrit higher than ____%.
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55%
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________ and __________ are the result of polycythemia.
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hypervisicosity (increased viscosity)
Hypervolmeia |
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__________ Polycythemia is a proliferative diseas of the pluipotent stem cell in the BONE MARROW. It is also called Polycythemia _____.
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Primary
Vera |
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________ Polycythemia (or just Polycythemia) is the result of HYPOXIA which causes an increase in erythropoeitin
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Secondary
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Complications of Polycythemia Vera include increased risk of _______ leading to CVA (Stroke), MI, or bleeding (nose bleeds, ulcers, hematuria.
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thrombosis
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Patients with polycythemia Vera often complain of pain in their big toe due to uric acid being elevated causing _____.
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Gout
(Also causes kidney stones.) |
