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110 Cards in this Set
- Front
- Back
hemoglobin norm is
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12-16g/dl
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hemocrit norm is
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38-47percent
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rbc norm is
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4.2-6
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wbc norm is
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5,000 to 10,0000
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neutrophils make up what percent of the differential.
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40-70
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basophils make up what percent of the diff
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1 percent
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lymphocytes make up what percent of the diff
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20-40
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monocytes make up what percent of the diff
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4-8
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esoninophils make up what percent of the diff
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2-4
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platelents counts are
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150k-400k
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shift to the left in diff means
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infarction, infection, stress, bacteria
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shift to the right in diff means
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virus, anemia
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hi neutrophil and hi bands mean/
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shift to left
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hi lymph and hi mono mean
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shift to right
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what does the MCV determine?
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size of RBC
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macro rbc's are seen with what anemias
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periucous, and folic acid anemias
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micro- no iron are seen with what anemia
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sickle cell.
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MCH measures what>?
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weight" amt of hemoglobin
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what is the best place to do a marrow aspiration
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illiac crest.
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what to monitor pt for after a marrow aspiration
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soreness and tenderness.. there is no bleeding
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what is the shillings test used for?
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measures the absorption of vit-b12. (pernicious anemia)
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if tablet shows up in urine when doing a shillings test, what does this indicate?
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does not have pernicious anemaia because they are able to absorb it.
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pernicious anemia is the absence of what/
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vit-b12
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what are some foods with vit-b12
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organ meats, liver, muscle meats. eggs
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what leads to the pheripheal neuropathy found with pernicious anemia
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decreased myelin, decreased potential of cells
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sources of iron are
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green leafy veggies, potatoes, liver, eggs, raisins approcots
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sources of folic acid are
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green veggies, fish whole grain
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sources of vit-b6 are
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meat potatoes
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sources of amino acids are
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eggs nuts.
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sources of vitamin c are
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strawberries, green leafty veggies
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folic acid helps with?
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red blood cell maturation
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iron does what for the body
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synthesis of hemoglobin
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amino acids do what?
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synthesis of nuclear protein
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vit c helps with what kind of absorbtion
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iron
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iron aborbtion is increased with what vitamine
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C
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an immobilized pt wihh receive what medication and what dose?
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heprin. 5000u/12hr
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reverse heprin with what?
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protamine sulfate
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when reversing heprin give how much protamine sulfate?
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1ml/100u hep
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serrum ferritin test shows what 0-12
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iron deficiency, anemia, measures stored iron.
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what is a reticulocyte
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immature rbc. 1% of all rbc
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increased number in reticulocytes means what?
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anemia
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large amount of protein in urin is what?
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bence jones protein
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multiple myeloma is cancer of what?
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plasma cell
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what exposure to chemicals can cause hematological cancers
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benzine
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jaundice is prevelant in sicke cell anemia how do you assess for it
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conjuntiva. sclera.
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vit c deficit can lead to what problem with the lips
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cheilitis, dry cracking inflamation
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iron deficit can cause a smooth tongue texture also called
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glottis
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bone pain in leukemia is do to
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the rapid production of abnormal cells
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with accute blood loss when is it evident through cbc's
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12hrs
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when doing a bone marrow aspiration how to you postiion the pt.
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on the side.
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what is the benefit of packed rbc's
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1/2 the volume when fluid overload is an issue.
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what gauge needle is used for blood transfusions
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18-16-14
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blood transfusions must be complete in
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2-3hrs
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when blood is on the floor, must start administration within how long
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30mins
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what volume loss is it mostly noticable that the pt is in trouble
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30
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with a 40% volume loss you see what
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bp below normal at rest, rapid pulse, cold clammy skin
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with a 30% volume loss you see what?
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tachycardia
postural hypotension |
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with a 50% volume loss you see
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shock and potential death
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type 0 blood has what antigen
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none
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type a has what antigens
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A
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when giving blood check vitas pulse resp and temp how often?
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every 5 minutes for 15 minutes.
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what to give if pt has fluid v overload while giving blood
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lasix
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when giving blood start out at what rate.
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1ml/ min for 15 minutes.
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how is febril non hemolitic reaction caused
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sensitive to wbc, platelets or plasma antigen.
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signs of febril non hemolitic reaction are
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chills, fever of 101 within one hr of giving, HA, N&V
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what to do if you suspect febril nonhemolitic reaction
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stop blood, keep ns going, give tylenol, monitor vs, call dr
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how is allergic urticaria reaction caused
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allergic to what donor took before donation. chocolate, penicillin, pollen.
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signs of allergic urticaria are
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skin rash, hives
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what to do if you suspect allergic urticaria
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stop blood, keep vein open with ns,notify blood bank or dr. give antihistamine and/or corticosteroid turn blood back on and monitor.
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signs of delayed hemolytic reaction include
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extreme fatigue 6 weeks to 6 months, gradual decline in cbc.persistent low grade fever.
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nursing interventions for someone with delayed hemolytic reaction are.
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give ferrous sulfate,
improve nutrition |
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ferous sulfate can result in what
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constipation and dark stools.
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nutrition for a person with delayed hemolytic reaction is
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eggs, spinach , oj, increase iron and vit c
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how long does it take ferous sulfate to restore cbc's to norm
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6 months
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anaphylactic blood reaction happens most often in individuals with
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multiple transfusions
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what to ask apt with multiple transfusions
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how did you handle it?
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signs of anaphylactic blood reaction
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flushing, bronchospasms, chest pain, loss of airway
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what to do if you suspect an anaphylactic reaction
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stop blood, keep ns running, Code, cpr, maintain airway, give epinephrine
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what to do if the person had an anaphylactic reaction to a prior infusion
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ask blood bank for blood from donor lacking IgA, use filter, frozen washed cells.
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what is the causes for an acute hemolytic reaction
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ABO compatibility problem, or improper storage of blood.
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signs of acute hemolytic reaction
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flank pain,
decreased bp, N&V,anxiety, restlessness. |
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most fatal reaction from a blood infusion is
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acute hemolytic reaction
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what to do do if you suspect acute hemolytic reaction
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stop blood, keep vein open, change tubes, hang D5W, give o2, give epinephrine and nitro, insert foley, monitor I and O. may need clotting factors infused. notify lab immediatley..
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what drugs do you administer when you suspect an acute hemolytic reaction
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epinephrine and vasopressors.
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circulatory overload is due to
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fluid being administered faster than the circulation can accommodate.
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monitor what with circulatory overload
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breath sounds., distended neck veins, rales, Ha, dyspnea
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nursing interventions for a pt with circulatory overload.
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place in high fowlers with feed dependent, give diuretic,give o2, may need phlebotomy.
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if you suspect sepsis while giving blood you should do what?
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stope blood, give tylenol, dc tubing, lines, bags, send to blood bank to culture. give antibiotic, vassopres, corticosteriods.
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corticosteroids given with allergic urticaria and with sepsis include
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prednisone, decadron, solu-medrol.
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neutrophils life span is
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12 hrs
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anemia is characterized by an imbalance of how many mls or more per day.
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3ml
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iron deficiencey anemia usually occurs in who
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children or elderly
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with iron dificency anemia, rebs are
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microcytic
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what med is given with an iron def anemia.
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ferrous sulfate,
dextran |
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goods to encourage with iron deficiency anemia are
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red meats, eggs, green leafy vegs, carrots, oj, raisins
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NI's with iron deficiency anemia are
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increase fiber-rt ferrous sal
give before meals, |
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dextram im must be given how
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IM, Z-track, air lock.5ml
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with iv iron, watch for this
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anaphlactic reactions
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megablastic anemias include
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pernicious anemia and folic acid anemia
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pernicious anemia results because there is a lack in
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intrinsic factor
B-12 |
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pernicious anemia is evident by what test
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shillings test.
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peripheral neuropathy ret decreased production of myelin is evident with what anemia
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perniciouis anemia.
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what med is given with pernicious anemia.
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cyanocobalamine IM. 100-200mcg/month
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how to give cyanocobalamine
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100-200mcg/month to replenish then 1 injection each day for a week.
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with folic acid deficiency give what med
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folite PO.
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folic acid deficiency is promonent in who
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alcoholics
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hemolytic anemias are
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an inadequate number of circulating red blood cells (anemia) caused by premature destruction of red blood cells.
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one type of hemolytic anemia is
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sickle cell anemia.
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excellerated erythropoiesis is found in
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sickle cell anemia
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treatment for sicke cell is
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hydration, avoid stress, pain med. give folic acid, genetic counceling
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