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RNSG 1341
Chapter 29 & 33 Hematologic Disorders
| Question | Answer |
|---|---|
| Albumin | Important for osmotic pressure and edema prevention |
| Polycythemia | High red blood cells |
| Leukocytosis | Higher than normal WBCs (Greater than 10,000) |
| Leukopenia | Lower than normal WBCs (Lower than 5,000) |
| RBC production | Tissue hypoxia cause Kidneys to release erythropoietin (Epogen) which Stimulates bone marrow to Produce more RBCs |
| S&S of anemia | Nail clubbing Syncope, dizziness Orthostatic hypotension |
| Types of anemia | Blood loss Nutritional Hemolytic Aplastic (bone marrow suppression) |
| Blood loss anemia | - Circulating blood volume decreases - Cardiac output falls - Heart/resp rate increase, peripheral veins constrict fluid shifts - Circulatory failure and shock |
| S&S of blood loss anemia | - Rapid pulse/breathing - Pale, cool, clammy skin - Low BP - Decreased LOC - Oliguria (decreased urine output) |
| S&S of Iron deficiency anemia | -Brittle, spoon-shaped nails - Cheilosis (Crack at corner of mouth) - Glossitis ( Smooth, irritated tongue) - Pica (craving non-food items i.e. clay or starch) |
| What increases the absorption of iron | Orange juice |
| Sources of iron | - Beef, chicken, pork, turkey - Egg yolks - Clams, oysters - Green leafy vegetables - Beans - Fortified cereal |
| Pernicious anemia | failure to absorb vitamin B12 due to a lack of intrinsic factors, which are secreted by the gastric mucosa |
| S&S of B12 anemia | - Pallor/jaundice - Weakness - Paresthesias (numbness/tingling) in extremities - Proprioception problems (sense of one's position in space) |
| S&S of pernicious anemia | - Glossitis - Diarrhea - Plus B12 anemia S&S |
| B12 for pernicious anemia must be administered | IM and must be given for life |
| Sources of B12 | - Meats - Shrimp, oysters - Eggs - Milk - Cheese |
| S&S of Folic Acid Deficiency | - Pallor - Weakness - Fatigue - Palpitations - Shortness of Breath (SOB) |
| CNS symptoms (numbness/tingling and altered proprioception) occur in which type of anemia? | B12 anemia |
| Sources of folic acid | - Green leafy vegetables - Fruits - Cereals - Meats - Kidney beans - Broccoli - Milk |
| Causes of folic acid deficiency | - Inadequate intake (undernourishment) - Increased metabolic requirements - Malabsorption |
| How are B12 deficiency and folic acid deficiency anemia so differentiated? | CNS affects occur in B12 deficiency anemia, |
| Hemolytic Anemia | - Premature destruction (lysis) of RBCs - Increased reticulocytes (immature RBCs) in circulating blood |
| Intrinsic (within RBC) hemolytic anemia causes | - Cell membrane/structure defect - Hemoglobin structure defect |
| Extrinsic (acquired) (outside RBC) hemolytic anemia causes | - Mechanical trauma to the RBC - Autoimmune disorders - Bacteria and other infections - Drugs, toxins, chemical agents, venoms |
| S&S of Hemolytic Anemia | - Generally mild or moderate - Jaundice - if breakdown of heme units exceed liver ability - Bone marrow expands/bones deform or fracture |
| Treatment for Hemolytic Anemia | - Steroids - Suppresses immune system - Blood transfusions - Plasmapheresis (Separation of blood components to extract plasma) - Splenectomy |
| Aplastic Anemia | - Bone marrow fails to produce blood cells - Number of stem cells in the marrow reduced - Leads to pancytopenia (deficiency of all cellular components of blood) - Cause of aplastic anemia is often unknown |
| S&S of Aplastic Anemia | - Fatigue - Pallor - Tachycardia. - Infections - Progressive Weakness. - Exertional dyspnea - Excessive bleeding |
| Aplastic | Onset is usually insidious (Occur in short period of time) |
| How is Aplastic Anemia diagnosed? | Bone Marrow aspiration |
| Damaged bone marrow presents as | Fat |
| Treatments of Alplastic Anemia (medications) | - Immunosuppressants - Erythropoietin - Antibiotics |
| Treatments of Alplastic Anemia | - Blood transfusion - Splenectomy (if spleen is destroying RBCs) - Stem cell transplantation |
| Serum ferritin tests detect | Iron storage protein |
| Hemoglobin electrophoresis detects | Hemolytic anemia |
| Schilling test detects | Vitamin B12 absorption |
| Bone marrow examination detects | Aplastic anemia |
| Polycythemia | Excess of RBCs (hyper viscous with hematocrit > 55% |
| Three types of polycythemia | - Primary - Secondary - Relative |
| Primary polycythemia | |
| Secondary polycythemia | Overproduction of RBCs due to increased erythropoietin levels |
| Relative polycythemia | Caused by fluid deficit (not RBCs) |
Created by:
pdimple
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