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TT2 Anemia
TT2 NHCC Anemia
| Question | Answer |
|---|---|
| What is the definition of anemia? | Anemia is a deficiency in the # of RBC’s, the quantity of HGB, and/or the volume of packed RBC (hematocrit). |
| What are the two ways that anemia is classified? | Size = Cytic and Color=Chromic |
| What are the 3 causes of anemia? | 1. Associated with blood loss (acute or chronic) 2. Decreased RBC production, 3. RBC destruction |
| Who is at risk for iron deficency anemia? | · ♀ reproductive years / poor diets / very young / · Mom’s run out, 7-9 mos start making own, Mon at risk = infant at risk too |
| What are causes of iron deficency anemia? | slow, chronic blood loss that isn’t being replaced· ↓ intake – inadequate diet· ↓Absorption · ↓ Chronic loss – stool, menstruation, PG· ↓ serum Fe & ↑ TIBC – look at stores too |
| What is the most common cause of anemia? | Iron deficency - 30% of the population |
| How much iron is lost daily through feces, sweat, and urine | 1 mg Fe lost daily |
| What is the major cause of iron deficency for adults? | blood loss |
| What are the 2 main source of chronic blood loss? | GI and GU |
| What are the causes of blood loss in the GI tract? | – Peptic ulcers, gastritis, esophagitis, diverticula, hemorrhoids, neoplasia |
| How much blood loss in the stools does it take to turn the stool black? | 50-75 mL |
| What is the main cause of blood loss in the GU? | menstrual bleeding, avg 45 mL |
| What does the Reticuloendothelial System (RES) do? | Metabolizes Hgb at the end of RBC lifecycle into bilirubin, Spleen, Produces RBCs during fetal development, Removes old and defective erythrocytes, "Captures" iron from Hgb catabolism,Stores about 1/3 of platelet supply |
| What is the morphologic classification of Iron Deficency Anemia? | Microcytic, Hypochromic (small, pale not Hgb rich) |
| What are the lab values seen in Iron Deficency Anemia? | LOW serum Fe·, ↑ TIBC (as body tries to compensate Look at the stores as well |
| What is the treatment for Iron Deficency Anemia? | Determine and correct cause, Iron supplements, Diet counseling, Balance of O2 supply and demand |
| What is the most common cause of Folic Acid Deficency? | dietary inadequacy |
| What happens during Folic Acid Deficency? | dietary inadequacy causes defective RBC production. Similar to B-12 except for NO neural changes |
| What is the morphologic classification of Folic Acid Deficency? | · Macrocytic and normochromic |
| What is the treatment for Folic Acid Deficency? | Folic or folinic acid, PO or IM |
| What is Pernicious Anemia? | Deficiency of Vitamin B-12, it is a form of cobalamin deficiency – causes neural changes |
| What type of anemia causes neural changes? | Pernicious Anemia |
| What is the morphologic classification of Pernicious Anemia? | · Macrocytic and normochromic |
| What is the treatment for Pernicious Anemia? | Monthly vit B-12 injections & sub lingual, Usually for the rest of life |
| Causes of chronic blood losses? | ulcers, menses, cancer |
| What is the threat of blood loss? | shock and tissue diffusion |
| How much blood can adults lose without serious effects? | 500 cc |
| What are the symptoms of blood loss associated with? | Hypovolmia and hypoxemia |
| What are the two types of blood loss? | Acute and Chronic |
| What are the clinical manifestations of mild to moderate blood loss? | Weakness, fatigue, Changes in vital signs, Postural hypotension, Thirst |
| What are the clinical manifestations of severe blood loss? | Changes in vital signs, Decreased cardiac output, Clammy skin |
| What are 3 Medical Interventions for blood loss? | Identify source of bleeding, Transfusion therapy, Iron supplements |
| What are 3 Nursing Interventions for blood loss? | Monitor vital signs, Schedule activities to promote rest, Safety precautions |
| What is the MOST serious form of anemia? | Hemolytic Anemia |
| What is hemolytic anemia caused by? | auto-immune, the body is attacking itself caused by, Chemical agents, medications, Infections, Systemic diseases |
| What are the Physiologic Changes associated with anemia? | The severity and presence of changes depends on the type of anemia, ↓ O2 carrying capacity, Change in viscosity, Ventricular hypertrophy and CHF |
| What causes Ventricular hypertrophy and CHF in anemia? | low Hg over a long period of time and the heart gets bigger pumping harder all the time. Hg all saturated, just not enough RBC |
| Can a decreased O2 carrying capacity have the Hgb saturated? | Yes, can have Hgb saturated but low Hgb volume. |
| What effect does Change in blood viscosity have on the heart? | heart works harder |
| What can an Increase in Cardiac Output cause? | Tachycardia especially w/ blood loss, Palpitations – ventricular irregular beats response to decreased hgb. Can lead to cardiac irritation, irregularity. |
| What does Accelerated erythropoietin cause? | Sternal tenderness and Bone tenderness – long bones (RBC’s made in long bones & marrow) |
| What are the signs and symptoms of Tissue Hypoxia? | Angina, Night cramps, Fatigue, Weakness, Dyspnea, Increased respiratory rate |
| What are the signs and symptoms of Lack of Hemoglobin? | Pallor |
| What causes fatigue and weakness with anemia? | okay when resting but at work ther is not enough oxygen |
| What is pallor? | lack of color - caused by the redistribution of blood to the vital organs |
| Where is pallor seen? | Seen in mucous membranes, gums, and conjunctiva. Sometimes it happens so gradually that you don’t notice until the person becomes symptomatic |
| What are the symptoms of an increaase in cardiac output in anemia? | Tachycardia, Palpitations, Heart failure (severe anemia), Orthostatic hypertension |
| What level of hgb is considered mild anemia? | 10-14 |
| What are the manifestations of mild anemia? | If symptoms develop, it’s because pt has underlying disease or experiencing a compensatory response to heavy exercise – Symptoms include palpitations, dyspnea, and diaphoresis. |
| What level of hgb is considered moderate anemia? | 6-10 |
| What are the manifestations of moderate anemia? | Cardiopulmonary symptoms are increased and may experience at both rest / activity |
| What level of hgb is considered severe anemia? | less than 6 |
| What are the manifestations of severe anemia? | displays many clinical manifestations involving many body systems |
| What diagnostic tests should be done when anemia is suspected? | CBC, Hgb, Hct, RBC indices (MCV, MCH, MCHC), Total Fe, Total iron binding capacity (TIBC), Folate/Vitamin B12, Bilirubin, Reticulocyte count, Sedimentation rate |
| What skin changes should be assessed for? | Petechiae, ecchymosis, Pallor or Ruddy complexion,Jaundice, Change in skin texture |
| Besides diagnositc tests, what should be assessed for anemia? | Risk factors, Medications, Complete physical, Nutrition status – Vit C, Proteins, Skin, Head and Neck - Visual disturbances, Oral mucosa, Chest Tenderness, Abdomen - Liver and spleen, Back and Extremities for Pain, Lymph Nodes for Swelling, Mental status, |
| What is the most important intervention? | Teaching |
| What are three Medical and Nursing Management interventions for anemia? | Alleviate and control cause of anemia, relieve symptoms, prevent complications - cardiac megaly, birth defects, etc |
| What food should be avoided when treating anemia? | eggs, corn, beans, cereal products containing phytates |
| What are good dietary sources of iron? | § Organ meats, dark green vegetables, dried fruits, fish, veal, orange juice |
| What are some of the manifestations of chronic iron defiency? | Pallor most common, glossitis (inflam of tongue) 2nd, cheilitis (inflam of lips |
| What are the GI manifestations of Cobalamin Deficiency aka Pernicious Anemia? | sore tongue, anorexia, nausea, vomiting, and abdominal pain |
| What are the neuromuscular manifestations of Cobalamin Deficiency aka Pernicious Anemia? | weakness, paresthesias f the feet and hands, reduced vibratory and position senses, ataxia, muscle weakness, and imparted thought processes ranging from confusion to dementia. |
| What are the GI manifestations of Folic Acid Deficency? | smooth beefy red tongue |
| With blood loss are clinical sx and symptoms or lab values a better indicator of anemia? | Clinical signs and symptoms |
| What are sx and symptoms of internal hemorrhage? | pain – tissue distention, organ displacement, nerve compression |
| Why is jaundice likely in hemolytic anemia? | because the increased destruction of RBC causes an elevation bilirubin levels |
| Why would the spleen and liver enlarge with hemolytic anemia? | due to hyper activity |
| What type of anemia causes increased erythrocyte destruction? | hemolytic |
| What type of anemia causes decreased erythrocyte production? | Iron deficency, pernicious anemia,. folic acid deficency, |
Created by:
2007Nurse
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