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Stack #38910

RRC Maintenance - Anemias

anemia any condition altering or reducing the body's ability to transport O2
causes of anemia decrease in number of RBC, reduction in Hgb, reduction in hct, change in shape/appearance of RBC
iron-deficiency anemia lack of Fe leads to decreased amounts of Hgb resulting in decreased O2-carrying capacity of RBC
causes of iron-deficiency anemia chronic blood loss, inadequate dietary intake, parasite infection, impaired absorption
pernicious anemia lack of intrinsic factor in parietal cells of stomach which results in an inadequate absorption of vit B12...there is a decrease of HCl secretion which is necessary for the secretion of the intrinsic factor
causes of pernicious anemia autoimmune, celiac disease, gastrectomy, radiation therapy of gastric tissue, meds
causes of folate deficiency anemia insufficienct folate intake, ETOH abuse resulting in impaired absorption of B vitamins
hemolytic anemia characterized by RBC destruction where the body compensates significantly for RBC destruction by increasing marrow production, but when demand outstrips supply, the result is hemolytic anemia
causes of hemolytic anemia may be hereditary, toxins, impaired immune response, mechanical hemolysis
aplastic anemia secondary to decreased or absent hemotopoiesis in bone marrow as a result of injury or death to hemocytoblasts...affects production of RBC, WBC and platelets
causes of aplastic anemia radiation exposure, viruses, antibiotic therapy, myelosuppressive drugs
sickle cell disease affects the ability of O2 to bind to RBC as result of "sickle"-shaped structure of RBC
sickle cell crisis triggered by low O2 tesion which causes RBC to become rigid and elongated with crescent shape...unable to pass into capillary and cause vascular occlusion and local hypoxia...this further exacerbated condition
polycythemia vera production and presence of increased numbers of RBC...increase can be so great that blood circulation is impaired as result of hyperviscosity and hypervolemia
idiopathic thrombocytopenia autoimmune disease where platelet are coated with antibodies. Platelets function normally, however are destroyed in spleen as they are recognized as foreign and are destroyed by macrophages
hemophilia hereditary clotting disorder (x-linked) that results in a breach in the clotting cascade resulting in the inability to form a stable fibrin clot at site of injury
major complication of hemophilia hemarthrosis -> bleeding into the synovial cavity
s+sx of iron deficiency anemia apathy, irritability, lack of concentration, dyspnea, headaches, tachycardia, pallour, pica, splenomegaly, lassitude, weakness, greenish skin discoloration, c/o being cold, thin friable nails
s+sx of pernicious anemia and folate anemia lassitude, pallour, tachycardia, dyspnea, angina, glossitis, anorexia, dyspepsia, diarrhea, constipation, peripheral paresthesia, loss of proprioception
s+sx of aplastic anemia develops gradually -> fatigue, dyspnea, susceptibility to infection, febrile, predisposition to bleeding
s+sx of sickle cell disease pallour, lassitude, weakness, jaundice r/t RBC hemolysis, cholecystitis, increases in erythropoiesis creates an enlarged marrow space (ie: frontal skull bone), systemic organ damage, pain r/t tissue ischemia
s+sx of polycythemia vera pounding headaches, tinnitis, vertigo, vision difficulties, intermittent claudication, angina, thrombophlebitis, generalized phlebitis r/t increased # of basophils, hepato/splenomegaly, peptic ulcer pain, plethora, hyperurecemia
s+sx of ITP mild --> bleeding gums, petechiae, slow persistent oozing of any break in skin/mucous membrane, prolonged bleeding time
s+sx of hemophilia ranges from excessive bleeding from minor cuts to spontaneous internal hemorrhages
intervention for Fe-deficient anemia increase amount of heme and non-heme iron sources in diet
Why should someone taking iron supplements be encouraged to increase vitamin C intake as well? vitamin c increases absorption of iron
teaching about iron supplements give with food to decrease GI upset, caution about change in stool color, don't take Ca++ at same time as Fe as it decreases absorption (don't take tums to relieve GI upset due to Ca++ content), teaching about constipation (increase fluids, fiber, exercis
heme iron sources organ meats, fresh tuna, salmon, egg yolks, dark meat on chicken
non-heme rron sources spinach, dark green leafy veggies, beans
Why can't vitamin B12 be given orally? it is destroyed by gastric chemicals
What food should you teach your clients that are high in folate? organ meats, darky leafy and root veggies, whole grains, salmon, milk
What is the treatment for aplastic anemia in those younger than 45 years? bone marrow transplant
Why is O2 given to an individual in sickle cell crisis? to treat hypoxemia and control sickling
What is a phlebotomy? What type anemia is it used to treat? used to drain the vasculature of excess volume --> use in treating polycythemia vera
What do you need to assess for after a phlebotomy? hypovolemia
What can the nurse to do to promote activity tolerance in those with anemia? plan care to alternate periods of rest and activity adn limiting visitors, phone calls, noise and interruption from hospital staff
What can the nurse do to promote adequate nutrition in those with anemia? teach about dietary requirements, suggest eating small frequent meals throughout the day, encourage client to become involved by establishing optimal weight outcomes and a dietary plan
interventions for those at risk for bleeding? use of electric razor and soft-bristle toothbrush to reduce potential for initiating bleeding
Why should someone with polycythemia vera increase their fluid intake? to decrease the viscosity of their blood
For individuals at risk for bleeding, what should be assessed? hetaturia, melena, hematemesis, hemoptosis, bruising, petechiae
What should an individual with hemophilia do in the situation where s/he starts to bleed? application of cold compresses, gentle direct pressure and elevation/rest of affected part....seek medical attention promptly
Created by: bella83