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Stack #38910
RRC Maintenance - Anemias
| question | answer |
|---|---|
| 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
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