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68wm6 p2 Anemia
Anemia
| Question | Answer |
|---|---|
| What is hypovolemic anemia? | Decreased RBC, hemoglobin, and hematocrit due to hemorrhaging |
| Until how long can it take for lab results for hypovolemic anemia to be accurate? | Hours after injury |
| What is the Tx for Hypovolemic anemia? | Same as for Hypovolemic Shock |
| What is Pernicious Anemia? | Autoimmune disorder resulting from the destruction of parietal cells and eventual gastric mucosa atrophy |
| What vitamin is a PT with Pernicious Anemia potentially lacking in, and why? | Parietal cell damage ---> Decreased intrinsic factor production ---> Intrinsic factor not available to combine with Vitamin B12 |
| Vitamin B12 is needed for what? | growth and maturation of all body cells |
| Vitamin B12 deficiency leads to what in RBCs and nerve cells? | *Leaves erythrocyte membranes fragile and easy to rupture *Leads to large, immature RBCs *Progressive demyelination and degeneration of nerves and white matter |
| List 5 S/Sx of pernicious anemia: | *Jaundice *Dyspnea *Hypoxia *Edema of legs *Constipation or diarrhea *Dysphagia *Parasthesia *Smooth and erythematous tongue *Partial or total paralysis due to destruction of the nerve fibers of the spinal cord |
| What test shows malabsorption of B12? | Schillings test |
| What test shows decreased serum levels of B12? | Megablastic anemia profile |
| How is a schillings test performed? | PT is given radioactive B12 PO and a parenteral flushing of nonradioactive B12. Urine is monitored for percentage of radioactive B12 for 24 hrs. Low % in urine indicates deficient intrinsic factor. |
| What is the B12 therapy for pernicious anemia? | *IM injections given daily for 2 weeks *Then Weekly for one month *Then Monthly for the rest of the patient’s life |
| How often is the CBC monitored for a PT with pernicious anemia? | Every 3 - 6 months |
| What is the name for vitamin B12? | Cyanocobalamin |
| What is Aplastic Anemia (Aplasia)? | patients have lower counts of all blood cells due to a failure of the normal process of generation & growth |
| What is Pancytopenia? | Low RBCs, Low WBCs, and Low Platelets |
| In a PT with Aplastic Anemia (Aplasia), what is hematopoietic tissue replaced by? | Fatty tissue |
| Oral leukoplakia manifests in which anemia? | Aplastic Anemia (Aplasia) |
| Skin with lemon-yellow–tinged pallor and a "raw-beef" tongue manifests in which anemia? | Pernicious anemia |
| What will be found in a bone biopsy of an Aplastic Anemia (Aplasia) PT? | *Hypoplastic or aplastic fatty deposits *Decreased cellular elements *Decreased hematopoietic activity |
| Why are blood transfusions avoided when possible in PTs with Aplastic Anemia (Aplasia)? | to prevent iron overloading and the development of antibodies to tissue antigens, and to minimize the risk of rejection for a bone marrow transplant candidate |
| What is medical therapy is used for PTs with Aplastic Anemia (Aplasia) who cannot recieve a bone marrow transplant? | Immunosuppressive therapy: antithymocyte globulin |
| What is used to control the cause of aplastic anemia? | GM-CSF Granulocytic-macrophage colony-stimulating factor |
| What is the most common cause of iron deficiency anemia in adults? | chronic intestinal or uterine bleeding |
| What are the S/Sx of iron deficiency anemia? | *Glossitis *Pagophagia (desire to eat ice, clays, or starches... pica?) *Paresthesias *Pallor *Inflamed mucous membranes |
| What is the medical management of iron deficiency anemia? | *Pallor *Inflamed mucous membranes *Iron rich diet |
| Iron/Ferrous Sulfate should not be taken with what? | Antacids |
| What foods are high in iron? | organ meats, white bean, leafy vegetables, raisins, molasses, dry fruits, and egg yolk |
| What is the most common clinical manifestation of iron deficiency anemia? | Pallor |
| What percentage of black americans has sickle cell trait? | 81% |
| What is Polycythemia Vera (primary polycythemia)? | Excessive bone marrow production (hyperplasia of bone marrow) causing increased circulating erythrocytes, granulocytes and platelets (inc RBCs/Granulocytes/Platelets/basophils) |
| What is secondary polycythemia caused by? | Caused by hypoxia rather than a defect in the evolution of the RBC. Hypoxia stimulates erythropoietein in the kidneys which stimulates erythrocyte production. |
| The venous distention and platelet dysfunction associated with secondary polycythemia causes what? | *Esophageal varices *Epistaxis *GI bleeding *Petechiae *Hepatomegaly and Splenomegaly from organ engorgement |
| In a PT with Polycythemia, repeated phlebotomy is done to maintain a hematocrit of what Percentage? | 45% - 48% |
| What is the purpose of drug therapy in polycythemia? | Decrease bone marrow response |
| What is the major complication of polycythemia vera? | Thrombosis due to the abnormal increased number of circulating RBCs and platelets |
| What is done to prevent thrombosis in a PT with polycythemia? | Encourage ambulation/ROM exercises |
Created by:
Shanejqb
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