RRC Maintenance - Anemias
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| anemia | any condition altering or reducing the body's ability to transport O2
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| causes of anemia | decrease in number of RBC, reduction in Hgb, reduction in hct, change in shape/appearance of RBC
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| iron-deficiency anemia | lack of Fe leads to decreased amounts of Hgb resulting in decreased O2-carrying capacity of RBC
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| causes of iron-deficiency anemia | chronic blood loss, inadequate dietary intake, parasite infection, impaired absorption
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| 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
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| causes of pernicious anemia | autoimmune, celiac disease, gastrectomy, radiation therapy of gastric tissue, meds
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| causes of folate deficiency anemia | insufficienct folate intake, ETOH abuse resulting in impaired absorption of B vitamins
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| 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
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| causes of hemolytic anemia | may be hereditary, toxins, impaired immune response, mechanical hemolysis
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| 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
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| causes of aplastic anemia | radiation exposure, viruses, antibiotic therapy, myelosuppressive drugs
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| sickle cell disease | affects the ability of O2 to bind to RBC as result of "sickle"-shaped structure of RBC
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| 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
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| 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
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| 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
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| 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
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| major complication of hemophilia | hemarthrosis -> bleeding into the synovial cavity
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| 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
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| s+sx of pernicious anemia and folate anemia | lassitude, pallour, tachycardia, dyspnea, angina, glossitis, anorexia, dyspepsia, diarrhea, constipation, peripheral paresthesia, loss of proprioception
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| s+sx of aplastic anemia | develops gradually -> fatigue, dyspnea, susceptibility to infection, febrile, predisposition to bleeding
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| 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
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| 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
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| s+sx of ITP | mild --> bleeding gums, petechiae, slow persistent oozing of any break in skin/mucous membrane, prolonged bleeding time
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| s+sx of hemophilia | ranges from excessive bleeding from minor cuts to spontaneous internal hemorrhages
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| intervention for Fe-deficient anemia | increase amount of heme and non-heme iron sources in diet
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| Why should someone taking iron supplements be encouraged to increase vitamin C intake as well? | vitamin c increases absorption of iron
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| 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
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| heme iron sources | organ meats, fresh tuna, salmon, egg yolks, dark meat on chicken
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| non-heme rron sources | spinach, dark green leafy veggies, beans
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| Why can't vitamin B12 be given orally? | it is destroyed by gastric chemicals
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| What food should you teach your clients that are high in folate? | organ meats, darky leafy and root veggies, whole grains, salmon, milk
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| What is the treatment for aplastic anemia in those younger than 45 years? | bone marrow transplant
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| Why is O2 given to an individual in sickle cell crisis? | to treat hypoxemia and control sickling
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| 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
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| What do you need to assess for after a phlebotomy? | hypovolemia
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| 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
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| 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
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| interventions for those at risk for bleeding? | use of electric razor and soft-bristle toothbrush to reduce potential for initiating bleeding
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| Why should someone with polycythemia vera increase their fluid intake? | to decrease the viscosity of their blood
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| For individuals at risk for bleeding, what should be assessed? | hetaturia, melena, hematemesis, hemoptosis, bruising, petechiae
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| 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
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