1
Q
What are the 3 categories of decreased RBC production anemia?
A
- decreased hemoglobin synthesis: iron deficiency, thalassemia, sideroblastic anemia
- defective DNA synthesis: cobalamin (B12) deficiency, folic acid deficiency
- decreased number of RBC precursors: aplastic, myeolproliferative diseases, chronic diseases, medications/chemo, radiation
2
Q
What are the 2 categories of hemolytic anemias (increased RBC destruction)?
A
- hereditary (intrinsic)
- acquired (extrinsic)
3
Q
What are the blood loss anemias?
A
- acute: trauma, blood vessel rupture, splenic sequestration crisis
- chronic: gastritis, menstrual flow, hemorrhoids
4
Q
What are the integumentary manifestations of anemia?
A
- pallor: decreased hemoglobin and blood flow to the skin
- jaundice: increased concentration of serum bilirubin
- pruritus: increased serum and skin bile salt concentrations
5
Q
What are the cardiopulmonary manifestations of anemia?
A
-cardiac output is maintained by increasing HR and stroke volume, and respiratory rate
6
Q
What are some nursing interventions for patients with fatigue?
A
- alternate rest and activity
- prioritize activities
- provide assistance
- evaluate nutrition
7
Q
Explain iron deficiency anemia?
A
-decreased hemoglobin synthesis
8
Q
- decrease in hemoglobin synthesis
- very common
- young, poor diet, pregnant very susceptible
- malabsorption (diseases, surgery)
- blood loss: ulcer, diverticulitis, menstrual
- hemolysis
- manifestations: pallor, glossitis, cheilitis (inflamed lips),
- diagnostics: labs, stool blood, endoscopy, colonoscopy
- treat underlying disease
- replace iron: food, supplement, transfusion of packed RBCs
- Drug: oral iron-ferrous sulfate, take with juice, if liquid inject through a straw, iron dextran given IM or IV
A
Iron deficiency anemia
9
Q
Who is at risk for iron deficiency anemia?
A
premenopausal pregnant low SES older adults blood loss
10
Q
What foods are rich in iron?
A
soybeans oatmeal raisins eggs shell fish grain bread red meat chicken/turkey green leafy veggies
11
Q
What do we need to educate pt’s about when they are taking an iron supplement?
A
- dark green to black stools
- dont take with daily
- foods high in vitamin C promote absorption
- takes 4-6 weeks for Hgb and Hct to return to expected range
12
Q
- disease involving poor production of Hgb
- decreased erythrocyte production
- hemolysis occurs
- autosomal recessive
A
thalassemia
13
Q
- frequently asymptomatic
- moderate anemia: microcytosis and hypochromia (small and pale cells)
- body adapts and no tx needed
A
thalassemia minor
14
Q
- life threatening
- physical and mental growth is retarded
- pale and jaundiced
- splenomegaly, hepatomegaly, cardiomyopathy
- symptoms develop in childhood
- hepatitis C due to increased blood transfusions
- no drug or diet is effective
- Tx: blood transfusions with chelating agents, splenectomy
A
thalassemia major
