Nur103 test 2.txt

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golfdiva
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144186
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Nur103 test 2.txt
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2012-03-31 14:29:27
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anemia
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char. of some types of anemia
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  1. What is the definition of anemia?
    Abnormally low number of circulating RBC’s, hemoglobin concentration or both – resulting in a lack of O2 to the cells,
  2. What are the usual causes of anemia?
    • inadequate production of RBC
    • increased destruction of RBC
    • poor nutrition
    • medication
    • blood loss
    • Insufficient or defective Hgb
  3. What is the pathophysiology of anemia?
    • Altered DNA synthesis
    • Bone marrow failure
    • Increased RBC loss or destruction
  4. What are some general sx of anemia?
    • Pale skin
    • conjunctivea
    • nail beds
    • lack of red blood cells
    • poor circulation
    • Angina, fatigue
    • DOE, (short of breath on excertion)
    • night cramps
    • bone pain
    • Cerebral hypoxia
    • Heart failure
    • Signs of circulatory shock
  5. What are some signs of Cerebral hypoxia?
    • headache,
    • dizziness,
    • dim vision,
  6. What are some signs of circulatory shock?
    • rapid blood loss
    • low bp,
    • tacy,
    • dec LOC
    • decreased UO (urine output)
  7. Why is bone pain associated with anemia?
    bone marrow working harder to put out rbc so bone pain and joint pain
  8. Name the 2 categories of anemia.
    • 1. blood loss anemia
    • 2. nutritional anemia
  9. Describe acute blood loss anemia.
    • hemorrhage,
    • could be GI bleed
    • circulating RBCs are normal size, shape, color
    • Normocytic anemia
    • normochromic anemia
  10. Define normocytic anemia.
    characterized by red blood cells that are normal in size and usually also in hemoglobin content
  11. Define normochromic anemia.
    an anemia marked by reduced numbers of normochromic red blood cells in the circulating blood
  12. Describe chronic blood loss anemia.
    • iron deficiency anemia
    • RBCs are microcytic (small)
    • hypochromic (pale)
    • low production from bone marrow
  13. Describe nutritional anemia.
    • Affect RBC formation
    • Vit B12 and folate play big role in RBC development
    • can't make rbc
  14. What causes nutritional anemia?
    • inadequate diet,
    • increased need,
    • malabsorption,
    • GI disorders ,
    • ulcerative colitis,
    • crohns,
    • mal absobtioin
  15. Name 3 types of nutritional anemia.
    • 1. iron deficiency anemia
    • 2. vitamin B12 anemia (pernicioius is on type)
    • 3. folic acid deficency anemia
  16. What is the most common type of nutritional anemial?
    iron deficiency anemia
  17. Who is at greatest risk for iron deficiency anemia?
    elderly
  18. What is irondeficiency anemia?
    inadaquate intake of iron
  19. What causes iron defieciency anemia?
    • inadequate intake,
    • malasorption,
    • pg,
    • chronic bleeding, ie: gi inflammation, heavy periods
    • alcoholism
    • hemrrhoids,
    • cancer
  20. What are the results of nutritional anemia?
    • fewer number of RBC’s,
    • microcytic cells,
    • hypochromic cells,
    • malformed cells
  21. What are the specific symptoms of nutritional anemia?
    • brittle nails
    • spoon shaped nails
    • mouth cracked at the corners
    • tongue smooth sore
    • eating habits unsual i.e. pica
  22. What is the treatment for nutritional anemia?
    several months of oral iron supplement along with vitamin C to help absorption
  23. What are some food sources rich in iron?
    • beef,
    • spinach,
    • organ meats,
    • foritfied grains,
    • fortified cream of wheat,
    • raisins
  24. Name 1 type of vitamin B12 anemia?
    pernicious anemia
  25. Describe the RBC in someone w/ B12 anemia.
    • RBCs are:
    • 1. Macrocytic
    • 2. misshaped
    • 3. fragile
    • 4. short life span
  26. What are the causes of vitamin b12 anemia?
    • 1. Failure to absorb dietary Vit B12 d/t lack of intrinsic factor (pernicious anemiaoral meds won't help) Occurs in clients who have stomach or ileal resections,
    • 2. loss of pancreatic secretions,
    • 3. chronic gastritis (may be due to alcohol),
    • 4. strict vegetarians.
  27. What are the symptoms of vitamin B12 deficiency anemia?
    • 1. Gradual onset neuro problems:
    • numbness and tingling in extremities
    • difficulty w/ propriception and balance
    • 2. Tongue smooth sore, glossitis, (beefy tongue)
    • 3. Mouth corner of mouth
  28. What are the tx for vitamin B12 deficiency anemia?
    • 1. must haveearly intervention to reverse sx
    • 2. increase intake of meats, eggs, dairy, suppliments
    • 3. Parenteral Vit B12 shots for lack of intrinsic factor
  29. What are some food sources for vitamin B12?
    animal products
  30. Describe the RBC in folic acid deficiency anemia.
    • RBC are:
    • 1. Fragile
    • 2. megaloblastic cells – large, immature
  31. What are the causes of folic acid deficiency anemia?
    • 1. Inadequate intake,
    • chronically malnourished ie: etoh, drugs, pregnant, chemo
    • 2. Increased needs
    • i.e. pregnant
  32. What are the symptoms of folic acid deficiency anemia?
    • 1. develop gradually
    • 2. no neuro sx
    • 3. pale,
    • 4. sob,
    • 5. palpatation,
    • 6. tognue, mouth etc.
  33. What is the treatment for folic acid deficiency anemia?
    • 1. diet supplements
    • 2. diet
    • Sources - green leafy veggies, fruits, cereals, meats
  34. What are hemolytic anemias?
    • 1. premature breakdown of RBCs
    • 2. normocytic & normochromic RBCs, but they don't last long
  35. What are the 2 causes hemolytic anemia?
    • 1. intrinsic
    • inside RBC
    • genetic, sickel cell
    • 2. Extrinsic
    • outside RBC
    • drug abuse, burns, radiation
  36. What is the treatment for hemolytic anemia?
    treat what is causing the problem
  37. Name one type of hemolytic anemia.
    sickle cell anemia
  38. Describe sickly cell anemia
    • 1. chronic hemolytic anemia
    • 2. hereditary,
    • 3. characterized by episodes of sickling of RBC crescent shaped
  39. Who gets sickle cell anemia?
    • 1. Most common among persons of African descent
    • 2. mediterranean
    • 3. india
  40. 5. How is sickle cell anemia dxed?
    blood test for the abnormal gene
  41. What are the s/s of sickle cell anemia?
    • 1. S/S same as above
    • unique to sickle cell anemia
    • 1. sickling,
    • 2. painful,
    • 3. clots,
    • 3. irritable,
    • 4. decreased circulation
    • 5. occlusion,
    • 6. ischemia,
    • 7. infarction,
    • 8. spasms,
    • 9. chest pain
    • 10. fever
  42. What is a sickle cell crisis?
    • rbc’s get stuck, clot,
    • decreased O2 to area,
    • severe pain.
  43. What are some contributing factors to sickle cell anemia crisis?
    • cold,
    • anesthsia,
    • increased demand for O2
  44. Describe aplastic anemia.
    • 1. auto immune
    • 2. bone marrow failure results in pancytopenia
  45. What is pancytopenia?
    • lack of normal cells in all componants of blood
    • i.e. RBC, WBC, platelets
  46. What are the causes of aplastic anemia?
    • 1. idiopathic (50%),
    • 2. radiation,
    • 3. chemo,
    • 4. exposure to chemicals,
    • 5. med,
    • 6. viral infections, (mono, hep c, hiv)
  47. What are the sx of aplastic anemia?
    • 1. Pallor
    • 2. fatigue,
    • 3. HA,
    • 4. DOE
    • as well as other typical anemia sx
    • vary w/ severity increase
  48. What are some risks with aplastic anemia?
    • 1. chance of bleeding as platelets are down,
    • 2. infection, wbc down
    • 3. lack of O2 as RBC is down
  49. What is MCV?
    average amount of space occupied by each blood cell, (volume)
  50. What are some treatments sof aplastic anemia?
    • 1. Remove causative agent,
    • 2. blood transfusions,
    • 3. bone marrow transplant – may or may not be successful
  51. What are some dx tests for anemias?
    • 1. CBC – what does this include? which wbc is abnormal?
    • B2. Iron levels & TIBC (total iron binding capacity):
    • 3. Serum ferritin-another iron testindicative of malnutrition in elderly
    • 4. Sickle cell test: screening for sickle cell
    • 5. Bone marrow examination:
  52. What are some nursing implications for pts taking iron supplemnents?
    • A. Iron supplements – do teaching!
    • 1. take on empty stomach if possible
    • 2. changes color of stool
    • 3. increase intake of dietary iron
    • 4. don't take iron w/ dairy, bran, coffee, tea, red wine, 5. overdose of iron toxic to young children
    • 6. multi vitamins have iron – be safe
    • 7. med may need to be taken for many months
  53. What is a drug for sickle cell anemia?
    hydroxyurea
  54. How is vitamin B12 taken?
    • Vitamin B12 parentally,
    • intranasal,
    • subq,
    • IM
  55. What do pregnant women, pts with sickl cell anemia and viamin B12 anemia need?
    • Folic acid
    • Usually oral, frequently combined hydroxyurea
  56. What is hydroxyurea used for?
    • for SCD to prevent crisissickle cell disease,
    • folic acid deficiency
  57. Microscope examination of a blood smear, fecal occult blood test
    Chronic blood loss
  58. sudden loss of blood
    Acute blood loss
  59. CBC, bone marrow biopsy
    Aplastic Anemia
  60. Serum iron, Transferrin iron binding capacity, Serum ferritin level
    Iron deficiency
  61. CBC, Vitamin B12 level, Methylmalonic acid (MMA) level, Homocysteine level, Schilling test, Red blood cell, folate level, Gastrin level, Intrinsic factor assay, Bone marrow staining
    Vitamin B12 deficiency
  62. HemoglobinMean corpuscular volume (MCV) will be larger than normal Color of the red blood cell—will be normal, serum folic acid
    Folice Acid deficiency
  63. Hemoglobin electrophoresis blood test for abnormal sickle cell gene
    Sickle Cell

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