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Erythrocyte sedimentation rate indicates what
What indicates iron metabolism?
If radiologic studies occur for blood diagnostics, what whould you expect it to be on?
If bleeding in urine, what might you expect?
problems with kidney or prostate
Normal Hemoglobin for women? men?
when there is a decrease in hemoglobin what is happening to the hemocrit?
decreasing as well.
Severity of anemia
- Mild:HgB 10-14
- Moderate: HgB 6-10
- Severe: HgB <6
What symptoms should you expect with mild anemia?
- Mild: May exist with no symptoms possible symptoms maybe palpatations, dyspnea, diaphoresis,
- Moderate: increased cardiopulmonary symtoms at rest or activity
- Severe: problems with integument ( touch, balance) eyes, mouth, cardiovascular, kidneys, and liver
People at risk for iron deficincy anemia
- premenopausal and pregnant women
- low money
- older adults
- blood loss
Causes of iron def. anemia
- Inadequate dietarty intake (only 5-10% ingested is absorbed)
- blood loss
For every 1 unit of blood transfused, how much does your hemoglobin go up?
What things should you ask witht a pt with iron def anemia
- Blood transfusion
- past iron def
- sickle cell
If giving iron supplementally how long should you give it to them, what is the best way to give it to them as, and what if it is liquid
2-3 months after hemoglobin levels return to normal, ferrous sulfate (enteric coated) and should be diluted and given a straw.
Anemia characterized by Large RBC's are easily destroyed because they have fragile cell membranes caused by impaired dna synthesisand characerized by the presence of large RBC's. What are two deficencys that are the cause of it?
- Colbalamin (vitamin B-12)
- Folic Acid Deficiency
what is required for colbalmin absorption in the small intestine?
Clinical manifestations of cobalamin (vitamin b-12) deficiency.
- general anemia symptoms
- red beefy tongue
- nausea and vomiting
- abdominal pain
Neuro clinical manifestations of B12 def.
- parethesias of the feet and hands
- decrease vibratory and postition senses. -can u feel this?
- ataxia (dizziness)
- muscle weakness
- impaired thought process- memory loss
Diagnostic test for b12 anemia
Medical Management for cobalamin def
- Parenteral administration
- oral intake of cobalmin does not correct the anemia
Common causes for folic acid def
- poor nutrition
- malabsorption sydromes
- alcohol abuse and anorexia
- lost during hemodialysis
Chronic myeloproliferative disease
Affects spleen, RBC, WBC, and platlets
Unknown cause/ Insidous onset
Primary polycythemia (polycythemia vera)
increases RBC production from erythropoietin
What clinical manafestations does polycythemia vera cause?
- congestion of conjuctiva, retina, and retinal veins
- Ruddy apperarance of the nose (always red nose)
- visual disturbances
- paresthesia of hands and feet (also burning)
Drugs for iron def
iron, vit b12, adb folate
Diagnostic tests for polycythemia
- Assessment of the spleen (spenomegaly)
- Lab value of thrombocytosis, leukocytosis, alkaline phosphatatas (elevated), b12 level (elevated), bone marrow hypercellularity of RBC, WBC, platelets
Medical management of polycythemia
- Phlebotomy: removes 300-500ml QOD
- Plasmapheresis (seperates rbc and plasma and put all back except albumin)
- Myelosuppressive drugs (Alkeran, Hydrea, Radioactive phophorus)
- other drugs such as allopurinol (for gout)
medical management of polycythemia
- low dose aspirin or paxil (eliminates the burning sensation in extrimities)
- additional fluid and alkalinize urin ( for prevention on uric acid stones)
- Agrylin: reduce platelet counts and aggregation
- If symptomatic splenomegaly: rest peirods and small meals
what should you monitor as a nurse for patients with polycythemia?
- Monitor for bleeding
- assess responce to phlebotomy and pheresisi
- monitor for thrombosis and joint mobility
- prevent N&V
- assess for abdominal pain
- monitor for stroke
- educated the client not to ever get dehydrated! can kill them!