Key Terms I
Blood cell production that occurs within the bone marrow.
Hematopoiesis.
A platelet count of <100000/uL. The patient is at risk for bleeding.
Thrombocytopenia.
These laboratory tests is used to diagnosis anemia.
Complete blood count (CBC), reticulocyte count, peripheral blood smear.
What is the clinical manifestation that the client needs to learn to cope with related to Anemia?
Fatigue.
The main goal of managing anemia is....
Correcting the cause.
This medication promotes synthesis of erythrocytes (RBCs) by stimulating RBC progenitor cells in the bone marrow. (the natural hormone is usually secreted by the kidneys.) It is used to treat anemia
Epoetin alfa.
The process of RBC production that is regulated by cellular 0xygen requirements and general metabolic activity. It is stimulated by hypoxia and controlled by erythropoietin (glycoprotein growth factor and made by the kidney)
Erythropoiesis.
Deficiency in the number of erythrocytes (RBCs) could be related to the quantity or quality of the hemoglobin and or the volume of packed red blood cells (HCT)
Anemia
What are normal hemoglobin levels for males and females? And how what is the value for mild, moderate and severe anemia?
Female: 12-16 g/dL, male: 14-18 g/dL. p. 599
mild: 10 -12 g/dL, moderate: 6 - 10 g/dL, severe: <6 g/dL. p. 608
(Measures gas carrying capacity of RBC)
The manifestations anemia are the result of?
Hypoxia.
What are some acute nursing interventions related to anemia?
Blood transfusions, drug therapy (erythropoietin, vitamin supplements, and Oxygen therapy to stabilize the patient. Dietary and lifestyle changes.
A mineral essential for proper function of all biologic systems. It is stored in the liver, spleen, and bone marrow. And it is absorbed in the duodenum. It be obtained from dietary sources or supplementation, PO, IV, or IM.
Iron.
An immature red blood cell.
Reticulocyte
Most common nutritional disorder in the world. It is among the very young, those with poor diets, women in their reproductive years.
Iron deficiency anemia.
This lab measures the packed cell volume of RBC expressed a percentage. And what are the normal ranges for males and females.
Hematocrit (HCT)
Male: 42-52%, Female: 37-47%.
What are some integumentary and cardiopulmonary manifestations a nurse may observe?
Integumentary: pallor, jaundice, pruritis.
Cardiopulmonary: tachycardia, tachypnea, systolic murmurs and bruits (low viscosity), angina pectoris, MI, Heart failure, cardiomegaly, pulmonary and systemic congestion.
What are the nursing diagnosis associated with anemia?
Fatigue
Impaired nutritional intake
Ineffective tissue perfusion (hypoxia)
Describe folic acid (folate).
Water soluble B complex vitamin. Dried beans, peas, oranges, and green vegetables. Absorbed in the upper duodenum. Used for erythropoiesis. Is in oral or injectable forms.
Destruction of RBCs by monocytes and macrophages in order to removes abnormal, defective, damaged, and old RBCs from circulation. This process occurs in the bone marrow, liver, and spleen.
Hemolysis.
A group of disorders caused by impairment DNA synthesis and characterized by the presence of large RBCs. Result form cobalamin (B12) and folic acid deficiencies.
Megaloblastic anemia
This procedure has minimal complications however there is a chance of damaging underlying structures. Other complications include hemorrhage due to thrombocytopenia and the risk of infection due to leukopenia.
Bone marrow biopsy.
(It gives a full evaluation of hematopoiesis, the ability to obtain specimens for cytopathology and chromosomal testing. The preferred site is the posterior iliac crest.
Clinical manifestation of iron deficiency anemia.
No symptoms until it is chronic. pallor (most common), glossitis (inflammation of tongue), cheilitis (inflammation of the lips), headache, paresthesia's, burning sensation of tongue.
What are the nursing interventions for the client with fatigue?
Balance activities with rest. Cluster care. Help client prioritize activates. Monitor for falls. Monitor cardiopulmonary status especially during times of activity. Schedule rest time after meals to ensure oxygen is going to vital functions. Collaborate with nutrition. Educate on medications that a nurse administer. Education on lifestyle modifications and food choices.
Used in pernicious anemia and other megaloblastic anemias. It can be given oral, intranasal, and IM.
cyanocobalamin (Vitamin B 12).
WBC, <5000/uL associated with bone marrow suppression.
Leukopenia.
The patient has pancytopenia (decrease in all blood cells). Moderate to managed with erythropoietin or blood transfusions. This occurrence is rare with only 2 to 5 new cases per million per year.
Aplastic Anemia
These studies may help to determine if the anemia is related to the GI system.
occult blood, endoscopy, colonoscopy.
(To determine bleeding)
In pernicious anemia a nurse may see these clinical manifestations.
Beefy red tongue and dyspnea with exertion/exercise.
Name some interventions/safety issues when it comes to administration of blood products.
Informed consent prior to administration
patent IV (22 gauge or larger IV)
Y tubing and NS
2 provider verification
Type and cross completed every three days
Never add anything to the blood
Ask about prior transfusions and reactions.
These medications may be used to pre treat a patient that has had prior blood transfusion reactions.
diphenhydramine and acetaminophen.