Key Terms I
Blood cell production that occurs within the bone marrow.
Hematopoiesis.
p. 585
A platelet count of <100000/uL. The patient is at risk for bleeding.
Thrombocytopenia.
p. 603
These laboratory tests is used to diagnosis anemia.
Complete blood count (CBC), reticulocyte count, peripheral blood smear.
p. 607
What is the clinical manifestation that the client needs to learn to cope with related to Anemia?
Fatigue.
p. 606
The main goal of managing anemia is....
Correcting the cause.
p. 608
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.
p. 845 Lilley
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.
p. 587
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
p. 606
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)
What are the manifestations a result of?
Hypoxia.
p. 608
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.
p. 608
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.
p. 846 Lilley
An immature red blood cell.
Reticulocyte
p. 587
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.
p. 609
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%.
p. 599
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.
p. 608
What are the nursing diagnosis associated with anemia?
Fatigue
Impaired nutritional intake
Ineffective tissue perfusion (hypoxia)
p. 608
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.
p 587
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
p. 613
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.
p. 603
(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.
p. 610
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. p. 608
Used in pernicious anemia and other megaloblastic anemias. It can be given oral, intranasal, and IM.
cyanocobalamin (Vitamin B 12).
p. 849 Lilley
WBC, <5000/uL associated with bone marrow suppression.
Leukopenia.
p. 602
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
p. 614
These studies may help to determine if the anemia is related to the GI system.
occult blood, endoscopy, colonoscopy.
(To determine bleeding)
p. 610
In pernicious anemia, a megaloblastic anemia, a nurse may see this clinical manifestation.
Beefy red tongue that may be shiny.
p. 612
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. p. 647
These medications may be used to pre treat a patient that has had prior blood transfusion reactions.
diphenhydramine and acetaminophen.