ANEMIAS I
Anemia is a condition in which ______ levels are lower than normal due to decreased __________, _____ or _________.
Anemia is a condition in which RBC levels are lower than normal due to decreased production, loss, or destruction.
The NUMBER ONE complication and nursing focus while caring for patients with sickle cell disease is ______.
Other complications include: (3)
The NUMBER ONE complication and nursing focus while caring for patients with sickle cell disease is pain.
Other complications include: stroke, vision and hearing loss, swollen extremities, liver/kidney/splenic issues, fatigue, chest pain, pneumonia, acute chest syndrome
Ingestion or inhalation of lead causes toxic effects on the body including the _______ system, ______ _______, and kidneys.
Ingestion or inhalation of lead causes toxic effects on the body, including the nervous system, bone marrow, and kidneys.
B-Thalassemia is an inherited _______ _______ disorder characterized by ineffective ________ and _______ of _____
Describe the effects of each subcategory:
1. Thalassemia minor: mild microcytic anemia (hgb ____g/dL less than normal)
2. Thalassemia intermedia: severe anemia and ______, requiring frequent blood transfusions
3. Thalassemia major (_____ _____): requires ______ to sustain life
B-Thalassemia is an inherited autosomal recessive disorder characterized by ineffective production and destruction of RBCs
Describe the effects of each subcategory:
1. Thalassemia minor: mild microcytic anemia (hgb 2-3g/dL less than normal)
2. Thalassemia intermedia: severe anemia and splenomegaly, requiring frequent blood transfusions
3. Thalassemia major (Cooley anemia): requires blood transfusions to sustain life
_________ is bleeding into a joint cavity, causing tingling and joint stiffness, and is a common complication of _________. This patient will require _____ therapy and _____ exercises.
Hemarthrosis is bleeding into a joint cavity, causing tingling and joint stiffness, and is a common complication of hemophilia. This patient will require PT therapy and ROM exercises.
(Memory trick: hemo=blood, arthro=joint)
name (6) iron-rich foods
name (6) iron-rich foods: red meats, tuna and salmon, eggs, tofu, enriched grains, dried beans, peas, and fruits, leafy greens, iron fortified cereals
Lab results may be affected in the patient with sickle cell anemia, including:
___ hemoglobin and hematocrit
___ reticulocyte count (immature RBCs)
___ BUN and creatinine
___ AST and ALT
Lab results may be affected in the patient with sickle cell anemia, including:
low hemoglobin and hematocrit
high reticulocyte count (immature RBCs)
high BUN and creatinine
high AST and ALT
MDHHS newest definition of elevated blood levels is ____ mcg/dL
Lead replaces _____ in hgb resulting in ______
The most common neurological side effect is ________
High lead levels cause __________ and ________
The most common GI symptom is ___________ _____
MDHHS newest definition of elevated blood levels is 3.5 mcg/dL
Lead replaces iron in hgb resulting in anemia
The most common neurological side effect is HA
High lead levels cause encephalopathy and seizures
The most common GI symptom is abdominal pain
Cooley anemia results in RBCs that are rigid and hemolyze easily, which causes severe _____ and chronic _____. RBC destruction causes increased bone marrow expansion, resulting in thickened bones seen as _______ deformities. Organ damage can occur from _________ _________ (RBC production outside the bone marrow)
Cooley anemia results in RBCs that are rigid and hemolyze easily, which causes severe anemia and chronic hypoxia. RBC destruction causes increased bone marrow expansion, resulting in thickened bones seen as skeletal deformities. Organ damage can occur from extramedullary erythropoiesis (RBC production outside the bone marrow)
Acute chest syndrome occurs when progressive inflammation and acute _____ injury leads to _____ _____, _ _ _, wheezing, fever, ______, tachypnea, or hypoxia caused by atelectasis, fat embolism, thromboembolism, and infection.
Acute chest syndrome occurs when progressive inflammation and acute lung injury lead to chest pain, SOB, wheezing, fever, cough, tachypnea, or hypoxia caused by atelectasis, fat embolism, thromboembolism, and infection.
Signs and symptoms of iron deficiency anemia include (6)
Signs and symptoms of iron deficiency anemia include fatigue, lethargy, pallor, tachycardia, tachypnea, irritability
In a patient with iron deficiency anemia, their RBCs will be _________ (______) and ________ (______)
In a patient with iron deficiency anemia, their RBCs will be hypochromic (lighter) and microcytic (smaller)
Risk factors for lead poisoning include: (4)
Risk factors for lead poisoning include:
1. homes built before 1978
2. soil under cars that used leaded gas (b4 1996)
3. ceramics or stained glass
4. old toys and furniture
5. lead pipes in older homes
6. adopted children
Hemosiderosis: excess iron supply from rapid RBC hemolysis _____ tissue damage> leads to _____ skin
Hemochromatosis: excess iron supply from rapid RBC hemolysis _____ cellular damage> can compromise _______ function
Avoid ______ rich and increase ______
Hemosiderosis: excess iron supply from rapid RBC hemolysis without tissue damage> leads to bronze skin (Hint: SID the sloth would never cause harm)
Hemochromatosis: excess iron supply from rapid RBC hemolysis with cellular damage> can compromise cardiac function (Hint: CHROMAsomes can cause harm)
Avoid iron rich and increase vitamin C
The four main components of blood include:
Before cells differentiate, they start as a __________ _____ _____
The four main components of blood include: RBCs, WBCs, Plasma, Platelets
Before cells differentiate, they start as a multipotent stem cell
Interventions for iron deficiency anemia related to:
1. blood loss (3)
2. inadequate intake (2)
3. malabsorption (4)
Interventions for iron deficiency anemia related to:
1. blood loss: upper GI scope/colonoscopy, birth control, blood transfusion
2. inadequate intake: increase dietary sources, PO iron supplement
3. malabsorption: increase vitamin C, IV iron, limit cow's milk (24oz per day), ascorbic acid
Therapeutic management for sickle anemia: (4)
Therapeutic management for sickle anemia: oxygen, analgesics, narcotics, transfusions and exchange transfusions, IV fluids at 1.5x MR, warm compress, bare hugger, rest, splenectomy, BMT, hydroxyurea
____________ is the first step in treating lead poisoning, starting with the _____ and then the _____.
Decontamination is the first step in treating lead poisoning, starting with the source and then the body.
Administration of _______ is important to treat B-Thalaseemia Major because it increases or decreases hgb, supresses extramedullary erythropoiesis, decreases need for ________ (why?), and lessens cardiac complications.
Other treatments include _________ 2x/month, splenectomy, and _ _ _... There is no cure!
Administration of PRBCs is important to treat B-Thalaseemia Major because it increases hgb, supresses extramedullary erythropoiesis, decreases need for splenectomy because healthy RBCs decrease splenomegaly, and lessens cardiac complications.
Other treatments include transfusions 2x/month, splenectomy, and BMT... There is no cure!
Which of the following statements are FALSE:
1. The normal RBC's lifespan is about 10-20 days
2. African Americans are among the most affected by sickle cell disease
3. Parents who both have the sickle cell trait have a 25% chance of having a child with the trait
Which of the following statements are FALSE:
1. The normal RBC's lifespan is about 10-20 days (120 days, RBCs have a 10-20 day lifespan in people with sickle cell disease)
3. Parents who both have the sickle cell trait have a 25% chance of having a child with the trait (50%, they have a 25% chance of having a child with the disease)
Full-term infants have _______ iron stores for about __ months after birth. This means pre-term infants are at an increased risk for ______ and ___________ delays.
Full-term infants have maternal iron stores for about 6 months after birth. This means pre-term infants are at an increased risk for anemia and neurocognitive delays.
Match the definitions with the correct term.
1. HbSS A. fetal hgb
2. HbA B. sickle cell anemia
3. HbSC C. normal adult hgb
4. HbSB D. beta thalassemia
5. HbF E. sickle cell disease
Which one is most severe?
Match the definitions with the correct term.
1. HbSS B. sickle cell anemia
2. HbA C. normal adult hgb
3. HbSC E. sickle cell disease
4. HbSB D. beta thalassemia
5. HbF A. fetal hgb
Which one is most severe? HbSS
Begin chelation therapy for BLL >____.
Begin IM or IV chelation therapy for BLL>____.
Lead is excreted via the _____, therefore, the most important interventions with chelation therapy include ______ and ______ ______ with hydration therapy.
Begin chelation therapy for BLL >45.
Begin IM or IV chelation therapy for BLL>70.
Lead is excreted via the urine, therefore, the most important interventions with chelation therapy include I&O and daily weights with hydration therapy.
Which of the following statements are TRUE?
1. Hemophilia is an autosomal recessive disorder that results in a deficiency of hgb
2. Hemophilia A is the deficiency of factor IX (9)
3. Severe hemophilia is categorized as bleeding common after injuries
4. Children with hemophilia should not play football
Which of the following statements are TRUE?
4. Children with hemophilia should not play football
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1. Hemophilia is an X-linked recessive disorder that results in a deficiency of coagulation factor
2. Hemophilia A is the deficiency of factor VIII (8)
3. Severe hemophilia is categorized as spontaneous bleeding without injury
(Memory trick: phobia is a fear, whereas philia is to love- hemo=blood, and people with hemophilia love to bleed)
**DAILY DOUBLE**
The use of edetate calcium disodium (chelation therapy medication) alone without dimercaprol can cause ______ ______.
**DAILY DOUBLE**
The use of edetate calcium disodium (chelation therapy medication) alone without dimercaprol can cause cerebral edema.