Hematology
Where is bone marrow found and what does it produce?
-Spongy tissue found in the center of flat bones, ends of long bones
-Produces RBC’s, WBC’s and Platelets
What will the nurse teach the patient on an Iron supplement?
-Take on an empty stomach (to increase absorption)
-Take with Vitamin C, citrus fruits or vegetables
-Avoid Milk
-Stool may be dark colored
-Iron can cause constipation
What are dietary sources of B12?
Meat, seafood, eggs, dairy products
What are dietary sources of folic acid?
-Fortified cereal and grains
-Nuts and seeds
-Leafy green vegetables
-Legumes
-Citrus fruits
Which labs are affected in Aplastic Anemia?
-RBC
-WBC
-Platelets
What is the function of the Spleen?
Patients who had a Splenectomy are at risk for?
-Filters blood
-Removes old defective RBC, Platelets and Bacteria
-Stores 30% of RBCs
Bleeding, blood clots (disrupts normal blood clotting) and infection
IDA Manifestations
What is painful swelling of the tongue?
What is Spoon Shaped Nails?
What is redness and cracking around lips?
Due to chronic IDA and hypoxia?
Glossitis
Koilonychias
Cheilosis
Clubbing
What are Clinical Manifestations of Vitamin B-12 deficiency?
-Neurologic dysfunction
-Lhermitte’s Sign
-Psychiatric dysfunction
-GI
What are some causes of Folic Acid deficiency?
-Medications
(metformin, birth control, chemo, methotrexate)
-Alcohol abuse
-Chronic GI issues
-Crohn’s celiac, GI surgeries
-Diet
-Dialysis
-Pregnancy
What is Thrombocytopenia?
Abnormally low number of platelets in the blood
Which hormone is produced in the Kidneys?
-Erythropoietin (EPO)
What are examples of foods for IDA treatment with diet?
-Red Meat
-Seafood
-Dark Leafy Green Vegetables
-Liver
-Eggs
-Legumes (lentils, beans, chickpeas)
Who is at a higher risk for Vitamin B-12 deficiency?
-Older adults
-Long term Alcohol use
-GI resection
-Certain medication (PPI, H2 Blockers)
-Chron's, Celiac Disease
-Vegetarian, Vegan
-Gastrectomy
What are Clinical Manifestations of Sickle Cell Anemia?
-Pain
-Acute Chest Syndrome (fever, chest pain, etc)
-CVA
-Infection
-Hand and Foot Syndrome
-Priapism
-Acute Sequestration Crises
-Hemolytic Crises
What are Clinical Manifestations of Aplastic Anemia?
-Fatigue
-Easy Bruising or Bleeding
-Frequent Infections
-Pale Skin, Shortness of Breath
Describe a few functions of the Liver
-Production site for clotting factors and prothrombin.
-Stores blood.
-Converts bilirubin to bile
-Stores extra iron within a storage protein called ferritin
-Small amounts of erythropoietin produced in liver
What are some Nursing Interventions for a patient with IDA?
-Teach the patient on sources of iron rich foods
-Monitor SpO2, Heart Rate, and RR
-Assess for fatigue, shortness of breath
-Encourage pacing activities, taking rest breaks
-Monitor nutrition intake
A procedure used to assess the body's ability to absorb Vitamin B-12
-Schillings Test
What are a few causes of a Sickle Cell Crisis?
●Dehydration
-Extreme Temperatures
-Infection
-Stress
-Hypoxia
-Alcohol and Smoking
-Surgery
-Illness
What are some examples of illnesses which can cause Aplastic Anemia?
-Autoimmune Disorders
-Chemo/Radiation
-Hepatitis
-HIV
-Exposure to Toxic Chemicals
Name the 3 Plasma Proteins
Albumin- Prevents plasma from leaking into tissues
Globulin- Main component of antibodies, nutrient transport, and clotting
Fibrinogen- A protein activated to fibrin to form clots
What are causes of IDA?
-Hemorrhage or chronic blood loss
-Menstrual bleeding, cancer, GI ulcer/bleed
-Poor absorption
-Celiac, Crohn’s, PPI, Antacids, H2 inhibitors, ASA, Gastrectomy, Gastric bypass
-Older adults
-Pica
Where are parietal cells located and what do they produce?
-Located in the stomach lining
-Produce Intrinsic factor (Essential for absorption of B-12)
What are interventions/treatments for a Sickle Cell Crisis also known as a Vaso Occlusive Crises?
-Oxygen
-Oral and IV Fluids
-Pain medications
-Antibiotics if infection present
-Hydroxyurea
-Prophylactic PCN (in kids until age 5)
-Blood transfusion
-Stem cell transplant
What teaching will the nurse include for the patient with Aplastic Anemia?
-Bleeding Precautions
-Take Precautions-Risk for Infection
-No raw foods, avoid fruits and vegetables you can't peel
-Avoid high risk activities