NR 324 MED SURG 1 FINAL EXAM Anemia- Chamberlain College of Nursing

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ANEMIA chapter 31
Bleeding= thru GI, menstrual
Bleeding # 1 cause of iron deficiency anemia
 Anemia= low erythrocytes (#, Volume and quantity of hmg)
 Cause of anemia= b/d loss, high RBC destruction, low RBC
production
 3-4-month length of RBC
 MEGALOBASTIC ANEMIA--
1-Pernicious- lack of intrinsic factor-B12
2-Follic acid deficiency (in pregnancy), long term sequelae of
fetus=neural tube defect/sparadifulum
 Iron=# 1 cause of pediatric overdose
Iron we can give PO—S/E=heart burn, black stool, constipation
-use citric juice to help with absorption
**Know the normal value of HGB/HMT, WBC and PLT
 Clinical of manifestation of anemia-low O2, tachycardia, dyspnea
 Assess first in skin color-with white conjunctiva(pale) it should be
pink, cheilitis, glossitis (beefy red tongues), fatigue, inflamed lip
 Iron deficient is one of the common chronic hematologic disorder
-LAB: Low HMG, HMT, PLT, WBC, stool guaiac test (make sure
not bleeding in GI, endoscopy, colonoscopy
-Check for renal disease if not from GI
-Goal is to correct the underline disease
_With iron-deficiency anemia, you will receive packed RBC
-Drug- oral iron-150-250mg, stool softener (Colace)
_Upset stomach-pectobysthmul med (black stool)
contraindicated=ed in PT on coumadin, it has aspirin
Iron-may stain skin
_At risk-pre menopause, pregnant, older adult, PT who lose b/d
Iron can cause GI effect-heart burn
 THALASSEMIA- synthesis HMG is wrong- minor – no need to
worry, major (multiple b/d transfusion, splenectomy= spleen out
because it stores RBC) =life threatening, Mediterranean, genetics

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,  Anemia of chronic disease= inflammation, autoimmune and
infection (HIV, Hepatitis, malaria), HF, malignant, Bleeding
episodes

 Sickle cell primary cause is genetic, incorrectly shape, not enough
HGB, PT has pain in crisis (HOT Mnemonic=Hydrate, O2, Pain
med)
 Chronic = no need of transfusion
 PANCYTOPENIA (everything)
 Acute blood loss-hemorrhage, retroperitoneal bleeding-
 1 unit of pack cell can bring up about 2%
 HEMOLITIC ANEMIA
-Thalassemia=hereditary
-Sickle cell=HOT is the Rx, autosomal, genetic, PT should avoid
altitudes, rest with DVT prophylaxis

SAME CHAPTER AS ANEMIA
 Thrombocytopenia=low PLT
 Too much PLT =thrombocytosis
 Polycythemia=high RBC-PT who smoke, hemacrotosis
 Should never have positive basophil in CBC
 Thrombocytopenia=monitor PLT, coagulation studies, HGB and
HCT, manage the b/d loss
 Heparin induced thrombocytopenia- most common
 On heparin drip PT=monitor PTT (every 4-6 hrs.) and PLT (can
cause it to drop--HIT)
 Normal PLR 150000-400000
 With thrombocytopenia-administer PLT transfusions, b/d
component therapy to mage hematologic diseases, soft tooth brush
 Expected outcome…watch out for bleeding, petechia, bruising
 TTP can be cause by drug
 Idiopathic (ITP) do not know where it comes from




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