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Anemia
"an insufficient supply of healthy red blood cells (RBCs), the volume of packed RBCs, and/or the quantity of hemoglobin"
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Erythrocytes
Another name for red blood cells (RBCs). (p. 854)
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ERYTHROPOIESIS
Production of the RBCs; Begins in the bone marrow - Ends in the blood or spleen 105 120 days; low oxygen Stimulates RBC production; Approximately 100 million/ minute are formed to replace an equal number of destroyed cells; Can increase this production 6-8 times to keep pace with increased destruction or blood loss
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stages of erythropoiesis
Stem cell; Erythroblast; Normoblast ; Reticulocyte; Mature erythrocyte small biconcave disk ( larger surface for oxygen to penetrate cell)
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Globin
"The protein part of the hemoglobin molecule (see later); the four different structural globin chains most often found in adults are the alpha1, alpha2, beta1, and beta2 chains. (p. 855)"
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Hematopoiesis
"Formation of blood; Blood cells begin maturation in the bone marrow and complete maturation in the blood stream and tissues; Bone marrow produces and differentiates all blood cells and platelets; Bone marrow flat bones of the body (sternum, ilium, ribs, vertebrae)"
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Heme
"Part of the hemoglobin molecule; a nonprotein, iron-containing pigment. (p. 855)"
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Hemoglobin
A complex protein-iron compound in the blood that carries oxygen to the cells from the lungs and carbon dioxide away from the cells to the lungs. (p. 855)
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HEMOLYTIC ANEMIA
Anemias resulting from excessive destruction of erythrocytes. (p. 856)
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HYPOCHROMIC ANEMIA
Pertaining to less than normal color. The term usually describes an RBC with decreased hemoglobin content and helps further characterize anemias associated with reduced synthesis of hemoglobin. (p. 855)
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MICROCYTIC ANEMIA
Pertaining to or characterized by smaller than normal cells. (p. 855)
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PERNICIOUS ANEMIA
A type of megaloblastic anemia usually seen in older adults and caused by impaired intestinal absorption of vitamin B12 (cyanocobalamin) due to lack of availability of intrinsic factor; type of RBC - macrocytic >8
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S&S of PERNICIOUS ANEMIA
"Weight loss, nausea & vomiting, constipation, bolated, fatigue, pale, short of breath, Paresthesias (tingeling/numbness), Lack of proprioception Loss of balance, Glossitis (swollen tounge), Fair-haired and prematurely gray"
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Reticulocytes
An immature erythrocyte characterized by a meshlike pattern of threads and particles at the former site of the nucleus. (p. 854)
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Spherocytes
"Small, globular, completely hemoglobinated erythrocytes without the usual central concavity or pallor. (al 854)"
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ANISOCYTOSIS
presence in the blood of erythrocytes showing excessive variations in size.
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FOLIC ACID ANEMIA
"anemia that is due to folic acid deficiency, Interrupts maturation of RBCs, Very fragile megaloblastic cells, Diagnosis - low serum folate, macrocytic RBCs, Oral folate 1-5 mg/day for 3-4 mo., Neural tubal defects"
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who at risk for FOLIC ACID ANEMIA
"Poor nutrition-encourage raw fruits and vegetables, liver, beef, fish, whole grains; Pregnant women, infants, teen-agers; Alcoholics; Malabsorption syndrome (celiac sprue), Patients receiving TPN, Medications (oral contraceptives & anticonvulsants)"
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IRON DEFICIENCY ANEMIA
"anemia that is due to iron deficiency; 'Microcytic, hypochromic; Need Fe for bone marrow RBCs to make hemoglobin; not going to carry as much oxygen"
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3 phases of Fe deficiency anemia
Bodys store of iron are depleted; Insufficient iron is transported to the bone marrow( bone gets weak); Small hemoglobin deficient cells enter the circulation
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MACROCYTIC ANEMIA /OR MEGALOBLASTIC ANEMIA
"a group of anemias of varying etiologies, marked by larger than normal red cells, absence of the customary central area of pallor, and an increased mean corpuscular volume and mean corpuscular hemoglobin."
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NEUTROCYTOPENIA / neutropenia
an abnormally low level of neutrophils in the blood. Neutrophils are white blood cells (WBCs) produced in the bone marrow that ingest bacteria.
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NEUTROPHILIA
increase in the number of neutrophils in the blood.
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NORMOCYTIC / NORMOCHROMIC ANEMIA
"that marked by a proportionate decrease in the hemoglobin content, the packed red cell volume, and the number of erythrocytes per cubic millimeter of blood. normal size and color"
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POIKILOCYTOSIS
presence in the blood of erythrocytes showing abnormal variation in shape.
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POLYCHROMATOPHILIA
"a condition in which the erythrocytes, on staining, show various shades of blue combined with tinges of pink"
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SCHILLINGS TEST
a test used to assess a patient's capacity to absorb vitamin B12 from the bowel
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THROMBOCYTOPENIA
is the presence of relatively few platelets in blood
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Morphologic classification
"is based on erythrocyte size, shape, and color "
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macrocytic/normochromic
"large size, normal color"
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microcytic/hypochromic
"small size, pale color"
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content of blood
"plasma, solutes, & formed elements (RBC's, WBC's, platelets)"
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required components for RBC's & Hemoglobin
Amino acids; Iron; Copper; Vitamin B12; Folic acid; Intrinsic factor
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S&S of anemia
"Integumentary - pallor(eyelids & mounth pale), skin cool to touch (feet), intolerance of cold; Cardiovascular tachycardia, murmurs, palpitations, orthostatic hypotension; Respiratory dyspnea on exertion; brittle nails"
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levels of anemia
Mild - 12-14 Hgb; moderate 6 - 10 Hgb; sever <6 Hgb (could be due to chronic renel failure)
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LABS for Fe anemia
Hgb 6-9 mg; low serium iron 10 mg/dl; loe serium ferritin (protein that stores iron)
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normal iron
"2 ml of blood loss -1 mg of iron; Stored in body as ferritin (liver, spleen, bone marrow)"
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treatment for Fe anemia
"Diagnose and correct cause; Diet- liver, beef, fish, dark green, leafy vegetables, spinach, egg yolk, raisins; Iron supplements to make iron available in the blood; Ferrous sulfate 325mg po; (Empty stomach, Stools?, Fluids 2500ml/day); Imferon injections - z track (last resort)"
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