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Anemia is a reduction in either the number of RBCs, the amount of _______, or the _______.
or the hematocrit (percentage of packed RBCs per deciliter [dL]) of blood).
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Anemia can result from....
- dietary problems
- genetic disorders
- bone marrow disease
- or excessive bleeding.
- **GI bleeding is the most common reason for anemia in adults.
- **deficiencies of iron, vitamin B12, folic acid, or intrinsic factor.
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Anemia can cause what type of cardiac manifestations?
- tachycardia
- murmurs and gallops
- orthostatic hypotension
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What is the Hb levels for males and females
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What is the hematocrit for males and females
- (Percentage of packed RBC per dL)
- 37-47% (women)
- 42-52% (men)
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What is the RBC, WBC, and platelet counts?
- RBC (4,200,000 to 6,100,000
- WBC (5,000-10,000
- Platelets (150,000-400,000
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What are the Respiratory manifestations of anemia
- decreased oxygen saturation levels
- dyspnea on exertion
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This reduced RBC life span causes_________ in patients with sickle cell disease.
hemolytic (blood cell–destroying) anemia
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Acquired hemolytic syndromes result from....
increased RBC destruction occurring in response to trauma, malarial infection, exposure to certain chemicals or drugs, and autoimmune reactions. All increase the rate of RBC destruction by causing membrane lysis (breakage).
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A decreased rate of erythrocyte precursurs is known as why type of anemia
hemolytic anemia
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a vitamin B12 deficiency results in what kind of anemia?
Macrocytic Anemia (cells are too large and only a few get released from bone marrow)
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an Intrinsic factor deficiency results in what kid of anemia?
Pernicious Anemia (without IF, B12 cannot be absorbed)
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What can cause Folic acid anemia?
nutrition, malabsorption (Crohns Disease), alcohol abuse, and drugs.
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What is Pancytopenia
deficiency of RBC, WBC, and platelets
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For Acute blood loss, what should be done and what meds should be administered?
Stop Bleeding, administer dextran, Hetastarch, albumin, lactated Ringer’s, supplemental iron.
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What are the 3 hallmarks of Polycythemia Vera?
- massive production of RBCs (greater than 6 mil)
- excessive leukocyte production
- and excessive production of platelets.
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What is the difference between Primary and Secondary Polycythemia?
- Primary: cancer; an increase in WBC, RBC, and platelets
- Secondary: hypoxia stimulates the production of erythropoiten in kidneys which increases RBC
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What is the difference between Immune Thrombocytopenic Purpura and Thrombotic Thrombocytopenic Purpura?
- Immune: autoimmune disorder that causes abnormal platelet destruction
- Thrombotic: formation of micro-thrombi/platelets that deposit in arterioles and capillaries resulting in few platelets in circulation
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With thrombocytopenia, the Nurse is most concened with:
hemmorhage
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For Immune Thrombocytopenic Purpura the Nurse can expect to treat it with
– corticosteroids, IV immunoglobulin, splenectomy, platelet transfusion
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For thromotic thrombocytopenic purpura the nurse can expect to treat the pt with:
corticosteroids, plasma exchange, anti-platelet agents
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When administering steroids for Thrombocytopenia, why is it important to check for blood in the stool?
to see if there is bleeding from GI ulcers, as that is a side effect of steroids
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What is the difference between leukopenia and neutropenia
- Leukopenia is a reduction in all of the WBC
- Neutropenia is a reduction in the neutrophils (big concern because those are the first line of defense)
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What is a low Neutrophil Count
1000-1500
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Why is bruising common with Leukemia
Because WBC are literally clogging up bone marrow so platelet counts are low
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The purpose of a lumbar puncture in a pt that is suspected to have leukemia is
in order to see if the Leukemia has effected the Nervous System
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What is Hodgkin's Disease?
- a malignant condition caused by proliferation of abnormal, giant, multinucleated cells called Reed Steinberg cells located in the lymph nodes
- enlarged cervical, axillary or inguinal nodes, fever, fatigue, night sweats
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What is Non Hodgkin's Disease
- malignant neoplasms of the immune system (lymphoid cancers that do not include Reed-Steinburg Cells)
- painless lymph node enlargement
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What is Multiple Myeloma
- neoplastic plasma cells (mature B-lymphocyte) infiltrate bone marrow and destroy bone.
- Very poor prognosis. (by the time they have symptoms, there has been large infiltration in bone)
- Common Manifestations are skeletal pain, fatigue, easy bruising
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A pt with multiple myeloma becomes lethargic. These manifestations may be explained by diagnostic results that indicate
hypercalcemia
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