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Anemia and Blood Disorders Overview
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Anemia and Blood Disorders Overview
Anemia and Blood Disorders Overview
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1
Question
What is anemia?
Answer
lower than normal hemoglobin and fewer than normal circulating erythrocytes. It is a sign of an underlying disorder and can be related to genetic problems in certain cultures.
2
Question
What are the causes of hypoproliferative anemia?
Answer
caused by a defect in the production of red blood cells (RBCs) due to iron deficiency, vitamin B12 or folate deficiency, nutritional deficiency, decreased erythropoietin production, or cancer.
3
Question
What are the causes of hemolytic anemia?
Answer
caused by excess destruction of RBCs due to altered erythropoiesis, other causes such as hypersplenism, drug-induced or autoimmune processes, and mechanical heart valves. It may also be due to chronic blood loss.
4
Question
What are the classifications of anemia?
Answer
Macrocytic-normochromic anemia, Microcytic-hypochromic anemia, and Normocytic-normochromic anemia.
5
Question
What is pernicious anemia?
Answer
a common type of megaloblastic anemia, characterized by the absence of intrinsic factor in gastric secretion. It is an autoimmune disorder that leads to chronic malabsorption of vitamin B12 and is common among Scandinavian, English, and Irish races, particularly in late adult life.
6
Question
List the causes of pernicious anemia.
Answer
Causes of pernicious anemia include: 1. Related to gastric atrophy, 2. Loss of intrinsic factor (genetic), 3. Insufficient dietary intake of food rich in vitamin B12, 4. Drugs that impede absorption of vitamin B12 in the stomach, 5. GI disorders, 6. Zollinger Ellison Syndrome.
7
Question
What is folate deficiency anemia?
Answer
Folate deficiency anemia usually has the same etiology as pernicious anemia and results from a diet lacking in foods rich in folic acid, such as green leafy vegetables, liver, citrus fruits, nuts, grains, and yeast. It can also be caused by increased alcohol intake and is common among clients undergoing hemodialysis.
8
Question
What is iron deficiency anemia?
Answer
Iron deficiency anemia is a chronic hypochromic microcytic anemia that results from an insufficient supply of iron in the body, leading to reduced hemoglobin concentration in RBCs and an inability to oxygenate the body.
9
Question
What are the etiologies of iron deficiency anemia?
Answer
Etiologies of iron deficiency anemia include: 1. Insufficient dietary intake of iron, 2. Chronic blood loss, 3. Impaired absorption of iron, 4. Excessive demands for RBC production due to hemolysis, and 5. Living in poor countries.
10
Question
What is hemolytic anemia?
Answer
Hemolytic anemia is an end result of conditions leading to hemolysis. Etiology can be genetic or problems intrinsic and extrinsic to the RBC.
11
Question
What is aplastic anemia?
Answer
Aplastic anemia occurs when the bone marrow stops producing blood cells (RBCs, WBCs, and platelets). Confirmatory diagnostic tests include bone marrow aspiration.
12
Question
What are the causes of aplastic anemia?
Answer
Causes of aplastic anemia include exposure to viruses, chemicals, radiation, or medications such as chloramphenicol, mephenytoin, trimethadione, and nitrogen mustards.
13
Question
What are the clinical manifestations of anemia?
Answer
Clinical manifestations of anemia include fatigue, weakness, malaise, pallor or jaundice, cardiac and respiratory symptoms, tongue changes (glossitis), nail changes (brittle nails and pallor), angular stomatitis and cheilosis, headache, dyspnea, palpitations, and pallor in the face, palms, and mucous membranes.
14
Question
What is the medical management for anemia?
Answer
Medical management for anemia includes identifying and correcting or controlling the cause, transfusion of packed RBCs, dietary therapy, iron or vitamin supplementation, and immunosuppressive therapy.
15
Question
What are the nursing assessments for anemia?
Answer
Nursing assessments for anemia include obtaining health history and physical examination, reviewing laboratory data, assessing presence of symptoms and their impact on the patient's life, nutritional assessment, and evaluating medications and potential blood loss.
16
Question
List the nursing diagnoses for anemia.
Answer
Nursing diagnoses for anemia include fatigue, altered nutrition, altered tissue perfusion, and non-compliance with prescribed therapy.
17
Question
What are the potential complications of anemia?
Answer
Potential complications of anemia include heart failure, angina, paresthesia, and confusion.
18
Question
What are the nursing interventions for anemia?
Answer
Nursing interventions for anemia include balancing physical activity, maintaining adequate nutrition, educating patients to promote compliance with medications and nutrition, monitoring vital signs and pulse oximetry, providing supplemental oxygen as needed, and educating clients about foods high in iron, vitamin B12, and folic acid.
19
Question
What is thalassemia?
Answer
Thalassemia is an autosomal-recessive genetic disorder that results in inadequate normal hemoglobin production and disrupts the synthesis of globin. It is common among people of Mediterranean, African, and Southeast Asian origin.
20
Question
What are the types of thalassemia?
Answer
Types of thalassemia include Thalassemia Minor, which arises from mutation in one beta globin gene causing minor disruption, and Thalassemia Major, which results in significant impairment of beta-globin synthesis due to mutations in both beta genes.
21
Question
What are the clinical manifestations of minor thalassemia?
Answer
Clinical manifestations of minor thalassemia include mild to moderate anemia and usually asymptomatic presentation. In children, it may present with pain, failure to thrive, frequent infections, diarrhea, splenomegaly, hepatomegaly, jaundice, and bone marrow hyperplasia.
22
Question
What is the medical management for thalassemia?
Answer
Medical management for thalassemia includes chronic transfusion, iron chelation with deferoxamine, splenectomy, and genetic counseling.
23
Question
What is sickle cell disease?
Answer
Sickle cell disease is a group of inherited disorders of mutant hemoglobin (hemoglobin S) that causes characteristic sickling of RBCs, leading to sickle cell anemia, which is an autosomal recessive disorder.
24
Question
Define sickle crisis.
Answer
Sickle crisis is an acute episodic exacerbation of the disease that can lead to vaso-occlusion in tissues and organs, resulting in organ damage syndromes.
25
Question
What are the clinical manifestations of sickle cell disease?
Answer
Clinical manifestations of sickle cell disease include sudden onset of pain in long bones, joints, chest, back, and abdomen, spleen enlargement (splenomegaly), and multi-organ infarcts leading to tissue necrosis.
26
Question
What factors stimulate sickling of RBCs?
Answer
Factors that stimulate sickling of RBCs include low oxygen level, high altitude, strenuous exercise, respiratory tract infections, anesthesia without oxygen, stress, exposure to cold, dehydration, and other infections.
27
Question
What is polycythemia vera?
Answer
Polycythemia vera is a condition characterized by excessive production of erythrocytes, leukocytes, and platelets due to overproduction by the bone marrow, leading to increased blood viscosity and total blood volume.
28
Question
What are the clinical manifestations of polycythemia vera?
Answer
Clinical manifestations include initial asymptomatic presentation, later signs of hypoxia related to microcirculation impairment, red mucosa, dizziness, headache, cardiovascular issues, heart failure, stroke, peptic ulcers, liver and spleen enlargement, and skeletal gout.
29
Question
What are the diagnostic findings for polycythemia vera?
Answer
Diagnostic findings for polycythemia vera include RBC counts as high as 8 to 12 million mm3, high hematocrit levels (over 54% in men, 49% in women), elevated platelet counts, and hyperplastic bone marrow.
30
Question
What is Immune Thrombocytopenic Purpura (ITP)?
Answer
Immune Thrombocytopenic Purpura is the most common thrombocytopenic disorder, an hemorrhagic autoimmune disorder resulting in the destruction of platelets.