ANCC AGACNP Barkley Review
Hemoglobin (Hgb) - answers-Main component of RBC's and the essential protein that
combines with and transports O2 to the body.
Males: 14-18 g/100 mL
Females: 12-16 g/100 mL
Hematocrit (Hct) - answers-Measures the percentage of a given volume of whole blood
that is occupied by erythrocytes: the amount of plasma to total RBC mass (RBC
concentration).
Females: 37-47%
Males: 40-54%
Total Iron Binding Capacity (TIBC) - answers-Increased levels indicate iron deficiency
(the greater their TIBC, the greater their need for iron).; Decreased levels may indicate
anemia, hemorrhage, hemolysis.
Normal: 250-450 mcg/dL
Serum iron - answers-Normal: 50-150 ug/dL
Mean Corpuscular Volume (MCV) - answers-Expression of the average volume and
size of individual erythrocytes.
Normal: 80-100 um3
Microcytic = < 80, Normocytic = 80-100, and Macrocytic = > 100.
Mean Corpuscular Hemoglobin (MCH) - answers-Expression of the average amount
and weight of Hgb contained in a single erythrocyte.
Normal: 26-34 pg.
Mean Corpuscular Hemoglobin Concentration (MCHC) - answers-Expression of the
average Hgb concentration or proportion of each RBC occupied by Hgb as a
percentage; more accurate measure than MCH.
Normal: 32-36%
,Hypochromic < 32%, normochromic 32-36%, hyperchromic > 36%
Differential for low mean corpuscular volume (MCV) - answers-Iron deficiency anemia
and thalassemia.
Differential for high mean corpuscular volume (MCV) - answers-B12 or folate deficiency
(Megaloblastic anemia), alcoholism, liver failure, and drug effects.
Differential for normal mean corpuscular volume (MCV) - answers-Anemia of chronic
disease, sickle cell, renal failure, blood loss, and hemolysis.
Iron deficiency anemia is what type if anemia? - answers-Microcytic, Hypochromic.
Iron deficiency anemia - answers-A microcytic-hypochromic type of anemia
characterized by iron deficiency that affects the production of hemoglobin and is
characterized by small red blood cells containing low amounts of hemoglobin.
Signs and symptoms of iron deficiency anemia - answers-Usually few symptoms if Hct
is greater than 30. As Hct decreases, symptoms present: pica, dyspnea and mild fatigue
with exercise, HA, palpitations, weakness, tachycardia, postural hypotension, and
pallor.
Laboratory findings in iron deficiency anemia - answers-Low Hgb, low Hct, low MCV,
low MCHC, low RBC, low serum iron, low serum ferritin (iron storage), high TIBC, *high
RDW (red cell distribution width.
*Indicates there is a large difference in size from the largest to smallest RBC.
How is iron deficiency anemia treated - answers-Ferrous sulfate orally 300-325 mg 1-3
hour after meals. Do not take iron supplements with antacids, it can interfere with
absorption. Take with vitamin C containing juices.
Increase iron intake: Raisins, green leafy vegetables, red meats, citrus products, and
iron-fortified bread and cereals.
What type of anemia is thalassemia - answers-Microcytic, hypochromic.
Thalassemia - answers-Genetic inherited disorders resulting in abnormal Hgb
production and microcytic, hypochromic anemia. Mostly found in Mediterranean, African
American, Middle Eastern, Indian, and Asian populations.
Etiology of thalassemia - answers-There is a decreased production of adult hemoglobin
(Hb A); The global part of Hb A has 4 protein sections called polypeptide chains - (1)
two of these chains are called alpha chains and are identical, (2) the other two are
identical but different from the alpha chains, called beta chains.
,What is the most common type of thalassemia - answers-Beta thalassemia
What is the cause of beta thalassemia - answers-There is a reduction or absent
production of beta globin chains.
Thalassemia Minor - answers-Heterozygous form of beta thalassemia; they only have
one copy of the beta thalassemia gene with a normal beta chain gene.
Thalassemia Major (Cooley's Anemia) - answers-Homozygous form of beta
thalassemia; they have two genes for beta thalassemia and no normal beta chain gene.
Signs and symptoms of Thalassemia Major - answers-In early life: failure to thrive,
feeding difficulties, bouts of fever, diarrhea, hepatosplenomegaly and jaundice,
maxillary enlargement.
Laboratory findings in Thalassemia Major - answers-Decreased Hgb, Low MCV, low
MCHC, normal TIBC, normal ferritin, decreased alpha or beta Hgb chains.
Treatment for Thalassemia Major - answers-No treatment for mild or moderate forms;
RBC transfusion/splenectomy for more severe forms; Do not give iron, because of the
possibility of iron overload.
Folic acid deficiency - answers-A microcytic, normochromic anemia (Megaloblastic
anemia) resulting from folic acid deficiency.
What group of people often have folic acid deficiency - answers-Alcoholics; Can be
treated with Folic Acid, Vitamin B1 (Thiamin), and/or a banana bag.
Signs and symptoms of folic acid deficiency - answers-Fatigue, dyspnea on exertion,
pallor, headache, tachycardia, anorexia, and glossitis.
* No neurological changes are noted, which is how B12 deficiency can be differentiated
from folic acid deficiency.
Glossitis - answers-Inflammation of the tongue.
Laboratory findings in folic acid deficiency - answers-Hct and RBC decreased, MCV
elevated (macrocytic), MCHC normal (normochromic), serum folate decreased, red
blood cell folate less than 100 ng/milk
* Normal red blood cell folate 140-628 ng/mL
Treatment for folic acid deficiency - answers-Folate 1 mg orally every day; foods high in
folic acid: bananas, peanut butter, fish, green leafy vegetables, iron-fortified breads and
cereals.
, Sickle Cell Anemia - answers-A genetic disorder that causes abnormal hemoglobin,
resulting in some red blood cells assuming an abnormal sickle shape. Sickle Cell
Anemia affects the African American population.
Cellular hypoxia causes acidosis and tissue ischemia. Pain occurs as a result of the
ischemia and blood hyper viscosity.
Sickle cell anemia crisis symptoms - answers-Sudden severe pain in extremities, back,
chest, and abdomen; aching joint pain; weakness; dyspnea.
What factors can cause sickling of the cells in sickle cell anemia - answers-Hypoxia,
infections, high altitudes, dehydration, physical or emotional stress, surgery, blood loss,
and acidosis.
Laboratory findings in sickle cell anemia - answers-Decreased hemoglobin (carries
oxygen), and peripheral blood smear shows sickle-shaped RBCs.
Treatment for sickle cell anemia - answers-Fluids for dehydration, pain medication
(Deluded), supplemental oxygen for hypoxemia.
Medication used for sickle cell anemia - answers-Hydroxyurea
Von Williebrand Disease - answers-A genetic disorder that results in the reduced ability
to create blood clots; caused by deficiency in von Willebrand factor and clotting factor
VIII (8).
Signs and symptoms of Von Williebrand Disease - answers-Prolonged, frequent, or
severe episode of bleeding; easily bruised.
Treatment for Von Williebrand Disease - answers-Desmopressin (DDAVP), recombinant
von Willebrand factor (VWF)/factor VIII concentrate (exogenous form).
*DDAVP works by making the body release more VWF into the blood. It also helps
increase the level of factor VIII in the blood.
Leukemias - answers-Neoplasm arising from hematopoietic cells in the bone marrow.
More frequently noted in males.
Acute Myelogenous Leukemia (AML) - answers-Constitutes 80% of acute leukemia in
adults, remission rates from 50 to 85%, long-term survival is 40%.
Acute Lymphocytic Leukemia (ALL) - answers-More difficult to cure in adults than
children (90% remission rate in children).
*Hallmark of disease: Pancytopenia with circulation blasts.
Hemoglobin (Hgb) - answers-Main component of RBC's and the essential protein that
combines with and transports O2 to the body.
Males: 14-18 g/100 mL
Females: 12-16 g/100 mL
Hematocrit (Hct) - answers-Measures the percentage of a given volume of whole blood
that is occupied by erythrocytes: the amount of plasma to total RBC mass (RBC
concentration).
Females: 37-47%
Males: 40-54%
Total Iron Binding Capacity (TIBC) - answers-Increased levels indicate iron deficiency
(the greater their TIBC, the greater their need for iron).; Decreased levels may indicate
anemia, hemorrhage, hemolysis.
Normal: 250-450 mcg/dL
Serum iron - answers-Normal: 50-150 ug/dL
Mean Corpuscular Volume (MCV) - answers-Expression of the average volume and
size of individual erythrocytes.
Normal: 80-100 um3
Microcytic = < 80, Normocytic = 80-100, and Macrocytic = > 100.
Mean Corpuscular Hemoglobin (MCH) - answers-Expression of the average amount
and weight of Hgb contained in a single erythrocyte.
Normal: 26-34 pg.
Mean Corpuscular Hemoglobin Concentration (MCHC) - answers-Expression of the
average Hgb concentration or proportion of each RBC occupied by Hgb as a
percentage; more accurate measure than MCH.
Normal: 32-36%
,Hypochromic < 32%, normochromic 32-36%, hyperchromic > 36%
Differential for low mean corpuscular volume (MCV) - answers-Iron deficiency anemia
and thalassemia.
Differential for high mean corpuscular volume (MCV) - answers-B12 or folate deficiency
(Megaloblastic anemia), alcoholism, liver failure, and drug effects.
Differential for normal mean corpuscular volume (MCV) - answers-Anemia of chronic
disease, sickle cell, renal failure, blood loss, and hemolysis.
Iron deficiency anemia is what type if anemia? - answers-Microcytic, Hypochromic.
Iron deficiency anemia - answers-A microcytic-hypochromic type of anemia
characterized by iron deficiency that affects the production of hemoglobin and is
characterized by small red blood cells containing low amounts of hemoglobin.
Signs and symptoms of iron deficiency anemia - answers-Usually few symptoms if Hct
is greater than 30. As Hct decreases, symptoms present: pica, dyspnea and mild fatigue
with exercise, HA, palpitations, weakness, tachycardia, postural hypotension, and
pallor.
Laboratory findings in iron deficiency anemia - answers-Low Hgb, low Hct, low MCV,
low MCHC, low RBC, low serum iron, low serum ferritin (iron storage), high TIBC, *high
RDW (red cell distribution width.
*Indicates there is a large difference in size from the largest to smallest RBC.
How is iron deficiency anemia treated - answers-Ferrous sulfate orally 300-325 mg 1-3
hour after meals. Do not take iron supplements with antacids, it can interfere with
absorption. Take with vitamin C containing juices.
Increase iron intake: Raisins, green leafy vegetables, red meats, citrus products, and
iron-fortified bread and cereals.
What type of anemia is thalassemia - answers-Microcytic, hypochromic.
Thalassemia - answers-Genetic inherited disorders resulting in abnormal Hgb
production and microcytic, hypochromic anemia. Mostly found in Mediterranean, African
American, Middle Eastern, Indian, and Asian populations.
Etiology of thalassemia - answers-There is a decreased production of adult hemoglobin
(Hb A); The global part of Hb A has 4 protein sections called polypeptide chains - (1)
two of these chains are called alpha chains and are identical, (2) the other two are
identical but different from the alpha chains, called beta chains.
,What is the most common type of thalassemia - answers-Beta thalassemia
What is the cause of beta thalassemia - answers-There is a reduction or absent
production of beta globin chains.
Thalassemia Minor - answers-Heterozygous form of beta thalassemia; they only have
one copy of the beta thalassemia gene with a normal beta chain gene.
Thalassemia Major (Cooley's Anemia) - answers-Homozygous form of beta
thalassemia; they have two genes for beta thalassemia and no normal beta chain gene.
Signs and symptoms of Thalassemia Major - answers-In early life: failure to thrive,
feeding difficulties, bouts of fever, diarrhea, hepatosplenomegaly and jaundice,
maxillary enlargement.
Laboratory findings in Thalassemia Major - answers-Decreased Hgb, Low MCV, low
MCHC, normal TIBC, normal ferritin, decreased alpha or beta Hgb chains.
Treatment for Thalassemia Major - answers-No treatment for mild or moderate forms;
RBC transfusion/splenectomy for more severe forms; Do not give iron, because of the
possibility of iron overload.
Folic acid deficiency - answers-A microcytic, normochromic anemia (Megaloblastic
anemia) resulting from folic acid deficiency.
What group of people often have folic acid deficiency - answers-Alcoholics; Can be
treated with Folic Acid, Vitamin B1 (Thiamin), and/or a banana bag.
Signs and symptoms of folic acid deficiency - answers-Fatigue, dyspnea on exertion,
pallor, headache, tachycardia, anorexia, and glossitis.
* No neurological changes are noted, which is how B12 deficiency can be differentiated
from folic acid deficiency.
Glossitis - answers-Inflammation of the tongue.
Laboratory findings in folic acid deficiency - answers-Hct and RBC decreased, MCV
elevated (macrocytic), MCHC normal (normochromic), serum folate decreased, red
blood cell folate less than 100 ng/milk
* Normal red blood cell folate 140-628 ng/mL
Treatment for folic acid deficiency - answers-Folate 1 mg orally every day; foods high in
folic acid: bananas, peanut butter, fish, green leafy vegetables, iron-fortified breads and
cereals.
, Sickle Cell Anemia - answers-A genetic disorder that causes abnormal hemoglobin,
resulting in some red blood cells assuming an abnormal sickle shape. Sickle Cell
Anemia affects the African American population.
Cellular hypoxia causes acidosis and tissue ischemia. Pain occurs as a result of the
ischemia and blood hyper viscosity.
Sickle cell anemia crisis symptoms - answers-Sudden severe pain in extremities, back,
chest, and abdomen; aching joint pain; weakness; dyspnea.
What factors can cause sickling of the cells in sickle cell anemia - answers-Hypoxia,
infections, high altitudes, dehydration, physical or emotional stress, surgery, blood loss,
and acidosis.
Laboratory findings in sickle cell anemia - answers-Decreased hemoglobin (carries
oxygen), and peripheral blood smear shows sickle-shaped RBCs.
Treatment for sickle cell anemia - answers-Fluids for dehydration, pain medication
(Deluded), supplemental oxygen for hypoxemia.
Medication used for sickle cell anemia - answers-Hydroxyurea
Von Williebrand Disease - answers-A genetic disorder that results in the reduced ability
to create blood clots; caused by deficiency in von Willebrand factor and clotting factor
VIII (8).
Signs and symptoms of Von Williebrand Disease - answers-Prolonged, frequent, or
severe episode of bleeding; easily bruised.
Treatment for Von Williebrand Disease - answers-Desmopressin (DDAVP), recombinant
von Willebrand factor (VWF)/factor VIII concentrate (exogenous form).
*DDAVP works by making the body release more VWF into the blood. It also helps
increase the level of factor VIII in the blood.
Leukemias - answers-Neoplasm arising from hematopoietic cells in the bone marrow.
More frequently noted in males.
Acute Myelogenous Leukemia (AML) - answers-Constitutes 80% of acute leukemia in
adults, remission rates from 50 to 85%, long-term survival is 40%.
Acute Lymphocytic Leukemia (ALL) - answers-More difficult to cure in adults than
children (90% remission rate in children).
*Hallmark of disease: Pancytopenia with circulation blasts.
