NURS 6202 Exam 2 Anemia, Leukemia,
Cancer, Transplant, Head Injury with
complete solution
Iron deficiency anemia s/s
Pallor, glossitis (inflammation of tongue), cheilitis (inflammation of lips), HA,
paresthesia's, burning sensation of tongue
Where is iron absorbed? What type is contraindicated?
Iron is absorbed in the duodenum and proximal jejunum. Enteric coated or
sustained release are contraindicated as they release further down the GI tract.
How should I take my iron supplement?
Best before meals acidic environment, can stain teeth, dilute with straw. Start
with one a day and build up to 2-3
What are side effects of taking iron supplements?
Stomach upset, heartburn, constipation, diarrhea
How long will it take to see Hbg or Hct improvement?
90 days, sometimes 120
Cobalamin and Folic acid deficiency similar s/s
both insidious onset, sore, red, beefy, shiny tongue, anorexia, N/V, abd pain,
weakness, paresthesia's feet/hands, ataxia, dementia like confusion. Folic is
abscence of neuro
Sickle cell s/s
pallor, jaundice, pain
Cobalamin B12 think
neuropathy, stocking glove neuropathy
Iron deficiency think
pale, tired
Folic acid think
early graying of the hair
Folic acid deficiency other s/s
, absence of Neuro s/s
What is aplastic anemia?
Pancytopenia- decrease of all blood cells, T cells target and destroy cells
Hemolytic anemia s/s
jaundice, increased bilirubin, hepatosplenomegaly (spleen, liver) enlarged d/t
macrophage phagocytosis.
What symptoms would you see in mild anemia?
Palpitations, dyspnea, fatigue
Moderate anemia s/s
bounding pulses, fatigue, dyspnea, "roaring in ears"
Severe anemia s/s?
tachycardia, increased pulse P, systolic murmur, int. claudication, angina, HF, MI,
blurry vision, anorexia, hepatosplenomegaly, sore mouth, dysphagia, weight loss,
lethargy, cold sensitivity, pallor, jaundice, pruritus, glossitis, smooth tongue,
bone pain, tachypnea, orthopnea, dyspnea at rest, HA, vertigo, irritable,
depressed, impaired thought process
Why does anemia often go unrecognized in the older adult?
Often mistaken for normal aging changes, or overlooked d/t other health
conditions, look for confusion, ataxia, pallor, CVD and respiratory issues
Pain management for sickle cell
Patient priority is pain treatment! try not to send home with narcotics,
preventative-Hydrea-anti-sickling, treatment(only cure)- stem cell transplant,
vaccinated, folic acid, flu shots, hydrate! avoid high altitudes, counseling and
support groups, educate!
What is MCV?
Size
What is MCH?
Color
What is an RDW?
Red cell distribution width, far they are spaced out, if its high can indicate iron
deficiency
Mild anemia
Hgb 10-12
Moderate Hgb
8-10
Severe anemia Hgb
under 6
GI bleed on a lab will look like what?
Low Hgb Hct, normal or low MCV/MCH
What is the normal blood platelet count?
normal 150-400
Cancer, Transplant, Head Injury with
complete solution
Iron deficiency anemia s/s
Pallor, glossitis (inflammation of tongue), cheilitis (inflammation of lips), HA,
paresthesia's, burning sensation of tongue
Where is iron absorbed? What type is contraindicated?
Iron is absorbed in the duodenum and proximal jejunum. Enteric coated or
sustained release are contraindicated as they release further down the GI tract.
How should I take my iron supplement?
Best before meals acidic environment, can stain teeth, dilute with straw. Start
with one a day and build up to 2-3
What are side effects of taking iron supplements?
Stomach upset, heartburn, constipation, diarrhea
How long will it take to see Hbg or Hct improvement?
90 days, sometimes 120
Cobalamin and Folic acid deficiency similar s/s
both insidious onset, sore, red, beefy, shiny tongue, anorexia, N/V, abd pain,
weakness, paresthesia's feet/hands, ataxia, dementia like confusion. Folic is
abscence of neuro
Sickle cell s/s
pallor, jaundice, pain
Cobalamin B12 think
neuropathy, stocking glove neuropathy
Iron deficiency think
pale, tired
Folic acid think
early graying of the hair
Folic acid deficiency other s/s
, absence of Neuro s/s
What is aplastic anemia?
Pancytopenia- decrease of all blood cells, T cells target and destroy cells
Hemolytic anemia s/s
jaundice, increased bilirubin, hepatosplenomegaly (spleen, liver) enlarged d/t
macrophage phagocytosis.
What symptoms would you see in mild anemia?
Palpitations, dyspnea, fatigue
Moderate anemia s/s
bounding pulses, fatigue, dyspnea, "roaring in ears"
Severe anemia s/s?
tachycardia, increased pulse P, systolic murmur, int. claudication, angina, HF, MI,
blurry vision, anorexia, hepatosplenomegaly, sore mouth, dysphagia, weight loss,
lethargy, cold sensitivity, pallor, jaundice, pruritus, glossitis, smooth tongue,
bone pain, tachypnea, orthopnea, dyspnea at rest, HA, vertigo, irritable,
depressed, impaired thought process
Why does anemia often go unrecognized in the older adult?
Often mistaken for normal aging changes, or overlooked d/t other health
conditions, look for confusion, ataxia, pallor, CVD and respiratory issues
Pain management for sickle cell
Patient priority is pain treatment! try not to send home with narcotics,
preventative-Hydrea-anti-sickling, treatment(only cure)- stem cell transplant,
vaccinated, folic acid, flu shots, hydrate! avoid high altitudes, counseling and
support groups, educate!
What is MCV?
Size
What is MCH?
Color
What is an RDW?
Red cell distribution width, far they are spaced out, if its high can indicate iron
deficiency
Mild anemia
Hgb 10-12
Moderate Hgb
8-10
Severe anemia Hgb
under 6
GI bleed on a lab will look like what?
Low Hgb Hct, normal or low MCV/MCH
What is the normal blood platelet count?
normal 150-400
