NUR 324 Anemia Test Study Guide

Anemia
- Anemia
o Major pathophysiological condition affecting RBCs
o Defined as a decreased RBC mass that becomes clinically apparent when levels of
Hgb and hematocrit (Hct) are less than normal
o A complete blood count (CBC) measures all RBCs and RBC characteristics
o Different types of anemia produce different CBC results
o Causes include…
 Decreased RBC production
 Increased RBC destruction
 Blood loss
- Complete blood count (CBC)
o Includes…
 Hemoglobin (Hgb)
 Hematocrit (Hct): percentage of blood made up of RBCs
 Number of RBCs
 Reticulocyte Count: indicates bone marrow activity
 Measures the number of new RBCs in the blood and helps to
determine whether the bone marrow is producing new RBCs at an
appropriate rate
 Increased reticulocyte numbers associated with anemia suggested
accelerated destruction or loss of RBCs
 Normal reticulocyte count is approx. 1% of total RBCs
o Mean Corpuscular Volume (MCV): indicates size of RBC
o Mean Corpuscular Hemoglobin (MCH): indicates color of RBC
o Mean Corpuscular Hemoglobin Concentration (MCHC): indicates color of
RBC
- Cannot make the diagnosis of anemia looking only at hemoglobin and hematocrit
- Diagnosing anemia
o Lab studies
 CBC
 Peripheral blood smear
 Iron
 Folic acid
 Bone marrow aspiration and/or biopsy
o Echocardiogram
o Electrocardiogram (ECG)
o Additional diagnostic tests are based on type of anemia
 Fecal occult blood test
 Vitamin B12 levels
- RBC size and color

, o Normal
o Microcytic = small in size
o Macrocytic = larger in size
o Hypochromic = loss of color
- Polycythemia
o Described as the opposite of anemia
o Overabundance of RBCs
o Primary Polycythemia: hyperproliferation of all blood cells
 Blood becomes viscous and required periodic phlebotomy
o Secondary Polycythemia: more common; a hyperproliferation of the RBCs in
response to chronic blood hypoxia (COPD)


- Anemia caused by acute blood loss
o The adult can usually lose 500 mL of blood without serious or lasting effects
o If the loss reaches 1,000 mL or more, serious adverse effects such as hypovolemic
shock and cerebral hypoperfusion can occur
o Acute blood loss is a rapid loss of blood as in hemorrhage caused by trauma,
childbirth, rupture of a major blood vessel, or organ
o Severe GI bleeding can occur in disorders such as esophageal varices or
penetrating peptic ulcer
o Pathophysiology includes…
 The lack of sufficient number of RBCs to carry oxygen causes tissue
hypoxia  kidney  erythropoietin  bone marrow starts to synthesize
RBCs
 Baroreceptors sense decreased BP  stimulation of the sympathetic
nervous system causing arterial vasoconstriction
 Simulation of the RAAS
 Antidiuretic hormone (ADH) release
- Blood loss from GI tract
o Patients bleeding because of esophageal varices often exhibit hematemesis
o Coffee ground emesis is blood mixed with stomach acid and mucus in vomitus
o Melena is blood mixed in stool = dark, tarry stool
- Chronic slow blood loss
o Most common causes include…
 Peptic ulcer
 Inflammatory bowel disease
 Colon cancer
 Menorrhagia = excessive monthly menstrual loss
- Subjective
o O2 carrying capacity is reduced which leads to the hypoxia of the tissues