NR 283 Concept Review Exam 3 PATHO STUDY GUIDE

NR 283 Concept Review Exam 3 PATHO STUDY GUIDE **Please be sure to study etiology, clinical manifestations and complications, pathophysiology of the following topics: Hematology RBC-function- Erythrocytes (or RBC’s) are the most abundant cell type in the body • Its primary job is tissue oxygenation • The cell has 2 unique properties: o A biconcave shape which makes it optimal for gas transport o The capacity to be reversible deformed. The cells can change shape to make it through all the different size vessels in the body • Erythrocytes have a lifespan of 120 days • Hemoglobin is the oxygen carrying protein of the erythrocyte that gives RBC’s their color • Each erythrocyte has over 300 hemoglobin molecules; 1 HGB can carry 4 oxygen molecules Erythropoiesis is the creation of erythrocytes from the bone marrow Erythropoietin-produced, what does it do- Erythropoietin is the hormone that stimulates the production of erythrocytes. o It is produced by the kidneys Epogen (epoetin alpha) is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and not on dialysis to decrease the need for red blood cell (RBC) transfusion Anemias-types/ S/S of each- Anemia is a decreased total number of erythrocytes or a decrease in the quality or quantity of hemoglobin • Causes of anemia are: o Impaired erythrocyte production o Acute or chronic blood loss o An increase in the destruction of erythrocytes o A combination of all 3 Types of anemia • pernicious anemia -It is caused by a vitamin b12 deficiency • The main problem is the absence of intrinsic factor which is an enzyme needed to absorb vitamin b12 in the stomach • Absence of this factor can be genetic or can be related to problems with the stomach • P.A. is most commonly caused by people who have had their stomach or a part of their stomach removed, however a history of alcohol use or smoking can cause it as well • PA takes years to develop so initial symptoms can be very non-specific • When your hemoglobin starts to be affected (when it decreases) symptoms include weakness, fatigue, and paresthesia’s of feet and hands folate deficiency anemia • Folate is another vitamin necessary for DNA synthesis of erythrocytes • Folate deficiency anemia is commonly seen in alcoholics and malnourished people • With this type, there is no enzyme responsible for making sure we absorb the folate. We are strictly lacking an adequate amount • Folate is found in dark, leafy green vegetables, citrus fruits, beans and nuts o Folic acid is a synthesized form of folate • Clinical manifestations include: o Cheilosis - fissures and scales in the mouth o Stomatitis- inflammation of the mouth painful ulcers of the tongue Iron deficiency anemia- is the most common type of anemia • There are many causes, including insufficient iron in the diet, certain medications, excessive menstrual bleeding in females, or ulcer’s • Iron is important because it is used for the production of HGB • The development occurs slowly through 3 stages: o Body’s iron stores are depleted. Normal blood cell production occurs o Now insufficient amounts of iron are transported to the marrow where iron deficit RBC’s are produced with low amounts of HGB o The HGB deficient cells enter circulation to replace the normal aging cells that are getting ready to die • Clinical manifestations start occurring at stage 3 • Early symptoms are non-specific including fatigue, weakness, and SOB • As it become more severe, clinical manifestations can include: o Koilonychias - the fingernails become brittle and concave or spoon shaped o the tongue becomes sore and reddened o the corners of the mouth become dry and sore