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Summary NURS 3320 Exam 2 Study Guide

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This is a comprehensive and detailed study guide on Exam 2 for Nurs 3320. An Essential Study Resource just for YOU!?

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Pathophysiology Exam 2 Blueprint


Chapter 10
1. Define the terms describing abnormalities in the blood.
This is a general objective that simply means the term definitions in the beginning of the
chapter are key to understanding the chapter content.
 Hematocrit—percent by volume of cellular elements in blood—essentially erythrocytes
 Hemoglobin—amount of hemoglobin per unit volume of blood
o Mean corpuscular volume (MCV)—indicates oxygen carrying capacity of blood
 Hematopoiesis—development of blood cells from a single stem cell
o Erythropoiesis—production of RBCs
o Leukopoiesis—production of WBCs
o Thrombopoiesis—production of platelets
 Erythropoietin (EPO)—hormone that originates from the kidneys which stimulates RBC
production in the red bone marrow in response to tissue hypoxia
 Hemostasis—process of stopping bleeding
o Intrinsic (activated by endothelial injury IN blood vessel) and extrinsic pathways
(activated by tissue and platelet injury)
 Pancytopenia—decrease in RBCs, WBCs, and platelets in the blood
 Leukopenia—a decrease in WBCs
 Leukocytosis—an increase in WBCs
 Dyspnea—increased effort to breathe
 Pallor—pale face
 Microcytic—blood cells are smaller
o Occurs in iron-deficient anemia and thalassemia
 Macrocytic—blood cells are large
o Occurs in pernicious anemia
 Petechiae—flat, red, pinpoint hemorrhages on the skin
2. Describe and compare the pathophysiology, etiology, manifestations, diagnostic tests,
and treatment for each of the selected anemias: iron-deficiency, pernicious, aplastic, sickle
cell, and thalassemia.
The key is to be able to differentiate between these anemia
Iron deficiency anemia
 Pathophysiology
o Insufficient iron impairs hemoglobin synthesis (iron sits on hemoglobin to change
its structure)
o Microcytic, hypochromic RBCs—result of low hemoglobin concentration in cells
 Etiology (cause)

, o Dietary intake, chronic blood loss, duodenal absorption, severe liver disease,
infections and cancers
 Signs and symptoms
o Pallor of the skin, fatigue, lethargy, irritability, degenerative changes (brittle hair
and ridged nails)
o Stomatitis and glossitis, inflammation in the mucosa and tongue
o Delayed healing and tachycardia, heart palpitations, dyspnea (shortness of breath),
possible fainting as the anemia becomes more severe
 Diagnostic tests and treatment
o Lab tests demonstrate low values for hemoglobin and hematocrit. On microscopic
examination the erythrocytes appear hypochromic and microcytic
o Underlying cause must be identified and resolved if possible, treatment and
prognosis depend on cause.
o Iron rich foods/supplements may be administered
Pernicious anemia—Vitamin B12 Deficiency
 Pathophysiology
o Lack of absorption of vitamin B12 due to lack of intrinsic factor secreted by
gastric mucosa
o Parietal cells can no longer produce hydrochloric acid which occurs with the
atrophy of the mucosa, resulting in a low level/absence of acid in gastric
secretions—achlorhydria
o Deficit of B12 absorption leads to impaired maturation of erythrocytes owing to
interference with DNA synthesis
 Etiology
o Most common cause of vitamin B12 deficiency is malabsorption
 Surgical procedures as gastrectomy also result as an outcome
o Dietary insufficiency is rare as the source of B12 is animal foods
 Vegans/vegetarians need to include a B12 fortified food in daily intake
 Signs and symptoms
o Tongue enlarged, red, sore and shiny
o Digestive discomfort
o Paresthesia in the extremities or loss of coordination and ataxia
 Diagnostic tests
o Megaloblastic on microscopic examination, marrow is hyperactive, vitamin B12
level and the presence of hypochlorhydria or achlorhydria
 Treatment
o Oral supplements, injections and replacement therapy

Aplastic anemia
 Pathophysiology

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