anemia

When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that all leukemias have which common feature?

Unregulated accumulation of white cells in the bone marrow, which replace normal marrow

A client with sepsis is experiencing disseminated intravascular coagulation (DIC). The client is bleeding from mucous membranes, venipuncture sites, and the rectum. Blood is present in the urine. The nurse establishes the nursing diagnosis of Risk for deficient fluid volume related to bleeding. The most appropriate and measurable outcome for this client is that the client exhibits

Urine output greater than or equal to 30 mL/hour

what should you tell the patient to avoid with any of these anemia

alcohol

Erythropoietin Deficiency effects of long term hemodialysis

also lose blood into dialyzer causing iron deficiency, folic acid deficiency develops, folate passess into dialysate

why is fatigue the most common side effect of anemia

b/c due to not enough RBC in the body there is not enough oxygen getting through the organs to function

Sickle Cell Disease cardiac issues

cardiomegaly tachycardia cardiac murmurs

iron deficiency anemia Medical management

cause stool occult oral supplementation history

sickle cell clogged blood vessels

causes heart failure organ failure chronic pain

patients with B12 deficiency become

confused paresthesia Difficulty maintaining balance

Iron supplement side effects

constipation cramping black stool

Erythropoietin Deficiency

directly related to renal function pts on dialysis kidney disease

primary treatment of iron deficiency anemia

give oral supplement ( 6-12 months ) Instruct pt to increase iron in diet PO iron on empty stomach to enhance absorption may have to gradually increase dose to prevent stomach cramping

Blood loss anemia

hererage - trauma - GI bleed - Child birth

nursing interventions B12 & Folic acid deficiency

inspect skin, musoc membrane, tongue Mild jaundice * Neuro assessment * Gait assessment

The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned the co-worker may have?

iron deficiency anemia explanation: People with iron deficiency anemia may crave ice, starch, or dirt; this craving is known as pica.

Folic Acid deficiency

lack of veggie intake alcoholism liver disease pregnancy celiac disease

Erythropoietin Deficiency what can raise, maintain HCT levels

parenteral erythropoietin ( epogen, procrit) in combination with oral iron supplements

B12 deficiency anemia

patients who follow a vegan diet patients with GI surgerys

iron deficiency anemia

results from blood lost alcohol disorders excessive use of Aspirin and NSAIDS lack of intake of iron ( cannot adequately synthesis hemoglobin)

iron deficiency anemia clinical manifestations

smooth red tongue brittle / ridged nails fatigue pale skin short of breath

what have a pt. develop with Pernicious Anemia

smooth sore red tongue mild diarrhea extreme pale skin in the mucous membrane

A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms?

"Eat small amounts of bland, soft foods frequently."

A female patient has a hemoglobin of 6.4 g/dL and is preparing to have a blood transfusion. Why would it be important for the nurse to obtain information about the patient's history of pregnancy prior to the transfusion?

A high number of pregnancies can increase the risk of reaction.

A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, which action should the nurse take?

Administer the prescribed enoxaparin (Lovenox)

A nurse caring for a client who has hemophilia is getting ready to take the client's vital signs. What should the nurse do before taking a blood pressure?

Ask if taking a blood pressure has ever produced bleeding under the skin or in the arm joints.

A client in end-stage renal disease is prescribed epoetin alfa and oral iron supplements. Before administering the next dose of epoetin alfa and oral iron supplement, what is the priority action taken by the nurse?

Assesses the hemoglobin level

A nurse cares for a client with anemia requiring nutritional supplementation. Which nursing intervention best promotes client adherence with the prescribed therapy?

Assist the client to incorporate the therapeutic regimen into daily activities.

When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods?

Beans, dried fruits, and leafy, green vegetables

Which of the following are assessment findings associated with thrombocytopenia? Select all that apply.

Bleeding gums Epistaxis Hematemesis

A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from? Select all that apply.

Blood loss Abnormal erythrocyte production Destruction of normally formed red blood cells

Which is a symptom of hemochromatosis?

Bronzing of the skin

A client with multiple myeloma reports pain along the spinal column. The client is prescribed naproxen (Aleve) and oxycodone. Prior to administering these medications, the nurse

Checks the client's BUN and creatinine

The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption?

Eating calf's liver with a glass of orange juice

A client is receiving chemotherapy for cancer. The nurse reviews the client's laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority?

Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI

Destruction Hemolytic anemia Sickle Cell Disease

Inheritance of sickle hemoglobin gene - cells clump together become sickled - causes fever , chronic pain, swelling - changes shape when exposed to low oxygen - Bone marrow expanding - african american community

A client with a diagnosis of pernicious anemia comes to the clinic and reports numbness and tingling in the arms and legs. What do these symptoms indicate?

Neurologic involvement

The nurse provides care for an older adult client, diagnosed with anemia, who has a hemoglobin of 9.6 g/dL and a hematocrit of 34%. To determine the cause of the client's blood loss, which is the priority nursing action?

Observe the client's stools for blood.

A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. The client is taking prednisone daily and reported feeling pain after manually opening the garage door. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain?

Osteoporosis

A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?

Pallor, tachycardia, and a sore tongue

B12 deficiency anemia absence of Intrinsic factor also impair vit B12 absorption referred to as

Pernicious Anemia

Which of the following is considered an antidote to heparin?

Protamine sulfate

A pregnant woman is hospitalized as the result of sickle-cell crisis. Which finding indicates the outcome has been achieved for this client?

Reports joint pain less than 3 on a scale of 0 to 10

A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron?

Rich sources of vitamin C

The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for?

Schilling test

what is the test for B12

Schilling test

A client with a pulmonary embolism is being treated with a heparin infusion. What diagnostic finding suggests to the nurse that treatment is effective?

The client's activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value.

A few minutes after beginning a blood transfusion, a nurse notes that a client has chills, dyspnea, and urticaria. The nurse reports this to the health care provider immediately because the client probably is experiencing which problem?

A hemolytic allergic reaction caused by an antigen reaction

The nurse is providing education to a client with cancer radiation treatment options. The nurse determines that the client understands the teaching when the client states that which type of radiation aims to protect healthy tissue during the treatment?

Brachytherapy

A patient with chronic renal failure is examined by the health care provider for anemia. Which laboratory results will the nurse monitor?

Decreased level of erythropoietin

A nurse is reviewing the various manifestations of anemia across the lifespan and notes a significant difference in how the older adult client responds to anemia versus a younger individual. Which concepts related to aging and the response to anemia does the nurse recognize? Select all that apply.

Fatigue is often greater than in younger clients. Heart rate does not increase as much as in younger clients. Confusion is often greater than in younger clients.

During the review of morning laboratory values for a client reporting severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which finding?

Low ferritin level concentration

Complications of sickle cell triggers

lead to sickle cell exasperation - can make cells more sickled - can be triggered by cold bc of vasoconstriction that slows blood flow

The registered nurse (RN) and licensed practical nurse (LPN) are preparing an educational program for clients who may be at risk for the development of iron-deficiency anemia. Which client(s) would receive the greatest benefit from this program? Select all that apply.

An adolescent with bulimia nervosa An older adult client on a fixed income A client with Crohn's disease

A male client has a hemoglobin count of 10.2 gm/dl, a hematocrit value of 36%, and a low ferritin level. What question should the nurse ask first?

Have you experienced abdominal pain?

A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia?

Creatinine level of 6 mg/100 mL

A nurse is caring for a client with iron deficiency anemia. Which food or beverage will the nurse suggest to the client to eat or drink when taking supplemental iron?

Orange juice

A nurse is doing a physical examination of a child with sickle cell anemia. When the child asks why the nurse auscultates the lungs and heart, what would be best the response by the nurse?

To detect the abnormal sounds suggestive of acute chest syndrome and heart failure