Patho & Pharmacology I

ron Deficiency Anemia: Causes & Risk Factors

-demographic -social -diet

RBC demise

-spleen removes aged, lysed, and dead RBCs from circulation -broken down into component parts (iron and bilirubin) -recycled to make new RBCs, stored in liver, or secreted as waste -excess may cause problems for liver, spleen

foods that impair iron absorption

-tea, cereal products containing phytates

55% liquid component (plasma) are made up of

-water, antibodies& proteins, nutrients , waste products

Stages of Erythropoiesis

1. Hematopoietic stem cell 2. Myeloid stem cell 3. Proerythroblast 4. Basophilic erythroblasts 5. Polychromatic erythroblasts 6. Orthochromatic erythroblasts 7. Reticulocytes 8. Mature erythrocyte

Polycythemia

A disorder characterized by an abnormal increase in the number of red blood cells in the blood

Anemia

A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.

Which of the following situations would result in the release of erythropoietin?

A patient with lung disease and chronic hypoxia

red blood cells

Blood cells that carry oxygen from the lungs to the body cells.

functions of folate

DNA synthesis, forms RBC in bone marrow, prevents neural tube defects

Anemia Etiology

Decreased RBC production Iron deficiency Aplastic Blood loss Erythrocyte destruction Sickle cell Hemolytic

A person who is planning to become pregnant should ensure that they receive adequate levels of which supplement to reduce the risk for fetal neural tube defects?

Folic acidFolic acid

Non-haem iron

Found in beans, nuts, wholemeal foods, less easily absorbed by the body

Haem iron

Found in meat and easily absorbed by the body

isufficient RBC production

Iron deficiency, folic acid deficiency, pernicious anemia, aplastic anemia, chronic renal failure

Insufficient iron for hemoglobin synthesis

Leads to production of abnormally small RBCs that are unable to carry sufficient O2 to tissue •Hypochromic, microcytic RBCs •Low MCV, MCH, and MCHC •Serum ferritin level decreased •Serum iron level decreased •Total iron binding capacity (TIBC) increased

45% cellular components are made up of

Leukocytes (WBCs) Thromobcytes (Plts) Erythrocytes (RBCs)

Two stages of hematopoiesis

Mitosis (proliferation) Maturation (differentiation)

The nurse is teaching a patient with iron-deficiency anemia about foods to increase iron intake. Which food may enhance the absorption of oral iron forms?

Orange juice

general s/s of anemia

Pica (crabing for nonfood substances such as dirt) Koilonychias (spoon-shaped nails) Blue sclerae

Erythorpoiesis

The making of RBC through a hormone EPO that stimulates cells to become RBC from progenitor stem cells in bone marrow When EPO stimulates it hemoglobin will be transcribed and causes a proerythroblast cell to form

sickle cell anemia

a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape

RBC disorders

anemia and polycythemia

iron deficiency anemia

anemia resulting when there is not enough iron to build hemoglobin for red blood cells

Hematopoiesis

blood cell formation

Foods that enhance iron absorption

citrus fruits, tomatoes, chili peppers

complete blood count (CBC)

comprehensive blood test that includes red blood cell count (RBC), white blood cell count (WBC), hemoglobin (Hgb), hematocrit (Hct), white blood cell differential, and platelet count

aplastic anemia

failure of blood cell production in the bone marrow

Red blood cells differ from other cell types in the body, because they

have no cytoplasmic organelles

Reticulocytes are

immature RBCs

Folic Acid Deficiency Anemia

inability to produce sufficient red blood cells due to the lack of folic acid, a B vitamin essential for erythropoiesis

Thalassemia

inherited defect in ability to produce hemoglobin, leading to hypochromia

The most appropriate treatment for secondary polycythemia

interventions to improve oxygenation

Pernicious anemia is caused by a lack of

intrinsic factor

The primary source of erythropoietin is the

kidney

Where is RBC made?

red bone marrow

hemolytic anemia

reduction in red cells due to excessive destruction

Erythrocytes (Red Blood Cells)

transport oxygen and carbon dioxide

Vitamine B12 anemia

•Causes disruption in DNA synthesis of blast cells •RBCs cannot be properly synthesized •Leads to deformed, abnormally large RBCs with poor O2-carrying capacity

Treat underlying cause Monitor for Fe Replacement SE

•Nausea, vomiting, diarrhea, constipation, stomach cramps and pain •Causes black, tarry stools •Liquid oral preparations may stain teeth •IV forms: pain upon injection, orthostatic hypotension Beware of Iron toxicity!!