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Hematologic ProblemsMedical Surgical Nursing

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What is the underlying cause of the clinical manifestations of anemia?
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Hypoxia
What is used as the primary measurement of the severity of anemia?
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Hemoglobin levels (Hgb) Mild-10-14 Moderate-6-10 Severe-less than 6
What are the three main causes of anemias caused by decreased erythrocyte production?
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-Less hemoglobin is made (iron-deficiency, thalassemia, sideroblastic anemias) -defective DNA synthesis in RBCs (usually nutritional deficiency of B12 or folic acid). Megaloblastic anemias -low numbers of erythrocyte precursors (aplastic anemia, chroni
What is the most common, chronic hematologic disorders in the world?
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Iron-deficiency anemia
Who is most susceptible to iron-deficiency anemia? (3)
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-the very young -those with poor diets -women in their reproductive years
What hematologic disorder can develop from disease or removal of the duodenum?
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Anemia, namely iron-deficiency anemia...this is where dietary iron is absorbed
What is the major cause of iron deficiency anemia in adults?
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GI (ulcers, diverticuli, gastritis, etc.) or GU bleeds (menstruation)
What are the symptoms associated with iron-deficiency anemia?
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Pallor, glossitis, cheilitis (lips inflammation), headache, parathesias, burning tongue
Which type of iron supplements are best for the treatment of iron-deficiency anemia, enteric coated/sustained release or uncoated?
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Uncoated, if it's delayed release it is digested in the wrong place for optimal absorption
What can enhance absorption of an iron supplement?
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Taking one hour before meals, with orange juice
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Which type of iron is best absorbed, ferrous sulfate or ferrous gluconate?
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Ferrous sulfate
For a patient who is on iron supplements, what else should they be instructed to take?
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Stool softeners or laxatives
What are the special considerations and instructions for the administration of parenteral iron?
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It can be given IM or IV. Separate needles are used for withdrawing it and injecting it, and 0.5 mL of air should remain in the syringe to clear the iron completely out. No more than 2 mL per injection, use Z track, no massage afterwards. Inject into upper outer quadrant of the buttocks. IV: don't mix or dilute, admin at 1ml/min, saline flush line
How long after hemoglobin levels return to normal should a patient with iron-deficiency anemia continue to take iron?
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2-3 months
When should a patient be administered parenteral iron?
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If they have a malabsorption syndrome, intolerance of oral iron, need beyond oral limits or are non-compliant in oral therapy
_________ is a group of disease that have an autosomal recessive genetic basis involving inadequate production of normal hemoglobin and hemolysis.
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Thalassemia
What ethnicities or areas of origin are prone to developing Thalassemia?
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Middle Eastern, Asia, Africa
What is the difference between thalassemia minor and thalassemia major?
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Minor-heterozygous expression, milder form. Major: Homozygous genes, severe
What is the clinical maifestation of Thalassemia major?
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Physical and mental retardation, pallor, hepatomegaly, splenomegaly, jaundice, thickened cranial and maxillary cavities.
What is the clinical manifestation of Thalassemia minor?
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Mild to moderate anemia with microcytosis (small cells) and hypochromia (pale cells)
  
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