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NR 283 Exam 3 Concept Review, NR 283: Pathophysiology, Chamberlain College of Nursing $10.99   Add to cart

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NR 283 Exam 3 Concept Review, NR 283: Pathophysiology, Chamberlain College of Nursing

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NR 283 Exam 3 Concept Review, NR 283: Pathophysiology, Chamberlain College of Nursing

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  • May 5, 2023
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NR 283 Exam 3 Concept Review / NR283 Pathophysiology Exam 3 Study Guide (Latest):
Pathophysiology: Chamberlain




NR 283 Concept Review Exam 3
**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

Sideroblastic anemia -is another type of anemia

,  It is characterized by a problem with the synthesis or creation of HGB

 In SA, there is plenty of iron, but it is not used correctly to make the HGB

 The erythrocytes end up with a little bit of HGB and a circle of iron in the RBC itself

 SA’s can be classified as:

o Acquired: the most common and are idiopathic (no known cause)

o Hereditary: this is rare and is almost always found in men

o Reversible: this is associated with alcoholism because the alcohol impairs heme
synthesis

 CM’s include those commonly seen with anemia

 These people will also have signs of a syndrome called hemosiderosis or iron overload

Enlarged liver/spleen, deposits of iron in heart affecting its function

Polycythemia Vera- polycythemia which is the term for an excess production of RBC’s

 There are many forms of Polycythemia

 The main one I will focus on is primary absolute polycythemia, also known as
Polycythemia Vera.

 The main cause is unknown but thought to be due to a genetic alteration of the
erythrocyte receptor

o So the receptor is not sensing that there are enough circulating erythrocytes and
just keeps producing them

 The clinical manifestations of PV are due to an increase in the viscosity or thickness of
the blood

o The number of blood cells increase in the vessel but the amount of plasma or fluid
does not so you have an overcrowded vessel which makes the blood very thick

 This can cause clogging and occlusion of blood vessels (think congested highways)

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