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AHN 568 Fluids Electrolytes Test with Questions and Answers Verified 100% Correct | Latest Update
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AHN 568 Fluids Electrolytes Test with Questions and Answers Verified 100% Correct | Latest Update
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AHN 568 Fluids Electrolytes Test withQuestions and Answers Verified 100%
Correct | Latest Update
Iron deficiency anemia: Physical exam findings - ✔✔1. S&S: initially may be
asymptomatic, fatigue, exertional dyspnea, dizziness, HA exercise
intolerance, PICA
2. Pallor, red smooth tongue, tachy, palpitations, paresthesias, hemic heart murmur,
spoon shaped brittle nails (Koilonychia); cheilosis (cracking of mouth)
3. STAGES:
1. depletion of body stores labs may be normal
2. normal hgb, but depleted iron stores per lab
values
3. iron depletion, slight anemia, normal MCV
4. severe iron def, hypochromic red cells, and
low MCV with marked anemia; microcytosis,
poikilocytosis, and hypochromia
Iron deficiency anemia: LAB and diagnostics - ✔✔1. Elevation of red cell distribution
width (RDW)
2. retic count decreased,
3. ferritin (less than 10-12 mcg/dl) TIBC
(greater than 300 mg/dl)
,4. Fe below 50 mg/dl
5. platelets elevated, elevation in WBC in severe
6. GOLD STANDARD BONE MARROW IRON STAIN; Prussian blue negative; marrow
hyperplasia, micronormoblastic******
Iron deficiency anemia: Management - ✔✔1. oral ferrous sulfate 300-325 mg tid one-hour ac
meals for 6 mo.; follow up in 6-8 weeks
with cbc, transfusion of packed RBC may be necessary is anemia symptomatic, each mml
of transfused RBC delivers 1 mg of iron
2. parenteral iron or IM is reserved for intolerance or noncompliance; test dose of 0.5ml;
Benadryl and epi should be available, painful; give in large muscles; may stain skin; IV
admin may cause phlebitis; 7-10 days you should see retic response and increase in HCT;
failure to respond within 5-8 weeks warrants further eval
Folic acid deficiency: Diagnostic findings - ✔✔1. Normal stores 5000-20,000 mcg
2. Signs of folate def take about 4 months
3. Fatigue, pallor, mouth/tongue pain, may not present till anemia severe; may show signs of
malnutrition, glossitis, stomatitis, GI symptoms, hyperpigmentation, infertility, ortho hypo,
weight loss, neurological symptoms less common.
Folic acid deficiency: Lab findings - ✔✔1. folate less than 4 mcg/L
2. RBC folate better indicator of tissue levels less than 100 ng/ml
3. MCV usually greater than 115 or may gradually increase over several months to years
and remain in normal range
Folic acid deficiency: Management - ✔✔1. Correct diagnosis;
2. oral folate 1-5mg daily for 3-4 months
3. folate to be given with b12 when both are deficient, after initiation of folate peak of retic 6-
8 days followed by a slow increase in hgb
, Chronic anemia: Physical exam findings - ✔✔1. S&S: frequently none; may complain
of symptoms of disease; physical findings of primary
disease
Chronic anemia: Lab findings - ✔✔1. Mild to moderate anemia
2. red cells normocytic and normochromic
3. retic count less than 1% or low absolute number
4. normal or increased iron stores (Differs from iron def anemia******)
5. ferritin usually high greater than 100, TIBC usually depressed less than 250.; RED cell
morphology varies very little; RDW usually normal; sideroblasts are absent in bone marrow
but iron stores are normal or increased
6. leukocytosis and thrombocytosis often seen in peripheral smear if infection or
malignancy present
7. LOOK at the ESR
Chronic anemia: Management - ✔✔1. Premenopausal women: trial of iron may be given:
check cbc in 2-3 weeks; 1.5 g/dl
increase should have occurred; failure warrants further investigation
2. not appropriate for men and postmenopausal women
3. NO SPECIFIC THERAPY (ORAL IRON NOT HELPFUL IN THIS ANEMIA) treat
underlying cause
ADH influence on electrolytes - ✔✔=hormone secreted by the posterior pituitary gland,
is the primary controller of ECF volume.
=It is stimulated to secrete by an increase in blood osmolality, which indicates a state of
water deficit.
=The release of ADH causes the kidneys to reabsorb more water in the distal convoluted
tubules, which dilutes the blood and normalizes the serum osmolality.
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