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NUR 324 Anemia Test Study Guide
- Course
- NUR 324
- Institution
- Gwynedd Mercy University
This is a comprehensive and detailed test study with emphasis on Anemia. *Essential Study Material!!
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Anemia- Anemia
o Major pathophysiological condition affecting RBCs
o Defined as a decreased RBC mass that becomes clinically apparent when levels of
Hgb and hematocrit (Hct) are less than normal
o A complete blood count (CBC) measures all RBCs and RBC characteristics
o Different types of anemia produce different CBC results
o Causes include…
Decreased RBC production
Increased RBC destruction
Blood loss
- Complete blood count (CBC)
o Includes…
Hemoglobin (Hgb)
Hematocrit (Hct): percentage of blood made up of RBCs
Number of RBCs
Reticulocyte Count: indicates bone marrow activity
Measures the number of new RBCs in the blood and helps to
determine whether the bone marrow is producing new RBCs at an
appropriate rate
Increased reticulocyte numbers associated with anemia suggested
accelerated destruction or loss of RBCs
Normal reticulocyte count is approx. 1% of total RBCs
o Mean Corpuscular Volume (MCV): indicates size of RBC
o Mean Corpuscular Hemoglobin (MCH): indicates color of RBC
o Mean Corpuscular Hemoglobin Concentration (MCHC): indicates color of
RBC
- Cannot make the diagnosis of anemia looking only at hemoglobin and hematocrit
- Diagnosing anemia
o Lab studies
CBC
Peripheral blood smear
Iron
Folic acid
Bone marrow aspiration and/or biopsy
o Echocardiogram
o Electrocardiogram (ECG)
o Additional diagnostic tests are based on type of anemia
Fecal occult blood test
Vitamin B12 levels
- RBC size and color
, o Normal
o Microcytic = small in size
o Macrocytic = larger in size
o Hypochromic = loss of color
- Polycythemia
o Described as the opposite of anemia
o Overabundance of RBCs
o Primary Polycythemia: hyperproliferation of all blood cells
Blood becomes viscous and required periodic phlebotomy
o Secondary Polycythemia: more common; a hyperproliferation of the RBCs in
response to chronic blood hypoxia (COPD)
- Anemia caused by acute blood loss
o The adult can usually lose 500 mL of blood without serious or lasting effects
o If the loss reaches 1,000 mL or more, serious adverse effects such as hypovolemic
shock and cerebral hypoperfusion can occur
o Acute blood loss is a rapid loss of blood as in hemorrhage caused by trauma,
childbirth, rupture of a major blood vessel, or organ
o Severe GI bleeding can occur in disorders such as esophageal varices or
penetrating peptic ulcer
o Pathophysiology includes…
The lack of sufficient number of RBCs to carry oxygen causes tissue
hypoxia kidney erythropoietin bone marrow starts to synthesize
RBCs
Baroreceptors sense decreased BP stimulation of the sympathetic
nervous system causing arterial vasoconstriction
Simulation of the RAAS
Antidiuretic hormone (ADH) release
- Blood loss from GI tract
o Patients bleeding because of esophageal varices often exhibit hematemesis
o Coffee ground emesis is blood mixed with stomach acid and mucus in vomitus
o Melena is blood mixed in stool = dark, tarry stool
- Chronic slow blood loss
o Most common causes include…
Peptic ulcer
Inflammatory bowel disease
Colon cancer
Menorrhagia = excessive monthly menstrual loss
- Subjective
o O2 carrying capacity is reduced which leads to the hypoxia of the tissues
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