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NURS 5461/62 UNCOMMON ANEMIAS EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
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NURS 5461/62 UNCOMMON ANEMIAS EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED Anemia is a decrease in RBCs or Hbg- always reflects underlying disease • Diagnosis depends on Hct [amount of RBCs in whole blood] or Hbg - Men- Hct <42% or Hbg <14g - Women- Hct <37% or Hbg &lt...

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  • 2 de noviembre de 2024
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NURS 5461/62 UNCOMMON ANEMIAS EXAM

QUESTIONS AND ANSWERS WITH COMPLETE

SOLUTIONS VERIFIED


Anemia is

a decrease in RBCs or Hbg- always reflects underlying disease • Diagnosis depends on

Hct [amount of RBCs in whole blood] or Hbg - Men- Hct <42% or Hbg <14g - Women-

Hct <37% or Hbg <12g

Approach to Evaluation of Anemia

Data to be obtained on all anemic patients - Hct and Hbg - MCV; MCHC - Reticulocyte

Count - Smear of peripheral blood

Three questions should be asked - What is MCV? - What is basic mechanism of the

anemia? - Does patient have another problem associated with anemia?

Mean Corpuscular Volume [MCV]

• Microcytic - MCV <80 • Normocytic - MCV 80-100 • Macrocytic - MCV >100

Basic Mechanism of Anemia

Decreased production of RBC by marrow • Bleeding • Hemolysis • Reticulocyte count

used to assess response of marrow to anemia- normal reticulocyte count is 1% • 1% of

new cells that are being released daily into circulation from the marrow

Reticulocyte Index-

reticulocyte count x patient's Hct/45

, Basic Mechanism of Anemia

If patient is anemic, marrow should be able to acutely triple its output of new cells •

Reticulocyte count must be adjusted for level of anemia to obtain reticulocyte index

In patients with bleeding or hemolysis, RI should be > or = 3% • Patients anemic from

abnormal production of RBCs have RI <3%, often <1.5%

Other Problems Commonly Associated with Anemia

G6PD Deficiency • Hemoglobinopathies • Thalassemia • Immune hemolysis after a virus

• Chronic inflammation • Malignancies • Hypothyroidism • Hyperthyroidism • Renal

Failure • Aortic Valve Replacement • Rheumatoid Arthritis • Collagen Vascular Disease

Drugs Associated with Anemia

Methyldopa • Quinine-pancytopenia • Quinidine • Chloramphenicol • Gold Salts • Anti-

TB drugs • Dilantin • Sulfa drugs-chronic dose • Methotrexate • Amphotericin • Cis-

platinum • Zidovudine

Anemia with a Low MCV

For the most part, anemia with low MCV is iron deficiency or thalassemia, Occasionally,

anemia of chronic

disease can be microcytic if **longstanding ONLY

Iron Deficiency Anemia

iN a child, man or postmenopausal woman aaa should be considered GI bleeding until

proved otherwise

IDA

- History of eating ice, starch or clay • Pica - on PE sore tongue, brittle ridged nails,

spoon nails or cheilosis •

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