Type of Anemia Iron Deficient

Etiology Blood loss, inadequate intake, dec. absorption R/T age, gastric size

Diagnostics

Clinical manifestations

Medical treatments Assess for cause of anemia, GI, uterine. Iron replacement

NUR care Oral ferrous sulfate (best absorbed with Vit. C) if giving Iron IM use Z-track. Enc, foods high in iron, organ meat, beans. Green leafy veggies, raisins, fortified cereals. Iron may cause constipation and dark stools. Pg 2018 Education on prevention of crisis, Management of pain, maintaining hydration (prevents vascular occlusion), good hygiene to prevent infection, support systems for family and patient Same as Iron def. anemia, careful with renal diet, watch potassium, sodium, protein Education on disease, prevention of infection, bleeding

Hgb, Hct, ferritin Fatigue, weak, paleness, levels tachycardia, smooth sore tongue, dyspnea

Sickle Cell

Genetic disorder, defective gene alleles for Hgb synthesis

Dx by large % of Hgb S seen on electrophoresis

Anemia of Renal disease Aplastic anemia

Due to dec. erythropoietin production from kidneys, dec. in life span of RBC Def. of RBC due to failure of bone marrow as result from toxic agents, infection.

CBC, PT, PTT

Chart p 2024 Fragile RBC sickle and clump together under conditions of low tissue oxygenation = pain, risk for pulmonary infarcts, renal, cardiac ischemia, necrosis of femur head, leg ulcers Symptoms of Anemia p 2009 occur rapidly

Prevent and monitor for infection, Drug therapy= Hydroxyurea (inc. Hgb F) for best practice, if in crisis, admin. O2, pain meds, IV fluids, PO fluids, no restrictive clothing Iron replacement Use of Epoetin Alfa (procrit) Blood transfusions, Immunosuppressive therapy if warranted, Splenectomy if spleen is interfering with RBC production, bone marrow transplant Inc . foods rich in vit B12 (eggs , dairy prod.)p 2018 B12 shots

Pernicious Anemia

Failure to absorb Vit. B12 due to def. in intrinsic factor

CBC, bone marrow biopsy, may also see thrombocytope nia (low platelets & leukopenia = low WBC) Shilling test of Vit. B12 absorption

Weakness , pallor, petechiae or ecchymosis

Pallor, wt loss, fatigue, smooth beefy red tongue, paresthesias

B12 injections monthly