Anemia

What is anemia

lack of red blood cells or RBC productivity/effectivness

what are the types of anemia

aplastic anemia

iron deficient anemia

folic acid deficiency anemia

pernicious anemia

general signs of anemia

pale ears

pale mucous membranes

spooning nails

SOB

postural hypotension

fatigue

beefy red tongue

what is iron deficiency anemia

rbc’s dont work well because of inadequate iron intake OR iron excretion in excess of intake

what is aplastic anemia

depression of bone marrow that causes decrease in ALL types of blood cells

what is pernicious anemia

the body cant absorb vitamin b12 which is important for RBC maturation

what is folic acid deficiency anemia

the body is not taking in enough folic acid, which is needed for RBC maturation

specific sx of iron deficiency anemia

asymptomatic in early stages

pallor, glossitis, chelitis

specific sx of pernicious anemia

paresthesia in extremities

weakness

loss of vibratory sense

loss of balance

smooth red tongue

specific sx of aplastic anemia

fever

infections

bleeding

specific sx of folate deficient anemia

weight loss

malnourished

risk factors of anemias

iron deficiency

• vegetarian

• blood loss

• older adults

pernicious anemia

• stomach surgery

• alcoholism

• chrons disease

aplastic anemia

• chemotherapy

• radiation

folic acid anemia

• decreased nutritional intake

• alcoholism

labs for anemia

CBC
RBC indices

serum ferritin

serum folate

serum iron

homocysteine

what are the RBC indices

mean corpuscular volume

mean corpuscular hemoglobin

mean corpuscular hemoglobin concentration

what is mean corpuscular volume

• measures size of rbc’s

what is mean corpuscular hemoglobin

measures the amount of hemoglobin per cell

can be normochromic or hypochromic - meaning iron deficiency anemia

what is mean corpuscular HGB concentration

measures HGB concentration relative to the size of the RBCs

what does serum ferritin levels show

what do serum homocystine show

what does serum reticulocytes show

• ferritin is iron storage indictor - for iron deficeint anemia

• homocystine is an amino acid that needs B12 to be broken down. if B12 is not present (pernicious anemia) then homocysteine will be increased

• immature RBCs

which one has increased mean corpuscular volume

pernicious anemia and folic acid anemia- they are after all called the macrocytic anemia

in which one is MCV normocytic

aplastic anemia

in which one is MCV, MCH and MCHC decreased

iron deficiency anemia

folic acid deficiency anemia verses pernicious anemia labs

both are macrocytic, so MCV is enlarged

homocysteine, folate and cobalamin are increased in pernicious anemia

serum folate levels will be low - less than 3 - for folic acid anemia

treatment - iron anemia

supplemental iron

folate rich foods

treatment pernicious anemia

• vit b 12 injections for life (cobalamin)

• monitor for gastric cancer bc it is a risk of b12 deficiency

aplastic anemia treatment

remove causitive agent

epoetin alfa

stem cell transplant

folic acid deficiency treatment

folic acid oral replacment: 1 mg or 5mg/day

folate food replacement

folic acid can mask

B12 deficiency

Folic acid can cause

dark yellow pee

nursing admin epoetin alfa

monitor hbg and hct 1x a week

hgb increase >1g/dl per week means need to monitor for CV event

how often recieve b12 injections

how to give liquid iron

once a month

diluted through straw to prevent teeth staining