Anemia Overview and Causes

Anemia

• Deficiency in erythrocytes (red blood cells (RBCs))
• Low quantity of hemoglobin
• Low volume of packed RBCs (hematocrit)
• Not a specific disease, but a sign of an underlying disorder
• Diverse causes, including blood loss and impaired erythrocyte production/destruction

Causes of Anemia

• Decreased RBC Production: Insufficient nutrients (iron, cobalamin, folic acid), reduced erythropoietin, or low iron availability.
• Increased RBC Destruction: Hemolysis (breakdown of RBCs), certain diseases (sickle cell), medications, or trauma.
• Blood Loss: Chronic bleeding (e.g., duodenal ulcer, colorectal cancer), acute trauma, or rupture of an aneurysm.

RBC Function

• Transport oxygen from lungs to body tissues
• Carry carbon dioxide from tissues to lungs
• Erythrocyte disorders can lead to tissue hypoxia, contributing to anemia symptoms.

Anemia-Clinical Manifestations

• Pallor (pale skin)
• Weakness and fatigue
• Shortness of breath (SOB)
• Tachycardia (rapid heart rate)
• Small red blood cells (microcytic)
• Jaundice (yellowing of skin and eyes)
• Inflammation and burning of the tongue (glossitis)
• Inflammation of the lips (cheilitis)
• Brittle or ridged nails
• Integumentary changes evident in dark-skinned individuals
• Attempts by the heart/lungs to provide adequate oxygen
• May result in angina pectoris or myocardial infarction in extreme cases and in presence of associated heart disease.

Anemia- Nursing Assessment

• Gathering subjective data, including past medical history, medications, and surgical interventions
• Assessing objective data, including general appearance, integumentary, respiratory, cardiovascular, and other relevant systems.

Anemia-Nursing Diagnoses

• Fatigue
• Imbalanced nutrition: less than body requirements
• Ineffective self-health management

Anemia-Nursing Management

• Goal to maintain normal activities of daily living, adequate nutrition, and prevent complications
• Implement/recommend dietary adjustments/supplements/blood transfusions as medically indicated
• Encourage/educate about activity/rest balance
• Monitor potential complications related to anemia.

Anemia - Gerontologic Considerations

• Common in older adults
• Signs may be mistaken for normal aging
• Common types of anemia in this population include nutritional deficiencies, renal insufficiency, and unexplained anemia.

Malabsorption

• Iron absorption occurs in the duodenum and proximal jejunum
• Malabsorption syndromes may involve diseases of this region
• Major GI sources include peptic ulcers, gastritis, esophagitis, diverticula, hemorrhoids, or neoplasia.

Specific Anemia Types, Causes, and Considerations

• Detailed information about specific anemia types such as iron-deficiency anemia or other specific types, including etiology and associated considerations given.

Diagnostic Studies

• Important lab findings for anemia, including hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), reticulocytes, serum iron, serum iron-binding capacity (TIBC), bilirubin, and platelets.
• Stool guaiac test, endoscopy, colonoscopy, bone marrow biopsy
• Further tests based on suspected cause

Drug Therapy

• Discussion on specific medications used to treat anemia
• Important factors like route for administration, safety precautions, and possible side effects.

Dietary Considerations

• Information about dietary habits and lifestyle changes to counteract/treat anemia (e.g. iron supplements, foods rich in iron, vitamin B12, and folic acid)

Dietary History

• Assessing nutrition as part of a patient's history, including their functional patterns as related to health perception—health management, nutritional-metabolic patterns, and elimination patterns.

Treatment, General

• Information regarding the treatment of each type of anemia, including medication use, lifestyle modifications (e.g., dietary changes), and potential surgical options.

Dietary Guidelines

• Guidelines on foods rich in nutrients important for red blood cell production.

Patient Teaching

• Instructions about managing anemia, including dietary recommendations, regular follow-up visits, medication compliance, and monitoring of symptoms.

Pressure Ulcers

• Localized injury to the skin or underlying tissue secondary to pressure or shear/friction.
• Typically heal by secondary intention
• Most common sites are the sacrum and heels

Contributing Factors to Pressure Ulcers

• Severity of Pressure
• Duration of Pressure
• Tolerance of affected tissue to external pressure

Pressure Ulcer Stages

• Staging definitions
• Relevant symptoms and clinical manifestations associated with each stage (1-4)

Clinical Manifestations-Infections

• Clinical signs of infection associated with pressure ulcers
• Potential complications of pressure ulcers
• Evaluation process to ensure proper healing and patient outcomes.

Assessment of Pressure Ulcers

• Methods for assessing the risk of pressure ulcer development
• Systematic inspection of skin, including assessment of mobility/sensory perception, hydration/moisture, activity/nutrition/friction and pressure points.

Prevention of Pressure Ulcers

• Proactive measures to prevent the development of pressure ulcers.
• Including patient-specific risk factors, and risk factors like moisture, friction, positioning, and other factors relevant to the individual patient's presentation.

Nutrition Therapy of Pressure Ulcers

• Providing nutritional guidelines and dietary recommendations to promote tissue/wound healing.

Constipation

• Difficulty passing stools, reduced stool volume, and/or retention of stool in the rectum.
• Could be idiopathic, but also attributed to issues such as insufficient dietary fiber/hydration, or some other underlying condition.
• Patient may be prescribed stool softeners, laxatives, or other medications
• Evaluation and management plans will include strategies focused on increasing fiber intake, fluid intake and/or exercise

Diagnostic Studies for Constipation

• Details on diagnostic tests specific to constipation to confirm or rule out any other contributing factors relevant to the patient's presentation

Therapeutic Interventions for Constipation

• Nonpharmacological options such as diet and lifestyle adjustments
• Pharmacological treatment options

Diarrhea

• Passage of three or more loose or liquid stools per day.
• Acute, chronic, or persistent.
• Relevant causative agents.
• Diagnosis and treatment options, including dietary changes, antibiotics, and other supporting treatment recommendations, based on patient presentation.

Factors influencing Diarrhea

• Conditions such as infection
• Stress or emotional distress
• Medication use
• Other acute or chronic disease states.

Diagnostics of Diarrhea

• Tests based on causative factors

Treatment Options

• Dietary modifications, fluid replacement, and medication prescriptions to treat symptoms appropriately.

Seizure

• Abnormal episodes of electrical activity in the brain, resulting in altered mental states, muscle contractions, or other abnormal behaviors
• Various etiologies and classifications
• Specific treatment methods, including medication regimens and other non-medical therapies

Diagnostic Tests for Seizures

• Various tests to diagnose seizures and confirm or rule out potential causes.
• Important to evaluate and treat any underlying conditions/diseases as a result to effectively manage symptoms.

Head Pain Disorders

• Various types, including tension-type, migraine, and cluster headaches, descriptions, symptoms, and treatments for each type
• Relevant assessment strategies, diagnostic studies, treatment options, and preventive strategies based on the patient's presentation are highlighted

Cardiovascular and Neurological Considerations

• Impact on swallowing functionality, hydration/nutrition, and cardiovascular/psychological health

Parkinson's Disease

• Neurodegenerative disorder associated with reduced dopamine levels in the brain.
• Symptoms, relevant diagnoses, and medical/nursing management strategies are discussed.

Parkinson's Disease-Nursing assessments will include;

• Assessing ability to perform ADLs
• Evaluating speech and swallowing issues, psychological status, balance, and gait, etcetera relevant to the patient's presentation
• Evaluating medications and potential side effects relevant to the patient's presentation
• Planning effective interventions to address the patient's specific needs and facilitate their independence

This quiz covers the essential aspects of anemia, including its definition, causes, and clinical manifestations. Understand how different factors like decreased RBC production and blood loss contribute to anemia, along with its impact on oxygen transport in the body. Explore the complexities behind this condition and its implications for health.