Exam 19 - Disorders of Erythrocytes and Leukocytes

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Questions and Answers

What is the role of intrinsic factor in vitamin B12 absorption?

Intrinsic factor helps in the synthesis of vitamin B12 in the stomach.

Intrinsic factor inhibits vitamin B12 absorption in the ileum.

Intrinsic factor is not involved in vitamin B12 absorption.

Intrinsic factor binds to vitamin B12 in the stomach, facilitating its absorption in the ileum. (correct)

What subjective data would you expect to find in a patient with pernicious anemia?

Increased energy levels and vitality

Increased appetite and thirst

Improved sense of balance and coordination

Palpitations, nausea, dysphagia, and indigestion (correct)

Which objective data is commonly observed in patients with pernicious anemia?

Increased muscle mass and strength

Normal blood pressure and heart rate

Smooth and erythematous tongue, infection of teeth and gums (correct)

Improved cognitive function and memory

Which diagnostic test is used to assess red blood cell size in patients with pernicious anemia?

Mean corpuscular volume (MCV) (B) Signup and view all the answers

What is the primary drug therapy for pernicious anemia?

Vitamin B12 replacement therapy (cyanocobalamin) (A) Signup and view all the answers

What is the recommended frequency of vitamin B12 injections after initial therapy for pernicious anemia?

Monthly (A) Signup and view all the answers

Which of the following nursing interventions is crucial for managing a patient with pernicious anemia?

Frequent mouth care (D) Signup and view all the answers

What dietary recommendations should be given to a patient with pernicious anemia?

High in protein, vitamins, and minerals (red meat, dairy, and eggs) (B) Signup and view all the answers

What is the primary cause of pernicious anemia?

Autoimmune destruction of parietal cells in the stomach (D) Signup and view all the answers

What is an important nursing intervention for patients with leukemia regarding infection control?

Enforcing neutropenic precautions (C) Signup and view all the answers

Which dietary recommendation should be provided to patients with leukemia?

High-protein, high-calorie diet (C) Signup and view all the answers

Which characteristic is associated with the pathophysiology of leukemia?

Accumulation of excess leukocytes in bone marrow (A) Signup and view all the answers

What should be avoided to reduce infection risk for patients with leukemia?

Contact with individuals who have infections (C) Signup and view all the answers

What is a key characteristic of anemia?

Below-normal levels of red blood cells (D) Signup and view all the answers

Which of the following can lead to anemia due to impaired production of red blood cells?

Nutritional deficiencies (A) Signup and view all the answers

What symptom might indicate a severe loss of blood volume in an individual with anemia?

Hypotension (C) Signup and view all the answers

Which diagnostic test is most relevant for detecting anemia?

Complete blood count (CBC) (C) Signup and view all the answers

What is the main focus of medical management for anemia?

Identifying and treating the cause (C) Signup and view all the answers

Which of the following could be an objective data point observed in a patient with anemia?

Pallor (C) Signup and view all the answers

What is a common clinical manifestation of chronic mild anemia?

Asymptomatic unless detected in lab (D) Signup and view all the answers

What is the primary cause of tissue pain in internal hemorrhage?

Tissue distention, organ displacement, and nerve compression (D) Signup and view all the answers

Which symptom may not be immediately evident after severe blood loss?

Decreased RBC, hemoglobin, and hematocrit (D) Signup and view all the answers

What is an essential intervention for a patient experiencing hemorrhage?

Start IV saline to replace lost volume (A) Signup and view all the answers

What does one unit of packed RBCs typically increase in hemoglobin levels?

1 g/dL (A) Signup and view all the answers

Which of the following is a common symptom of decreased renal perfusion?

Oliguria (B) Signup and view all the answers

What must be monitored frequently in a patient with hemorrhage?

Vital signs (A) Signup and view all the answers

Which factor is essential for Vitamin B12 absorption?

Intrinsic factor (D) Signup and view all the answers

What is a likely consequence of atrophy or partial gastrectomy in the stomach?

Megaloblastic anemia (C) Signup and view all the answers

Which of the following is NOT a nursing intervention for patients at risk of hemorrhage?

Encourage excessive physical activity (D) Signup and view all the answers

What is the primary treatment approach for patients with Polycythemia Vera?

Only supportive care (D) Signup and view all the answers

Which of the following is a possible cause of secondary Polycythemia Vera?

Chronic lung disease (B) Signup and view all the answers

What is an important nursing intervention for managing patients with Polycythemia Vera?

Monitor fluid and electrolyte balance (A) Signup and view all the answers

Which of the following diagnostic tests is used to identify Polycythemia Vera?

Bone marrow biopsy (D) Signup and view all the answers

Study Notes

Disorders Associated with Erythrocytes and Leukocytes

Anemia: Characterized by below-normal levels of red blood cells, hemoglobin, and hematocrit, leading to insufficient oxygen delivery to tissues and cells. Caused by factors like hemorrhage, increased destruction of red blood cells (hemolysis), impaired production of red blood cells, nutritional deficiencies (e.g., iron deficiency). Peripheral circulation compensates by shunting blood to vital organs, causing hypoxia elsewhere.

Pathophysiology of Anemia

Loss of red blood cells: Due to hemorrhage.
Increased destruction of red blood cells (hemolysis): Implies red blood cells are destroyed faster than the body can replace them.
Impaired production of red blood cells (bone marrow depression or failure): Bone marrow is unable to create new red blood cells at a sufficient rate.
Nutritional deficiencies: Such as long-term iron deficiency, leading to an inadequate supply of essential nutrients for red blood cell production.
Loss of oxygen-carrying elements: In the blood, causing a supply/demand imbalance in vital organs.

Clinical Manifestations of Anemia

Sudden loss of 1/3 of blood volume: Hypotension, respiratory distress, altered mental status.
Acute loss (Hgb below 5g/mL): Severe hypotension, myocardial infarction, stroke, severe altered mental status, death are potential complications.
Chronic mild anemia: May be asymptomatic, unless detected in lab. General malaise, heart palpitations, shortness of breath on exertion, dizziness/lightheadedness might be present.

Assessment of Anemia

Subjective data: Weakness, dyspnea, fatigue, vertigo, headaches, and sometimes insomnia.
Objective data: Observing signs and symptoms of shock, bleeding, pallor, and monitoring laboratory values.

Diagnostic Tests for Anemia

Complete blood count (CBC): Decreased RBCs, hemoglobin, and hematocrit.
Decreased serum iron, total binding capacity, and serum ferritin levels: Indicate a deficiency in iron, which is crucial for red blood cell production.
Increased reticulocyte count: Due to immature RBCs. Suggests the bone marrow is working to compensate for the loss of red blood cells.
Bone marrow biopsy: Revealing abnormalities.
Peripheral blood smears: Identifying cell shape/color abnormalities.
Decreased vitamin B12 level: Associated with some types of anemia.

Medical Management of Anemia

Intervention depends on the cause: May require blood transfusions, iron replacement, or addressing underlying conditions like hemorrhage.

Nursing Interventions and Patient Teaching for Anemia

A comprehensive approach tailored to the specific type and stage of anemia is required.

Jehovah's Witnesses

Opposed to homologous blood transfusions: Due to religious beliefs.
May agree to autologous transfusions: Using the patient's own blood previously collected.
May use volume expanders: To preserve circulatory volume.

Hypovolemic Anemia (Blood Loss Anemia)

Deficiencies in RBCs and other components: Due to low circulating blood volume from hemorrhage.
Blood loss of 1000 mL or more: Considered severe; less than 500 mL may be tolerated.
Causes: Surgery, GI bleeding, menstruation, trauma, burns.
Leads to hypovolemic shock: Sudden reduction in total blood volume.

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Description

This quiz covers the disorders associated with red and white blood cells, focusing on anemia. Explore the various causes of anemia, including blood loss, hemolysis, and nutritional deficiencies. Understand the pathophysiology and implications of these disorders for overall health.