Anemia What is it? What are
the causes?
MCV
Normocytic
, microcytic,
or
macrocytic?
S/S Treatment
iron deficiency caused by inadequate
diet, poor absorption,
GI bleed, or
menstruation
Microcytic pallor, glossitis,
chelitis, burning of the
tongue, headache,
paresthesia
1. Iron replacement- oral
is best (not w/ food)
2. Increase iron in the
diet – meat, eggs,
legumes, dark green
leafy veggies,
potatoes, enriched
cereals
3. Transfusions of packed
RBCs if caused by
blood loss
Thalassemia
Minor – there
but has to be
triggered
major –
symptoms as
young child
caused by inadequate
Hgb production
genetic –
Mediterranean and
near equatorial groups
microcytic pallor, jaundice from
hemolysis of RBCs,
splenomegaly, bone
marrow hyperplasia,
thickening of the
cranium and maxillary
cavity
1. Blood transfusions –
goal is to maintain
Hgb 10g/dL
2. Give desferal to
reduce iron
overloading
(packed RBCs)
pernicious Cobalamin or B12
deficiency
absence of IF
common in middle
aged Scandinavians
and African
macrocytic GI – glottis, anorexia,
nausea, vomiting,
abdominal pain,
neuromuscular –
weakness, paresthesia
of hands & feet, ataxia,
confusion, demetia
1. B12 given IM or
nasally
no dark greens
Folic acid
deficiency
folic acid is required for
DNA synthesis leading
to RBC formation
caused by dietary
insufficiency,
malabsorption
syndrome, alcohol
abuse, drug
interactions,
(contraceptives,
antisezsure),
macrocytic dyspepsia, glossitis
no neurological
problems as in
pernicious anemia
1. Increase folic acid in
the diet – green leafy
veggies, meat, fish,
legumes, whole
grains, orange juice,
peanuts
2. Replacement therapy
– typically 1 mg/day
by mouth, 5 mg/day,
may be needed in
alcoholism and
hemodialysis, anorexia malabsorption
aplastic
Pancytopenia
stem cell production
stops causing
pancytopenia,
hypocellular bone
marrow
normocytic fatigue, dyspnea,
neutropenia – fever
above 100.4 is a
medical emergency,
predisposition to
bleeding (petechiae –
red purpled spots,
ecchymosis – bruising,
epistaxis – nose
bleeds)
1. Prevent complications
from infection and
hemorrhage
2. HSCT (stem cell
transplant)
give RBCs, WBCs, Plts
sickle cell characterized by an
abnormal form of Hgb
in the RBC
lack of oxygen triggers
the cell to sickle and
causes vascular
occlusion
Common in African
Americans
normocytic pallor (mucous
membranes & grayish
skin in dark
individuals), jaundice
from hemolysis, prone
to gallstones, PAIN
from tissue ischemia
during sickle cell crisis,
infections such as
pneumonia may occur,
eventual involvement
of all body systems and
major organs, acute
chest syndrome
1. Pain management –
narcotics
2. Teach patients to
avoid high altitudes,
hydrate, and treat
infections
immediately
3. Patients should
receive influenza and
hepatitis vaccines
4. Chronic leg ulcers
treated with rest,
antibiotics, warm
saline soaks, and
debridement
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