EXAM 2 STUDY GUIDE
HEMATOLOGIC DISORDERS: 7-10 questions
• Identify general nursing strategies associated with altered anemia
• Describe the morphology, pathophysiology, clinical manifestations, therapeutic manageme
...
EXAM 2 STUDY GUIDE
HEMATOLOGIC DISORDERS: 7-10 questions
• Identify general nursing strategies associated with altered anemia
• Describe the morphology, pathophysiology, clinical manifestations, therapeutic management and nursing considerations of the following anemias:
o ***Laboratory norms: 6-12 years of age
▪ Hemoglobin:
• 11.5-15.5 g/dl
▪ Hematocrit:
• 35-45%
▪ MCV (mean corpuscular volume)
• 77-95 fL
• Measure of average size of RBC
• ↓ in microcytic; ↑ in macrocytic
▪ MCHC (mean corpuscular Hgb concentration)
• 31–37 g/dl
• Reflection of Hgb concentration
• Refer to color; in hypo-, values are ↓
▪ MCH (mean corpuscular Hgb)
• 25–33 pg/cell
• Reflection of Hgb concentration
• Refer to color; in hypo-, values are ↓
o Anemia
▪ Condition where the hemoglobin content of the blood is insufficient to satisfy bodily needs
▪ Causes:
• Blood loss
• Accelerated hemolysis
• Decreased production
▪ Typical Clinical Manifestations:
• Fatigue
• Dizziness
• Weakness
• Pallor
• ↑ heart rate
• ↑ breathing rate
o Types:
▪ Iron-deficiency anemia—MOST COMMON IN PEDS
• Nutritional anemia
• Microcytic-hypochromic—small, pale RBC
• Who’s at risk?
o Varied
o Premature babies at ↑ risk b/c they don’t get that blood rush the mom gives the baby late in that 3rd trimester, b/c premies are born early—this is why premature infants need the iron supplements at 2-3 months, whereas term babies don’t need it until 4-6 months
o Multiples and twins at ↑ because only finite amount of blood available in that last rush of blood; so not all the babies get enough iron
o Breast-fed exclusively babies at ↑ risk—breast milk doesn’t have same iron content as fortified iron formula
o Kiddos with chronic blood loss—GI bleeders, hemophiliacs
o Kiddos with poor dietary intake; whole milk doesn’t have same iron concentration as iron fortified formula
• Pathophysiology:
o Body stores iron that is used for erythropoiesis
o Iron necessary mineral for erythropoiesis to occur
o Not enough iron to transport to the bone marrow to make RBCs
o Bone marrow still makes RBCs but they are very small and have a lower hemoglobin concentration
• Clinical Manifestations:
o Typical signs of anemia plus:
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