NURS 4700 NURSING CONCEPTS AND INTERVENTIONS FOR THE CARE OF ADULTS EXAM 2 STUDY GUIDE MARQUETTE UNIVERSITY

NURS 4700 NURSING CONCEPTS AND INTERVENTIONS FOR THE CARE OF ADULTS EXAM 2 STUDY GUIDE MARQUETTE UNIVERSITY
Adult 2 Exam 2 S
Risk for Injury:
Hematologic Disorders (8)
Anemia: Clinical manifestations, complications. Collaborative care of various types of
anemia, nutrition
• Definition: low RBC, Hgb, Hct
o Normal values:
â–ª RBC: 4.7-6.1
â–ª Hct: 37-51
â–ª Hgb: 12.6-17.4
• Causes: blood loss, impaired production, increased destruction of erythrocytes (RBCs)
o Tissue hypoxia
• Manifestations
o Levels
â–ª Mild: Hgb 10-12 g/dl
â–ª Moderate: Hgb 6-10 g/dl
â–ª Severe: Hgb less than 6 g/dl
â–ª 8 = fate
o Integumentary changes: pallor, jaundice, pruritus
â–ª If suspect jaundice, check liver fxn tests
o Cardiopulmonary changes: heart compensating (increased HR), low blood viscosity
can lead to murmurs
• Gerontologic: common in older adults (after 70)
o Rt renal impairment, chronic diseases, poor diet
o Sx unrecognized or mistaken for normal aging changes: pallor, ataxia, confusion,
fatigue
• Diagnostics: CBC (hgb, hct, mcv, mchc, reticulocytes)
o Reticulocytes: immature RBCs; MCV: mean corpuscular volume; MCHC: mean
corpuscular Hgb concentration
o Diagnosed based on CBC, reticulocyte count, and blood smear
o Iron studies, serum b12 level, serum folate, stool guaiac test
• Anemia types dt decreased erythrocyte production
o Iron deficiency, megaloblastic (b12 or folic acid deficiency)
• Iron deficiency anemia (microcytic)
o At-risk groups: very young, elderly, poor diet, women of reproductive age
o Etiology: inadequate dietary intake; iron absorption altered (duodenum); blood loss
(GI/GU, hemodialysis)
â–ª Labs
• Decreases: Hgb/Hct, MCV, serum iron