Term
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Definition
1. maturation defects
a. cytoplasmic
b. nuclear
2. excessive destruction of RBCs (hemolytic anemias)
a. intrinisc RBC abnormalities
b. extrinsic mechanisms |
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Term
|
Definition
1. Erythropoiesis Stimulating Agents
2. biosynthetic form of the natural hormone erythropoietin
3. used for treatment of anemia associated with end-stage renal disease, chemotherapy -induced anemia, and for anemia associated with zidovudine therapy
4. longer acting form of epoetin called darbepoetin (Aranesp)
5. contraindications: drug allergy, uncontrolled hypertension, head and neck cancers, risk of thrombosis |
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Term
| Before administering epoetin alfa to a patient in renal failure, it is most important for the nurse to assess which lab result? |
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Definition
Hemoglobin level
Use of epoetin and darbepoetin is contraindicated in cases of uncontrolled hypertension and when hemoglobin levels are above 10 g/dL for cancer pts and 12 g/dL for renal pts. Use in pts with head or neck cancers or pts at risk for thrombosis is controversial as these meds increase tumor growth and risk for thrombosis. |
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Term
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Definition
1. essential mineral in the body
2. oxygen carrier in hemoglobin and myoglobin
3. stored in liver, spleen, and bone marrow
4. iron deficiency results in anemia
5. dietary sources: meats, certain vegetables and grains
6. dietary iron must be converted by gastric juices before it can be absorbed |
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Term
| Which food will nurse teach the pt to avoid when ingesting an iron supplement? |
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Definition
Eggs
Although eggs are a common dietary source of iron, they should be avoided when ingesting oral iron preps. veal, orange juice and fish will enhance iron absorption |
|
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Term
| Foods that enhance iron absorption |
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Definition
orange juice
veal
fish
ascorbic acid |
|
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Term
| Foods that impair iron absorption |
|
Definition
eggs*
corn
beans*
cereal products containing phytates
* also common dietary sources of iron |
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Term
| Oral iron preps are available as ferrous salts such as |
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Definition
| ferrous fumarate (Femiron), ferrous gluconate, ferrous sulfate (FeSO4) |
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Term
| Parenteral Iron supplements |
|
Definition
iron dextran (INFeD, Dexferrum)
iron sucrose (Venofer)
ferric gluconate (Ferrlecit)
ferumoxytol (Feraheme) |
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Term
|
Definition
1. prevention and treatment of iron deficiency syndromes
2. administration of iron alleviates the symptoms iron deficiency anemia, but the underlying cause of the anemia should be corrected |
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Term
|
Definition
1. most common cause of pediatric poisoning deaths
2. causes nausea, vomiting, diarrhea, constipation, and stomach cramps and pain
3. causes black, tarry stools
4. liquid oral preparations may stain teeth
5. injectable forms cause pain upon injection |
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Term
|
Definition
1. symptomatic and supportive measures - suction and maintenance of the airway, correction of acidosis, control of shock and dehydration with intravenous fluids or blood, oxygen and vasopressors
2. in pts with severe symptoms of iron intoxication, such as coma, shock or seizures, chelation therapy with deferoxamine is initiated
3. deferiprone is used in iron overload |
|
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Term
Parenteral Iron
Iron Dextran (INFeD, Dexferrum) |
|
Definition
1. may cuse anaphylactic reactions, including major orthostatic hypotension and fatal anaphylaxis
2. test dose of 25 mg of iron dextran is administered before the injection of the full dose, and then remainder of the dose given after an hour
3. used less frequently now, replaced by newer products ferric gluconate and iron sucrose |
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Term
Parenteral Iron
Ferric gluconate (Ferrlecit) |
|
Definition
1. indicated for repletion of total body iron content in pts with iron-deficiency anemia who are undergoing hemodialysis
2. risk of anaphylaxis is much less than with iron dextran and a test dose is not required
3. doses higher than 125 mg are associated with increased adverse events including abdominal pain, dyspnea, cramps, itching |
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Term
| The nurse has administered iron intravenously to a pt. to prevent orthostatic hypotension, it is recommended that the nurse have the pt remain in the recumbent position for how long? |
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Definition
|
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Term
|
Definition
1. water soluble, B-complex vitamin
2. essential for erythropoiesis
3. primary uses: folic acid deficiency, during pregnancy to prevent neural tube defects
4. malabsorption syndromes are the most common cause of deficiency
5. should not be used until actual cause of anemia is determined
6. may mask symptoms of pernicious anemia, which requires treatment other than folic acid
7. untreated pernicous anemia progresses to neurologic damage |
|
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Term
| The use of folic acid to prevent fetal neural tube defects should be started |
|
Definition
| at least 1 month before pregnancy |
|
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Term
| Cyanocobalamin (Vitamin B12) |
|
Definition
1. used to treat pernicious anemia and other megaloblastic anemias
2. administered orally or intranasally to treat vitamin B12 deficiency
3. usually administered by deep intramuscular injection |
|
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Term
| Nursing Implications Card 1 |
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Definition
1. assess pt history and medication history, including drug allergies
2. assess for potential contraindications
3. assess baseline lab values, especially Hgb, Hct, reticulocytes, others
4. obtain nutritional assessment |
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Term
| Nursing Implications Card 2 |
|
Definition
1. ferrous salts are contraindicated in pts with ulcerative colitis, PUD, liver disease and other GI disorders
2. keep away from children because oral forms may look like candy
3. iron dextran is contraindicated in all anemias except for iron deficiency anemia |
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Term
| Nursing Implications Card 3 |
|
Definition
1. for liquid iron preps, follow manufacturer's guidelines on dilution and administration
2. instruct pt to take liquid iron preps through a straw to avoid staining tooth enamel
3. oral forms of iron should be taken between meals for maximum absorption, but may be taken with meals if GI distress occurs
4. oral forms should be given with juice, but not with mild or antacids |
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Term
| Nursing Implications Card 4 |
|
Definition
1. Pts should remain upright for 15 to 30 minutes after oral iron does to avoid esophageal corrosion
2. pts should be encouraged to eat foods high in iron/folic acid
3. for iron dextran, a small test dose should be given - after 1 hour if no reaction the remainder of the dose can be given; administer deeply into a large muscle mass using the Z-track method |
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Term
| Nursing Implications Card 5 |
|
Definition
1. for IV doses of iron dextran give carefully according to manufacturer's instructions
2. have resuscitative equipment available in case of anaphylactic reaction
3. determine the cause of anemia before administering folic acid
4. administer oral folic acid with food
5. folic acid may also be given IV and added to total parenteral nutrition solutions |
|
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Term
|
Definition
1. improved nutritional status
2. increased weight, activity tolerance, well being
3. absence of fatigue |
|
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Term
| which action does the nurse perform when administering iron intravenously? |
|
Definition
| Flush the IV line with 10 mL of normal saline |
|
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Term
| Used to treat anemia that is associated with end stage renal disease, chemotherapy induced anemia and for anemia associated with zidovudine therapy |
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Definition
|
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Term
| Use of epoetin and darbepoetin is contraindicated in cases of |
|
Definition
| uncontrolled hypertension |
|
|
Term
| Individuals who require the highest amount of iron and are most likely to develop iron deficiency anemia |
|
Definition
| women (especially pregnant women) and children |
|
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Term
| Oral iron preparations are available as |
|
Definition
|
|
Term
| most common adverse effects associated with oral iron preps |
|
Definition
nausea, vomiting,diarrhea, constipation, stomach cramps, stomach pain
Excess iron intake can lead to accumulation and iron toxicity |
|
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Term
| Iron overdose is the most common cause of |
|
Definition
| pediatric poisoning deaths reported to US poison control centers |
|
|
Term
| Anemias caused by folic acid deficiency are treated with |
|
Definition
|
|
Term
| used to treat pernicious anemia and other megaloblastic anemias |
|
Definition
| Cyanocobalamin (Vitamin B12) |
|
|
Term
| To avoid discoloration of tooth enamal |
|
Definition
| sip oral iron through a straw |
|
|
Term
| Oral forms of iron need to be given with plenty of fluids but not with |
|
Definition
| antacids or milk and preferably not with meals because of the risk for decreased absorption of the drug |
|
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Term
|
Definition
| nausea, diarrhea, hematemesis, pallor, cyanosis, shock, and coma |
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