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Three main plasma proteins: |
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Albumins Globulins Fibrinogen |
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Increases osmotic pressure in blood |
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Transportation of certain substances Helps protect against infection Main component of antibodies |
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Important for blood clotting |
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Cellular components of blood |
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RBCs, WBCs, and platelets |
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Ability to change shape 120 day life span Undergo recycling process |
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Each Hgb molecule can carry 4 Fe- molecules |
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Trigger for RBC production |
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RBC growth factor **At rate of RBC destruction |
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Excessive tissue oxygenation result |
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Essential substances to form RBC/Hgb |
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Fe-, B12, Folic Acid, Pyridoxine |
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Located under diaphragm to left of stomach Stores RBCs and platelets Destroys old or imperfect RBCs Filters antigens |
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Can store large quantities of whole blood & cells Produces most of blood clotting factors Stores extra Fe- as ferritin Small amounts of EPO produced in liver Controls Vitamin K |
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Age-related changes re: blood |
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Decreased blood volume Decreased blood cell production Decreased levels of Hgb after middle age |
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Dx tests r/t blood issues |
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CBC [RBCs, WBC w/ differential, MCV, MCHC, MCH, H&H, platelets] Retic count Serum ferritin Transferrin TIBC Schilling test |
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Male: 14-18; 42-52% Female: 12-16; 37-46% |
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measures free Fe- in blood |
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Serum Ferritin: nsg consideration |
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Must know baseline to determine abnormality |
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Protein which transports Fe- from GI tract **Difficult to measure |
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Total iron binding capacity *Measures how much Fe- is bound to ferritin |
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Tests for pernicious anemia Evaluates vitamin B12 absorption |
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Schilling test: nsg considerations |
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Ct must save all urine for 24-48 hours |
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Radioactive B12 given orally Nonradioactive B12 given IM **IM absorbs faster |
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Reduction in either # of RBCs, amount of Hgb or Hct |
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Dietary issues, hemorrhage, organ/marrow failure, Drug ingestion, genetic aberrations, surgical procedures, rapid metabolic activity, malabsorption syndromes, dialysis, viral infection |
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Fe- is essential for life 2/3 of Fe- is contained in Hgb 1/3 stored in bone marrow, liver, muscle & spleen *Stores are used before Hgb in deficiency |
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Most common form of anemia |
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Iron deficiency: inadequate iron intake r/t |
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Fe deficient diet Chronic ETOH use Malabsorption syndromes Partial gastrectomy |
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Pts at high risk for iron def. |
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Women elderly adolescents those with poor nutrition |
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Iron Deficiency: Clinical Manifestations |
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Small RBCs (microcytic) Decreased MCV Low serum ferritin Weakness Pallor |
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Increase intake of Fe-rich foods Take oral Fe supplement |
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Organ meats, kidney beans, red meat, egg yolks, carrots, green veg, whole wheat, cereals, and raisins |
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