Definition
• A decrease in the number of RBCs, the
quantity of Hgb, and/or the volume of
PRBCs (which is measured by Hct).
• It is not a disease, it is a symptom of a
disease or condition
• Can lead to tissue hypoxia
• How do you know if someone has
hypoxia?
Etiologies
• Inadequate production of RBCs
• Premature or excessive destruction of
RBCs
• Acute or chronic blood loss
• Nutrition deficits
• Hereditary factors
• Chronic diseases
Types of Anemias
Hypoproliferative—Inadequate production of RBCs
Iron deficiency, aplastic anemia, B-12 deficiency, folic acid
deficiency, renal dz, chronic inflammation, cancer,
chemotherapy induced
– MCV—size
• Macrocytic (H): B12 or folic acid deficiency
• Microcytic (L): iron deficiency or Thalassemia
– MCH—average amount of Hgb in a cell
• Follows values for size
– MCHC—color (has to do with concentration)
• Hypochromic (L): iron deficiency or Thalassemia
• Normochromic (may read as H due to abnormal shape of
cell): hemolytic anemia
– RDW—has to do with identifying a wide variation of
sizes in the cells, indicating abnormal blood
conditions
Treatments
• Most common
• Usually from inadequate diet or blood loss
• Smooth, sore tongue
• Brittle nails
• Angular cheilosis
• Pica
• Low ferritin, microcytic RBCs
Ferrous Sulfate
• Action: Replaces iron stores needed for RBC development, energy,
and O2 transport
• Dosage: po 750-1500 mg/d; IV 125 mg in 100 mL over 1h; requires
IV push test dose first.
• SE: Nausea, constipation, epigastric pain, black stools
• Nursing: If giving IV, give IVP test dose first to assess for reactions.
If giving IM, give Z-track in large muscle.
• Education: (Related to po route only) Take tabs whole, between
meals with juice. If upset occurs, take after meals. Do not take with
antacids or milk. Drink liquid through straw. Store in tight, light
resistant container. Stools will turn black. Do not substitute one type
with another. Take 1h before lying down. Eat iron-rich foods.