Presentation Ms 1 (Group 2) ANEMIA

8/9/2019 Presentation Ms 1 (Group 2) ANEMIA

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MEDICAL & SURGICAL 1BLOOD

(ANEMIA)

GROUP 2


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DEFINITION OF ANEMIA

decrease in normal number of red blood cells(RBCs) or

less than the normal quantity of hemoglobin in the blood

Condition which occurs when have abnormally lowamount of red blood cell


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ETIOLOGY

1. Blood loss- acute or chronic.

o Acute

- interstitial fluid diffuses into the intravascular space and dilutes the

remaining RBC mass.

- levels of polymorphonuclear granulocytes, platelets, and, in

severe hemorrhage, immature WBCs and normoblasts may rise.

o Chronic blood loss

- loss is more rapid than can be replaced or, more commonly, if

accelerated erythropoiesis depletes body iron stores


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2. Destruction of RBC

Happen due to the infection or certain medication

Impaired erythropoiesis,

Lead to type of anemia

not sufficient to decrease the numbers of RBCs,

causes abnormal RBC size and shape.

Inherited condition :

Thalassemia

Sicklecell disease


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3. Inadequate production of RBC

Deficiency of essential factor (iron , vit B12, erythropoietin)

Body produce too few blood cell

Blood cell not work properly

Toxic hormone

Inflammatory disease , liver or kidney failure medication

example :

Sickle cell anemia Iron deficiency anemia

Vit B12 deficiency

Bone marrow problem


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OTHER CAUSE OF ANEMIA

Poor diet: low dietinironand vitamins,especiallyfolicacid rawmaterialsneeded to producesufficientnumbers of redblood

cells.

Family history: inherited genes

Alcoholism: Chronic drinking

Y?becausealcoholinterferes withtheabsorption of folicacid.

Vegetarians not getenoughiron or vitamin B12 intheir food.


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Chronicconditionslikekidneyor liver failure,and cancer increases Chronicblood loss fromsomeparts ofthebodydueto ulcers,haemorrhoids, etc,maylead to iron deficiencyanaemia.

Intestinalconditionslike Crohns disease: Intestinalpolypsand evenintestinalsurgerycan resultinnutritional

deficiencies Y? because ofpoorer absorption.

Other conditions: blood disorders, autoimmune disorders, exposureto toxinsand chemical, and the useand abuse ofcertainmedicinescanaffect redblood cell

production-cancer drug


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PATHOPHYSIOLOGY

A decrease ofnumber of RBC canbetraced to 3 difference condition:

I. Impaired ofproduction RBC

II. Increased destruction of RBC ,asinHemolyticand Sicklecellanemia

III. Massive or chronicblood loss

Someanemiaare related to geneticproblem


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TYPE OF ANEMIA1. IRON DEFICIENCY ANEMIA

- duetoblood loss,poor diet, or aninabilityto absorbenough

iron from foods.

2. PERNICIOUS ANEMIA (Vitamin B12 deficiency)

-anemiacausebyfailureto absorb dietaryvitamin B12

3. FOLATE ACID DEFICIENCY ANEMIA

- causebyinadequateintake of folicacid


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4. MEGALOBLASTIC ANEMIA

- ananemia (ofmacrocytic classification)that result frominhibition ofDNAsynthesisin redblood cellproduction

- often dueto deficiencyof vitamin B12 or folicacid

5. HEMOLYTIC ANEMIA

- notenough redblood cellintheblood , dueto premature of red

blood cells

6. SICKLE CELL ANEMIA

- diseasespassed downthrough familiesin redblood cell forman

abnormalprescent shape

- shaped like C or likea disc


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7. G6PD ANEMIA

- doesnthaveenough ofenzyme glucose-6-phosphate

dehydrogenase- help RBC functionnormaly

8.THALASSEMIA

- aninherited form of hemolyticanemia- RBC (HEMOGLOBIN)productionabnormilities


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SIGN AND SYMPTOM

Depend onseveritydiseases

Fatigue

Weakness

dizzinessPalpations (feeling theheart racing or beating

irregular)

Looking pale

Lowblood pressure

Cold skin

Jaundice (dueto BRCbreakdown)

Enlargement ofthespleen (certaincause ofanemia)


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INVESTIGATION

Investigationbased ontype ofanemia

Physicalexamination

Familyhistory

Laboratory review

Completeblood count

- to determinenumber of redblood celland whitecell

Blood smear examination- indicatethecause ofanemia

Irontest

- includetotalserumironand ferreting test

- determine whether anemiais dueto iron deficiency


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Hemoglobinelectrophoresis

-identifyvariousabnormalheamoglo bin intheblood

- to diagnosissicklecelland thalassemia

Bonemarrowaspirationandbiopsy

- a determine whether cellproductionishappening normally

Reticulocyte anemia

- ameasuretheyoung RBCs

-helpto determineif RBC productionisatnormallevel

Serum folate

- measureif folicacid deficiencyissuspected.


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COMPLICATION

Complications list for Anemia:

Anginaheart damageHeart failure

Heartattack

Skin discoloration

Cardiac failure

Chestpain

Headache


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TREATMENT Treatment for anemiaisbased ontype,causeand severityoftheanemia

Treatmentincludeinvestigation, diagnosisand management ofthe underlying causes

Treatment:

- highiron diet

- healthydiet

-vitamin B12 supplement

- blood transfusion

Eat wellbalanced mealthathighbiological value ofprotein

- Meat,poultry, fish,egg ,milk, dairyproduct


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serving fresh fruit and 2/3 servingvegetable

- to provide required folicacid

Vit C

- found abundancein fresh fruitpromoteforbetter absorption of folicacid and

iron from food


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- Long-term or seriousillnesses

kidneydisease,

cancer,diabetes,rheumatoid arthritis,inflammatorybowel disease (including

Crohns disease),

liver diseaseKidneyfailurethyroid disease


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HOW TO PREVENT

1) Increased intake of deficientnutrientindiet

- administer as supplement2) Changecookhabit

3) Taking dietaryhabit

4) Decreased alcohol intake

5) Controlchronic diarrhea

- helpcontrol folicacid

6) Blood transfussion


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WHO HIGH RISK

TO GET ANEMIA?

Factorsthat raiseyour riskfor anemiainclude:

-dietlowiniron, vitamins, or minerals

- Blood loss fromsurgeryor aninjury

- Long-terminfections

-A familyhistoryofinherited anemia,Sicklecellanemia

Thalassemia


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NURSING

CARE

PLAN


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Nursingdiagnosis

intervention rational

Activityintolerence RT

Tissue hypoxia and

dyspnea

1) Monitor vital sign toevaluate tolerance to

activity

2) Assist pt with self care

activity as needed

3) Restrict the ADL of

the pt

4) Plan activity

progression with pt

1) PT experiencing activityintolerance have

tachycardia , increased

respiratory rate

2) To decrease the amount

of energy expand by the

pt

3) To reduce the energy

4) Promote gradual return

to normal activity leveland improved muscle

tone without fatigue


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5 ) provide assistance

with activities and

ambulation as

necessary

6 )elevate head of bed

as tolerated

7) Recommend quiet

atmosphere , bed rest

if indicated

8)Identify and implement

energy savingtechnique

eg: sit while doing

activities

9) Administer oxygen as

order to relieve dyspnea

5 ) may help self

esteem enchance

when pt do some

things for self

6) Enhance lung

expansion to

maximize oxygenation

Of cellular uptake

7) Enhanced rest to lowerbody oxygen

requirement

8) To conserve limited

energy and prevent

fatigue

9) To anemic pt does not

have enough Hb to

carry oxygen to vital

organ


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Nutrition

imbalanced less

than body

requirement RTto disease

process or lack

of knowledge

of adequate

nutrition

1. Assess the elasticity

skin of the patient

to

2. Consult a dietation

3. Encourage patient to

eat in small amount

but frequent

4. Assess patient like

and dislike appetite

and condition

5. Discuss with the

patient on type ofdiet suitable for

himself

1. to see decreases of

nutrition

2. to provide diet instruction

3. to maintain nutrition in the

body

4. to recommendation of

appropriate diet.

5. to patient decide on type of

diet with nurse advise


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6. Encouragepatient to eat by

seeing comfort,food servingattractively

6. to provide

comfortenvironment thatcan increaseappetite.


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Risk of fall RT toweakness anddizziness

1. Assess the riskthe fall of thepatient

2. Assess patient tochangingposition

3. Make sure the bell alwaysnearest

4. Always keep thefloor dry and putsign of wet floorto preventpatient to fall

1. to providecomfortenvironment thatcan increase

2. to decreases thehigh risk of fall

3. to the patient foreasy the patientcall nurse whenneed help

4. to preventpatient to fall


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5. Make sure theside rail always

up

6. Always lower thebed

7. Tidy up all the

equipment togive comfortableenvironment toeasy patientmoved

8. Make sure allitem is easy topatient reach suchas chair andCupboard

5. to prevent patientto fall and support

patient from fall

6. to easy thepatient moved

7. to easy patient

moved

8. to avoid patientfall


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9. Wear suitable

shoes

10. Encourage patient

to rest and reduce

the movement the

patient.

9. to avoid slipper

10. To reduce energy

use by the patient


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GROUP MEMBER

NUYAH

JUNAIDAH

MOHDHISYAMMAILIN

NURNADIAH

GROUP 2

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Presentation Ms 1 (Group 2) ANEMIA