Know the clinical manifestations and ND for anemia Pallor decrease hemoglobin

Know the clinical manifestations and nd for anemia

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Know the clinical manifestations and ND for anemia · Pallor (decrease hemoglobin, blood flow to skin) · Jaundice (increase concentration of serum bilirubin) · Pruritus (increased serum and skin bile salt concentration) Cardiovascular Manifestations · Additional attempts by the heart and lungs to provide adequate O2 to the tissues · Cardiac output maintained by increasing the heart rate and stroke volum able 30-3 Manifestations of Anemia Body System SEVERITY OF ANEMIA Mild (Hgb 10-12 g/dL [100-120 g/L]) Moderate (Hgb 6- 10 g/dL [60-100 g/L]) Severe (Hgb <6 g/dL [<60 g/L]) Integument None None Pallor, jaundice, * pruritus * Eyes None None Icteric conjunctiva and sclera, * retinal hemorrhage, blurred vision Mouth None None Glossitis, smooth tongue Cardiovascular Palpitations Increased palpitations, “bounding pulse” Tachycardia, increased pulse pressure, systolic murmurs, intermittent claudication, angina, heart failure, myocardial infarction Pulmonary Exertional dyspnea Dyspnea Tachypnea, orthopnea, dyspnea at rest Neurologic None “Roaring in the ears” Headache, vertigo, irritability, depression, impaired thought processes
Gastrointestinal None None Anorexia, hepatomegaly, splenomegaly, difficulty swallowing, sore mouth Musculoskeletal None None Bone pain General None or mild fatigue Fatigue Sensitivity to cold, weight loss, lethargy ND: Fatigue, imbalanced nutrition, ineffective health management Know normal values of CBC- Hgb, Hct, RBC, PLTS, WBC Hbg female – 13.2-17,3 Hbg male – 11.7-15.5 Hct female – 39-50% Hct male – 35-47% RBC <33 Platlets 150-400 x 10^3 WBC 4.0-11.0 x 10^3 Know foods high in iron and be able to teach patients why they still need supplements Nutritional Therapy Nutrients for Erythropoiesis Role in Erythropoiesis Food Sources Cobalamin (Vitamin B 12 ) RBC maturation Red meats, especially liver, eggs, enriched grain products, milk and dairy foods, fish Copper Mobilization of iron from tissues to plasma * Shellfish, whole grains, beans, nuts, potatoes, organ meats Folic Acid RBC maturation Green leafy vegetables, liver, meat, fish, legumes, whole grains, orange juice, peanuts, avocado Iron
Hemoglobin synthesis Liver and muscle meats, dried fruits, legumes, dark green leafy vegetables, whole-grain and enriched bread and cereals, beans Niacin RBC maturation Peanut butter, beans, meats, avocado; enriched and fortified grains Pantothenic Acid (Vitamin B 5 ) Heme synthesis Meats, vegetables, cereal grains, legumes, eggs, milk Pyridoxine (Vitamin B 6 ) Heme synthesis Meats, fortified cereals, whole grains, legumes, potatoes, cornmeal, bananas, nuts Riboflavin (Vitamin B 2 ) Oxidative reactions Milk and dairy foods, enriched bread and other grain products, salmon, chicken, eggs, green leafy vegetables Vitamin E Heme synthesis. Protection against oxidative damage to RBCs Vegetable oils, meat, eggs, wheat germ, whole-grain products, seeds, nuts, peanut butter Amino Acids Heme and plasma membrane synthesis Eggs, meat, milk and milk products (cheese, ice cream), poultry, fish, legumes, nuts, tofu Ascorbic Acid (Vitamin C) Conversion of folic acid to its active forms, aids in iron absorption

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