Lecture Notes on Anemia and Sickle Cell Anemia

Overview

• Cathy from Level Up RN discusses various types of anemia and provides detailed information on sickle cell anemia.
• She concludes with a mini-quiz to test understanding of the key points covered.

Anemia Basics

• Definition: A blood disorder characterized by a decrease in red blood cells or hemoglobin.
• Causes:
  • Blood loss
  • Insufficient red blood cell production
  • Excess destruction of red blood cells
• Consequences: Decreased oxygenation to the body's tissues.

Common Types of Anemia

1. Blood Loss Anemia
   • Commonly caused by GI bleeding, trauma, and menorrhea.
2. Iron Deficiency Anemia
   • Insufficient intake or absorption of iron; common in pregnant women and children who consume excess milk.
3. Vitamin Deficiency Anemia
   • Insufficient intake of folic acid or B12.
   • Pernicious Anemia: Lack of intrinsic factor leading to inability to absorb B12 orally (requires parenteral administration).
4. Aplastic Anemia
   • Bone marrow damage caused by cancer, autoimmune disorders, or chemotherapy.
5. Hemolytic Anemia
   • Destruction of red blood cells due to genetic disorders, infection, autoimmune disorders, or medications.

Signs, Symptoms, and Treatment of Anemia

• Symptoms: Shortness of breath, pallor, fatigue, weakness, tachycardia.
• Treatment:
  • Oxygen and blood transfusions.
  • Iron supplements like ferrous sulfate or iron dextran for iron deficiency.
  • Vitamin B12 or folic acid supplements; intranasal B12 for pernicious anemia.
  • Erythropoiesis-stimulating agents, immunosuppressants, or bone marrow transplant for aplastic anemia.
  • Immunosuppressants or splenectomy for hemolytic anemia.

Sickle Cell Anemia

• Type: Autosomal recessive genetic disorder.
• Pathophysiology: Replacement of regular hemoglobin (HbA) with abnormal sickle hemoglobin (HbS), causing sickling of red blood cells and obstruction in blood vessels.
• Symptoms: Chronic anemia, pain, infection, organ damage, pain crises, and potential jaundice.
• Risk Factors: Family history, African American and Middle Eastern descent.

Crises in Sickle Cell Anemia

1. Vaso-occlusive Crisis: Characterized by severe pain, treated with opioid analgesics.
2. Splenic Sequestration Crisis: Blocked blood flow out of spleen, causing enlargement and potential hypovolemic shock.
3. Aplastic Crisis: Severe anemia typically related to a viral infection.
4. Acute Chest Syndrome: Impaired blood flow to the lungs; symptoms include dyspnea, fever, and cough.
5. Hyperhemolytic Crisis: Rapid decrease in hemoglobin levels.

Diagnosis and Treatment of Sickle Cell Anemia

• Diagnosis: Sickle turbidity test and hemoglobin electrophoresis.
• Treatment: Scheduled opioid analgesics, antibiotics for infections, IV fluids, blood products, and encouraged fluid intake to prevent dehydration and crises.

Patient Teaching for Sickle Cell Anemia

• Ensure adequate fluid intake to avoid dehydration.
• Perform meticulous hand hygiene and avoid crowds to prevent infection.

Mini-Quiz Review

• Question 1: Pernicious anemia is caused by a lack of intrinsic factor.
• Question 2: Vaso-occlusive crisis is characterized by severe pain.
• Question 3: Key patient teachings are adequate fluid intake and infection prevention.

Cathy encourages students to continuously review and use the provided medical-surgical nursing flashcards for better understanding and application of the concepts.