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Anemia

Anemia

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Published by simouny
An article on anemia, description, types, and treatment as well as nursing management.
An article on anemia, description, types, and treatment as well as nursing management.

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Categories:Types, School Work
Published by: simouny on Jan 09, 2009
Copyright:Attribution Non-commercial

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07/28/2013

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I. OVERVIEWWhat is Anemia?Anemia is an abnormally low number of circulation RBCs, low hemoglobin concentration, or both.Decrease number of circulating RBCs is the usual cause of anemia. This may result from blood loss,inadequate RBC production or increase RBC destruction. Insufficient or deficient hemoglobin within RBCscontributes to anemia. Depending on its severity, anemia may affect all major organ system. (Lemone,p934)II. DIFFERENT TYPES OF ANEMIA:
A. According to cause:
1.Decreased Erythrocyte Production
IRON DEFICIENCY ANEMIA
Iron deficiency anemia is the most common type of anemia. It develops when the supply of iron is inadequate of optimal RBC formation. The body cannot synthesize hemoglobinwithout iron. Iron-deficiency anemia results in fewer numbers of RBCs, microcytic andhypochromic RBCs, as well as malformed RBCs (poikilocytosis). Iron deficiency anemia mayresult from inadequate dietary iron intake. The body can store about ¼ to 1/3 of its iron,and it is not until those stores are depleted that iron-deficiency anemia actually begins todevelop. IDA is particularly common in older adults. Chronic, occult (hidden) blood loss mayoccur from slowly bleeding ulcers, gastrointestinal inflammation, hemorrhoids, an cancer.Inadequate dietary iron intake also contributes to anemia in older adults. Access totransportation may limit fresh food consumption, a factor contribution to poor iron intakeamong all adults, especially people with limited or fixed incomes.
ETIOLOGY:
Results in unavailability of iron hemoglobin synthesis
Due to low iron intake
x
Diminished absorption
x
Physiologically requierement such as pregnancy
x
Excessive iron loss such as chronic hemorrhage
x
Inadequate utilization of iron such as anemia and chronic disorder
MANIFESTATIONS:
Chronic iron deficiency may lead to:
x
Brittle spoon shaped nails
x
Cheilosis (cracks at the corner of the mouth)
x
A smooth soar tongue
x
Pica (cravings for unusual substances such as clay or starch)
THALASSEMIA
Thalassemia is another disease caused by decreased production of erythrocyte. It is anautosomal recessive genetic disorder of inadequate production of normal hgb. Thoughhemolysis also occurs, the predominant problem is the insufficient production of normal hgb.Thalassemia involves the problem with the globulin protein as compared to IDA where hehesynthesis is the problem.Members of ethnic group whose origin are near the Mediterranean sea and equatorial or nearequatorial regions of Asia and Africa. There are two form of disease: heterozygons andhomozygon. An individual who is heterozygous has one thalassemic gene and one normal geneand is said to have thalassemia minor, is milder than a homozygous person who has twothalassemic genes causing thalassemia major.
ETIOLOGY:
 
The causes of thalassemia are directly linked to genetics and how the genes that affecthemoglobin production are inherited. People with moderate to severe forms received variantgenes from both parents. People who are carriers of the disease received variant genes fromone parent and normal genes from the other parent. Regardless of the causes of thalassemia, treatment options are available for all forms of the disease.
CLINICAL MANIFESTATIONS:
Thalassemia minor
Asymptomatic
Splenomegaly
Mild jaundiceThalassemia major
Retarded physical and mental growth
Pale
Pronouncial hepatomegaly and splenomegaly
Jaundice
Thickening of the cranium and malillary cavity, caused by bone marrow hyperplasialeading to an appearance presembling doven syndrome
FOLIC ACID DEFICIENCY ANEMIA
o
VITAMIN B12 DEFICIENCY 
Vitamin B12 is necessary for DNA synthesis and is almost exclusively found in foods derivedfrom animals. Vit.B12 deficiency occurs when inadequate VitB12 is consumed, or morecommonly, when it is poorly absorbed from the gastrointestinal tract. Deficiency of thisvitamin impairs cell division and maturation, especially in rapidly proliferating red bloodcells. As a result, microlytic, misshapen (oval rather than concave) RBCs with thinmembranes are produced. Great numbers of these large, immature RBCs enter thecirculation. These cells are fragile, incapable of carrying adequate amounts of oxygen andhave a shortened life span.
ETIOLOGY OF VITB12 DEICIENCY:
Malabsorption disorders
Resection of the stomach/ileum
Loss of pancreatic secretions
Chronic gastritis (affect vitB12 absorption)
Dietary deficiency of vitB12 (occurs among strict vegetarians)
MANIFESTATIONS:
Manifestations develop gradually as bodily stores of the vitamin are depleted
Pallor/slight jaundice and weakness develop
Paresthesias (altered sensations, such as numbness or tingling) inextremities
Problems with proprioception ( sense of one’s position in place)
MEGALOBLASTIC ANEMIA
Are a group of disorders caused by impaired DNA synthesis resulting in defective RBCs. Theseanemias share the morphology of megablast (then large, abnormal, and premature RBCs) inthe blood and bone marrow.
ETIOLOGY
 
They are caused by deficiencies of vitB12(cobalamine) and folic acid.
MANIFESTATIONS:
Common feature include the following:
leukopenia, (a decrease number of white blood cells)
thrombocytopenia (a decreased number of platelets)
oral, GI, and neurologic manifestations
a favorable response to injections of either vitB12 or folic acid
Diarrhea
 Tinglingand numbness of hands and feet
Headaches
Sore mouth and tongue
Change in skin color
PERNICIOUS ANEMIA
A type of Megalobastic anemia. Pernicious anemia is a decrease in red blood cells that occurswhen the body cannot properly absorbvitamin B12from the gastrointestinal tract. Vitamin B12is necessary for the formation of red blood cells. Pernicious anemia, which results fromdeficiency, occurs most frequently in older than age 60 who have fair complexion and a familyhistory of family history of the disease.
ETIOLOGY:
Vitamin B12 deficiency usually results from malabsorption of the vitamin because of thedeficiency of the intrinsic factor that protects the vitamin so that it can be absorbed in theileum.Vitamin B12 normally binds chemically with the intrinsic factor that promotes its absorption. Incertain conditions, such as atrophy of the gastric mucosal cells, lack of secretion of the intrinsicfactor leads to malabsorption of vitB12. Normal erythrocyte maturation is dependent inadequate amounts of vitB12 for the synthesis of DNA molecules. Without vitB12, a microcytic ormegaloblastic anemia results, with marked anisocytosis (variation in RBC size) andpoikilocytosis (variation in RBC shape). Ineffective eryhtropoiesis a nd increased erythroblastdestruction result in hyperbilirubenemia. Although the most pronounced changes arise in RBCs,mild neutropenia and thrombocytopenia may occur.The onset of symptoms usually is insidious but maybe hastened by condition such as infection.Persons with pernicious anemia do not secrete hydrochloric acid (on gastric analysis) even afterparenteral stimulation with histamine.
MANIFESTATIONS:
Signs and symptoms of pernicious anemia are common to any of the anemic states.
Anorexia
Fatigue
Shortness of breath
Irritability
Soreness of the tongue characteristically occurs early in the illness and progressivelyworsens(soreness is quickly relieved after adequate vitB12 treatment)
Symmetric numbness and tingling of the toes and fingers occur on 10 percent of thesepeople (this may indicate early Neurologic disease)
Ataxia (loss of vibration sense) also maybe noted (Neurologic symptoms may not entirelyremit after treatment)

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