agents used to treat anemias. anemia decreased number of circulating red blood cells decreased...
TRANSCRIPT
Agents Used to Treat Anemias
AnemiaDecreased number of circulating red blood cellsDecreased hemoglobin = decreased oxygen capacity
Many causes
.22 - 2
Iron-Deficiency AnemiaBlood loss
Number one cause Nutritional deficit
2nd most common cause Clients with:
Bleeding disordersMensesPregnant womenInfants Blood donors
22 - 3
Treatment for Iron Deficiency Anemia
Correct the cause of blood loss if possible
Iron therapy: usually oral Absorption: proximal portion of the small intestine
5-10% usually absorbed may be as high as 20-30% if seriously depleted
.22 - 4
Treatment for Iron Deficiency Anemia
Three iron salts most commonly used are ferrous sulfate, ferrous fumarate, ferrous gluconate Ferrous sulfate more readily absorbed
Contains different proportions of elemental iron
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
22 - 5
Treatment for Iron Deficiency Anemia
Elemental iron: 200mg dailyTherapy should be continued for 6 months
Iron should be taken on an empty stomach
22 - 6
Treatment for Iron Deficiency Anemia
Concurrent use of Vitamin C can help increase absorption: give with orange juice
Iron should be given in divided doses
Parental therapy may be indicated
22 - 7
Therapeutic AgentsIron salts
Ferrous sulfateFerrous fumarateFerrous gluconate
Side effectsGastrointestinal upsetConstipation and dark stools
IM, IV
22 - 8
Antianemia medicationsChemotherapy-induced anemia
occurs in 7 out of 10 patients damages the normal blood cellsDoes not differentiate cancer cells from normal cells
Radiation therapy, certain drugs used to treat HIV/AIDs, and chronic renal failure can result in anemia
Examples: Epogen, Eprex and Procit
22 - 9
Epogen or Procrit
Synthetic productsGeneric: epoetin alfa recombinant
ErythropoietinSynthesized by the kidneysStimulates red blood cells
22 - 10
Nursing ConsiderationsLow dose may be lethal for childrenEducate patients to store iron out of
children’s reachRemind patients that iron may cause
black stoolsNeed to educate patients on the
necessity of taking iron on a long-term basis
Remind to take with vitamin C source
Megaloblastic Anemias
Large red blood cellsNeutrophil and platelet changes
Treated with vitamin B12
Intramuscular
22 - 12
Vitamin B12 Deficiency Normally Vitamin B12 is chemically
combined with intrinsic factor and then absorbed in the blood at the terminal ileum
Vitamin B12 deficiency can be caused by Gastrectomy pernicious anemia chronic use of drugs that decrease
Vitamin B12 absorption
22 - 13
Vitamin B12 Deficiency(cont’d)
Anemia develops when total-body B12 content falls below 200 mcg
Symptoms may take years to develop
22 - 14
Vitamin B12 Deficiency Symptoms
-weakness -sore tongue -numbing or tingling of the extremities -anorexia -shortness of breath -yellow complexion
If untreated, may lead to spasticity, emotional disturbances
22 - 15
B12 deficiency: treatment
Need to replenish stores as well as meet daily requirements
Parental therapy by intramuscular (IM) injection
May need maintenance therapy for life
22 - 16
Folic acid deficiency
The average daily diet contains 200 mcg of folic acid
Folic acid deficiency can occur in: pregnancy alcoholics nutritionally deprived patients patients using drugs that increase need for folic acid
22 - 17
Folic Acid DeficiencyFDA requires addition of folic acid to flours enriched breads cornmeals, pasta, and riceFolic acid deficiencies related to neural tube defects in the developing fetus
Most vitamin products contain 0.4mg of folic acid
Nursing Considerations
Assess the symptoms and effectiveness of the treatment
Vitamin B12 supplement should not be stopped; can cause neurological problems
22 - 19
Nursing ConsiderationsEncourage pregnant women or those planning to become pregnant to take folic acid supplements
Provide nutritional educationAssess for constipationEncourage appropriate follow-up with provider
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
22 - 20