Module 09 Hematological Disorder Anemia
Pathophysiology
Anemia is defined as a decrease in erythrocyte mass or hemoglobin concentration caused by impaired erythrocyte production, blood loss, or increased erythrocyte destruction. Anemia occurs when the number of red blood cells or the amount of hemoglobin decreases. Red blood cells are used by the body to transport oxygen via hemoglobin (hemoglobin binds oxygen to the RBC). The oxygen is then carried around the body and delivered to the cells, where it is used to perform cellular respiration and generate ATP. The cells produce ATP with oxygen (aerobic cellular respiration) and produce CO2, which we breathe out. Without oxygen (anaerobic respiration), cells use fatty chains for energy, which produces ketones as a byproduct (super acidic). Low oxygenation (hypoxia) causes an unbalanced pH, which then denatures proteins, preventing cells from reading their code/instructions because the code (DNA/RNA) is made of proteins.
Anemia’s pathophysiology is characterized by a decrease in red blood cell production, which affects the body’s gas exchange. Red blood cells develop in the bone marrow before being released into the system and transforming into reticulocytes (Arcangelo et al., 2017). Erythropoietin stimulates the production of red blood cells while decreasing tissue oxygenation and inducing hemoglobin formation (Arcangelo et al., 2017). Hemoglobin allows red blood cells to transport carbon dioxide and oxygen throughout the body. Anemia occurs when hemoglobin levels fall due to blood loss, red blood cell destruction, or decreased red blood cell production. The symptoms of anemia vary depending on the cause. Anemia is frequently caused by a combination of factors. Genetics, nutritional deficiency, physical trauma, or chronic disease can all cause (“Anemia,” 2017). Clinical manifestations of low hemoglobin levels include fatigue, shortness of breath, pale skin, irregular or fast heartbeat, weakness, and dizziness (Huether & McCance, 2017)
Etiology
“Anemia occurs when the production of red blood cells (RBCs) is decreased, the destruction of RBCs is accelerated, or there is a loss of RBCs due to bleeding. A combination of these mechanisms is present in many cases. Anemia is the most common hematologic disorder seen in primary care. Extremes in age, female sex, lactation, and pregnancy are all risk factors. Reduced RBC production can be caused by nutrient deficiencies, acquired bone marrow disease, genetic disorders, drugs, toxins, and chronic systemic diseases.” (Amenia evaluation, 2018) This is the most common type of anemia and is caused by a lack of iron in your body. Iron is required by your bone marrow to produce hemoglobin. Your body cannot produce enough hemoglobin for red blood cells if you do not consume enough iron. 2019 (Mayo Clinic)
Clinical Significance
Anemia is a condition in which the blood lacks healthy red blood cells. A lack of healthy red blood cells reduces the amount of oxygen that reaches the body’s organs. Clinical Manifestations of Anemia can differ depending on the type of anemia diagnosed. If the patient has mild anemia, they may not have any symptoms, or they may have fatigue, generalized weakness, dyspnea, and tachycardia. Clinical manifestations are also affected by the patient’s age, the presence of comorbidities, and hemoglobin levels. Severe or moderate anemia is defined by a decrease in blood pressure upon standing from a lying or sitting position, a change in Pallor, tachypnea, dyspnea, tachycardia, transient murmur, angina pectoris, heart failure, intermittent claudication, night cramps in muscles, headache, lightheadedness, tinnitus, roaring in the ears, and faintness (Banasik,2019).
Treatment
There are numerous treatment options for anemia. Giving blood transfusions is the most common treatment plan seen in professional settings. Blood transfusions help replenish the body’s blood supply. In addition, doctors will prescribe pain relievers, oxygen, iron supplements, and intravenous fluid solutions. It is also recommended that anemia patients change their nutritional diet and consume iron-rich foods. Iron is abundant in red meat, beans, and peanuts, for example. It is also critical to educate our anemic patients about the dangers of tobacco use. Tobacco products have the potential to aggravate the condition.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Copstead, Lee-Ellen C., and Jacquelyn L. Banasik. Pathophysiology. Elsevier, 2019. Evaluation of Amenia. (2018). Retrieved from https://bestpractice.bmj.com/topics/en- us/93/etiology
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
JARVIS, CAROLYN PH.D. PHYSICAL EXAMINATION AND HEALTH ASSESSMENT. ELSEVIER, 2019.
Mayo Clinic. (2017). Retrieved from https://www.mayoclinic.org/diseases- conditions/anemia/diagnosis-treatment/DRC-20351366
Mayo Clinic: Anemia. (August 16, 2019). Retrieved from https://www.mayoclinic.org/diseases- conditions/anemia/symptoms-causes/sync-20351360
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Question
Initial post
Pick one hematological disorder covered in this module. For this disorder, identify and describe three treatment strategies for the disorder.
What challenges could arise in carrying out these strategies and providing care to the patient?
Reply Post
What interventions could be utilized in order to overcome these challenges?