Chapter 31 Nursing Management: Anemia Caused by Blood Loss

Anemia resulting from blood loss may be caused by either ?
acute or chronic problems.
Acute blood loss occurs as a result of ?
sudden hemorrhage.
Causes of acute blood loss include ?
trauma, complications of surgery, and conditions or diseases that disrupt vascular integrity.
The two clinical concerns with blood loss?
First,there is a sudden reduction in the total blood volume that can lead to hypovolemic shock.

Second, if the acute loss is more gradual, the body maintains its blood volume by slowly increasing the plasma volume.

Although the circulating fluid volume is preserved, the number of RBCs available to carry oxygen is ?
significantly diminished.
The clinical manifestations of anemia from acute blood loss are caused by?
the body’s attempts to maintain an adequate blood volume and meet oxygen requirements.
It is essential to understand that the clinical signs and symptoms the patient is experiencing are more important than the ?
laboratory values.
For example, an adult with a bleeding peptic ulcer who had a 750-ml hematemesis (15% of a normal total blood volume) within the past 30 minutes may have postural hypotension, but?
have normal values for Hb and Hct.
36 to 48 hours, most of the volume deficit will be repaired by ?
the movement of fluid from the extravascular into the intravascular space.
When does the hemoglobin and hematocrit reflect the blood loss?
36 to 48 hours, most of the volume deficit will be repaired by the movement of fluid from the extravascular into the intravascular space.
The nurse should be alert to the patient’s expression of ?
pain
Internal hemorrhage may cause pain because of ?
tissue distention, organ displacement, and nerve compression.
In the case of retroperitoneal bleeding, the patient may not experience?
abdominal pain.
Instead, the patient may have numbness and pain in a lower extremity secondary to?
compression of the lateral cutaneous nerve, which is located in the region of the first to third lumbar vertebrae.
The major complication of acute blood loss is?
shock
When blood volume loss is sudden, plasma volume has not yet had a chance to ?
increase
In sudden loss of RBCs is not?
reflected in laboratory data, and values may seem normal or high for 2 to 3 days.
The plasma is replaced by ?
endogenous and exogenous means, the RBC mass is less concentrated.
What happens to the lab results after endogenous and exogenous means replacement of the RBC making its mass less concentrated?
RBC, hemoglobin, and hematocrit levels are low and reflect the blood loss.
Collaborative care is initially concerned with ?
(1) replacing blood volume to prevent shock and
(2) identifying the source of the hemorrhage and stopping the blood loss.
IV fluids used in emergencies include ?
dextran, hetastarch, albumin, and/or crystalloid electrolyte solutions such as lactated Ringer’s.
Once volume replacement is established, attention can be directed to?
correcting the RBC loss.
The body needs 2 to 5 days to?
manufacture more RBCs in response to increased erythropoietin.
What may be needed if the blood loss is significant?
blood transfusions (packed RBCs)
What happens if the bleeding is related to a platelet or clotting disorder?
replacement of that deficiency is addressed.
The patient may also need supplemental iron because ?
the availability of iron affects the marrow production of erythrocytes.
When anemia exists after acute blood loss, dietary sources of iron will probably?
not be adequate to maintain iron stores.
After acute blood loss, what preparations are administered?
oral or parenteral iron
For the postoperative patient, the nurse carefully monitors the?
the blood loss from various drainage tubes and dressings and implements appropriate actions.
Once the source of hemorrhage is identified, blood loss is?
controlled, and fluid and blood volumes are replaced, the anemia should begin to correct itself.
The sources of chronic blood loss are similar to those of?
iron-deficiency anemia
sources of chronic blood loss?
(e.g., bleeding ulcer, hemorrhoids, menstrual and postmenopausal blood loss).
The effects of chronic blood loss are usually related to ?
the depletion of iron stores and are usually considered as iron-deficiency anemia.
Management of chronic blood loss anemia involves ?
identifying the source and stopping the bleeding.
Supplemental iron may be?
required