Erythropoiesis Process

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Diagram illustrating the process of red blood cell production and destruction.

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The diagram shows the process of erythropoiesis, where low blood oxygen levels trigger the kidney to release erythropoietin. This hormone stimulates the bone marrow to produce new red blood cells (reticulocytes) using iron, vitamin B12, folic acid, and other nutrients. Red blood cells circulate for about 120 days before being removed by the spleen or destroyed through hemolysis. Hemorrhage can lead to blood loss.

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Types of Anemias

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Anemia is a red blood cell disorder with various types including Hypochromic (Iron or Vitamin Deficiency), Aplastic (Malfunctioning Bone Marrow), Pernicious (Lack of Intrinsic Factor), Genetic Factors (Sickle Cell Anemia or Spheroidal), Erythroblastosis Fetalis (Destruction by Antibodies), and Secondary (Bleeding, Leukemia, Cancer or Chronic Kidney Disease).

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Iron deficiency anemia is the most common type in all ages due to inadequate iron in the diet and blood loss.

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Iron deficiency anemia requires checking stool for occult blood if suspected, taking oral supplements with orange juice to increase absorption, and using IV for ICU, which can cause anaphylaxis from hypersensitivity.

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Megaloblastic anemias are caused by deficiencies of either vitamin B12 or folic acid.

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Megaloblastic anemias result in changes in the morphology of RBCs, causing large RBCs and soreness of the tongue. GI issues decrease absorption of folic acid, and oral B12 supplements are mainly IM.

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Anemia in kidney disease occurs in patients with end-stage kidney disease (ESKD) when the serum creatinine level exceeds 3 mg/dL.

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In anemia due to kidney disease, the kidneys fail to make erythropoietin, leading to anemia. Clinical manifestations and assessment, medical and nursing management are crucial.

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Clinical manifestations of anemia can be acute or gradual.

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Acute anemia is severe, quick, and hypovolemic shock, while gradual decline shows mild symptoms like pale skin, hypotension, tachycardia, increased RR, low O2, and concave nails.

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Medical management of acute anemia involves specific treatments.

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Acute anemia management includes giving isotonic fluids, administering O2, beta blockers, and blood transfusions.

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Top foods high in Vitamin B12 include turkey, chicken, and salmon.

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Turkey: 48.2 mcg, Chicken: 13.7 mcg, Salmon: 9 mcg

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Bran flakes and sardines are good sources of Vitamin B12.

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Bran flakes: 7.9 mcg, Sardines: 7.6 mcg

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Foods high in iron include kidney beans, lentils, and spinach.

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Kidney beans, lentils, spinach