PATCHS PROGRAM PUBLIC HEALTH NURSING ADVOCATES TEACHING CHILD HEALTH AND SAFETY HEALTH CARE PROGRAM FOR CHILDREN IN FOSTER CARE (HCPCFC)
Volume 1, Issue 13		SEPTEMBER 2003

Medical Information Fact Sheet

Anemia:

Anemia is a condition in which there is not enough healthy red blood cells to carry adequate oxygen to the tissues. There are many types of anemia, each with its own cause. These causes can be iron or vitamin deficiency, blood loss, a chronic illness, or a genetic or acquired defect or disease. It may also be a side effect of a medication. Anemia can be temporary or long-term and can range from mild to severe.

Now that summer is upon us we will also review drowning and prevention. Hope this information will provide everyone with valuable safety information.

Signs & Symptoms:

The main symptom of most types of anemia is fatigue. Other signs and symptoms may include:

• Weakness
• Pale skin, including decrease pinkness of the lips, gums, lining of the eyelids, nail beds and palms
• A rapid heartbeat
• Shortness of breath
• Chest pain
• Dizziness
• Irritability
• Numbness or coldness in hand and feet
• Headache

Initially, anemia can be so mild it goes unnoticed. But signs and symptoms increase as the condition progresses.

Vitamin Deficiency Anemia:

Regular intake of Vitamin B-12, folate and Vitamin C are need to produce red blood cells. Deficiency in these vitamins can lead to anemia.
Other signs and symptoms that may be present in Vitamin deficiency anemia are loss of appetite and diarrhea. As well as the signs and symptoms directly associated with a deficit to a particular vitamin.

Vitamin B-12 deficiency may show signs and symptoms including:

• Yellowing or darkening of the skin
• Sore mouth or tongue
• Yellow-blue colorblindness
• Mental confusion or forgetfulness

Complications:

Being deficient in vitamins can lead to many health problems. Birth defects may occur as a result of vitamin deficiency during pregnancy. Nervous system disorders can occur like mental confusion, forgetfulness and numbness and tingling in hands and feet. Nervous system disorders are usually attributed to B-12 deficiency. Vitamin C deficiency can lead to scurvy, a rare disease usually manifested by bleeding under the skin and around the gums.

Treatment:

Eating a health diet and taking vitamin supplements can treat vitamin deficiency.

Iron Deficiency Anemia:

Iron deficiency anemia is very common. If you have this type of anemia you may feel tired or look pale. This anemia is due to insufficient amount of iron present. It is very common in women. The cause may be due to lack of iron in the diet, inadequate absorption of iron, or some form of blood loss such as from menstruation or slow, internal bleeding.

Signs & Symptoms:

Iron deficiency anemia signs and symptoms include:

• Cracks in the side of the mouth
• Inflammation or soreness of the tongue
• Brittle nails
• Unusual cravings for non-nutritive substances, such as ice, dirt, paint or pure starch.
• Headache
• Poor appetite, especially in infants and children
• Susceptibility to infection
• Restless legs syndrome- an uncomfortable tingling or crawling feeling in the legs that is generally relived by moving them.

Treatment:

If left untreated, iron deficiency anemia can become severe and lead to heart problems including a rapid, irregular heartbeat. It can also lead to heart disease and angina. Also iron deficiency anemia can lead to problems during pregnancy including premature and low-birth weight babies. Children who experience severe iron deficiency anemia can have delays in growth as well as physical and mental delays.

Aplastic Anemia:

Aplastic anemia is a rare and serious condition that occurs as a result of the bone marrow stops producing enough new blood cells. As a result of this not only are there not enough red blood cells to carry oxygen to the tissues but there is also not enough white blood cells to fight germs and not enough platelets to help blood clot.
This places a person at higher risk for infections and uncontrollable bleeding. The cause of this condition is due to a mistaken immune system response that destroys the bone marrow.
This condition can also arise secondary to other treatments including cancer chemotherapy, medications, pregnancy and exposure to toxic substances.

Signs & Symptoms:

Signs and symptoms for aplastic anemia include:

• Frequent infections
• Unexplained bruising
• Easy bruising
• Nosebleeds and bleeding gums
• Prolonged bleeding from cuts
• Skin rash
• Fever

The signs and symptoms are in addition to the common signs and symptoms that were mentioned previously.
Aplastic anemia may come on suddenly. The illness may be brief or linger chronically. Without treatment, it may progress and become fatal.

Treatment:

Aplastic anemia can be mild, moderate or severe. In severe aplastic anemia, the blood cell counts are extremely low. This is life threatening and requires immediate hospitalization for treatment. Mild to moderate is still serious but may not require hospitalization for treatment.
Treatment may include observation in mild cases, blood transfusions, and medications and in severe cases, bone marrow transplantation.

Self-Care:

It is important if you have aplastic anemia to avoid excessive exercise, contact sports and infections.

Sickle cell anemia:

Sickle cell anemia is a lifelong, inherited blood disease. People with the diagnosis are usually diagnosed as infants. The disease usually causes red blood cells to change from healthy, round red blood cells to sickly and crescent-shaped ones. The disease causes anemia and pain, among other problems.
Sickle cell anemia affects mainly African-Americans, though people of South American, Southern European or Middle Eastern descent are also at risk. A baby born with sickle cell anemia inherits a gene for the disorder from each parent. Some people only inherit one gene; this is referred to as having sickle cell trait. People who have sickle cell trait do not develop the disease but they can pass the gene on to their children.

Signs & Symptoms:

Signs and symptoms vary from person to person. People with the trait do not typically have any symptoms or problems. Some people have mild problems while others have severe symptoms that require frequent hospitalizations.

Signs and symptoms include:

• Anemia and all the associated signs and symptoms
• Episodes of pain. Periodic episodes of pain called crises are a major symptom of sickle cell anemia. Pain develops when the sickle-shaped red blood cells block blood flow through tiny blood vessels. Usually blood vessels in the chest, abdomen and joints are affected. Pain also occurs sometimes in the bones. The pain may vary in intensity and can last for hours to weeks. Some people experience only a few episodes of pain; others may experience dozens of episodes a year. If the crisis is severe enough, a hospitalization may be required to receive intravenous painkillers.
• Hand-foot syndrome. Swollen hands and feet are usually the first of sickle cell anemia in infants. This is caused when the sickle-shaped cells block blood flow out of hands and feet. Pain and fever often accompany the syndrome.
• Jaundice. Jaundice is a yellowing of the skin and eyes due to liver damage or dysfunction. Usually people with sickle cell anemia have some degree of jaundice because the liver in overwhelmed by the rapid breakdown of red blood cells.
• Frequent infections because of damage to the spleen by the sickle shaped cells. The spleen provides different types of immune functions.
• Stunted growth. Due to lack of oxygen and nutrients because of abnormal blood cells there may be delays in growth.
• Vision problems. Due to sickle cells blocking the tiny vessels in the eyes.

Complications:

Complications to sickle cell anemia may include stroke, acute chest syndrome, organ damage, and blindness. Other complications may include skin damage and sores, gallstones and in men, painful erections.

Treatment:

There is no cure for sickle cell anemia. Treatments are used to reduce pain and prevent complications.
Medications used to treat sickle cell anemia include antibiotics, pain relievers and Hydroxyurea (helps stimulate hemoglobin formation).
Blood transfusions can be used to treat sickle cell anemia. This is to replace cells with healthy cells.
Supplemental oxygen. This adds oxygen to blood and helps person to breathe easier.
Bone marrow transplant. This replaces bone marrow so that it may produce healthy blood cells.

Self Care:

Good nutrition, rest and protection from infection are vital for maintaining good health. Also take folic acid supplements, a well balanced diet, drink plenty of water, avoid extreme temperatures, avoid stress, exercise regularly and when flying on planes make sure the cabin is pressurized.

Mayo Clinic. (2003). Anemia. [Online]. Available: http://www.mayoclinic.com/onvoke.cfm?id=DSOO321

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HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!! Chris Jordan, PHN was relocated from the Hole Ave office to the Metro Office. Michelle Haynes, PHN was relocated from the Hole Ave office to the Hemet Office.

 

Editor: Kristen Thompson, PHN
Contributors: William Chavez, PHN, MBA, Interim Assistant Nurse Manager and Judy Earp, MHA, Director of Public Health Nursing.