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Ch. 49
Pediatric Hematologic/Immunologic Dysfx
| Question | Answer |
|---|---|
| What is most common hematologic disorder of childhood | anemia |
| what are s/s or anemia | fatigue, pallor, tachy, SOB, murmur, nutrition deficiency, bone marrow failure |
| what is hemodilution | effect of anemia on circulation, blood diluted, turbulence for heart leads to murmurs, cardiac failure, cyanosis, growth retard |
| what is Hct/Hgb levels for aduilts | Hct male: 37-49, female: 36-46 Hgb male: 13-16, female: 12-16 |
| what is supportive care for anemia | IV fluids, O2, bed rest |
| How long does iron build up for term baby. What can lead to iron deficiency | 4-5mos, preemie: 2-3mos infection, illness, diet, malabsorption. |
| How give child more iron | iron fortified forumla, cereal, not just milk(no iron). Have dk stools, Vit C enhance absorption |
| Sickle Cell | replace normal Hgb wtih HgbS and takes sickle shape Hypoxia causes sickling |
| what is splenic sequestration | pooling blood enlarges spleen, lead to hemorrhage, pain in LUQ |
| Hemolysis leads to | hemo: anemia to hemodilution to heart failure |
| what is leading cause of death in sickle cell | bacterial infection |
| what can lead to sickle cell crisis | incr body's need for O2, trauma, infection, fever, stress, dehydration, high altitude, airplanes, hypothermia |
| what is most common type of crisis | vaso-occlusive (VOC) thrombotic, very painful. Vaso to hypoxia to tissue ischemia to infarction. |
| Splenic sequestration | hypovolemia, life threatening, blood pools, decr BP, incr HR |
| aplastic crises | decr RBC, viral inf or decr folic acid. Pallor, HA |
| tx for sickle of children | antibiotics, monitor bone marrow fx, blood transfusions lead to hemosiderosis(incr iron) then do chelation, hydroxyurea, no demerol |
| nsg mgmt of sickle cell | monitor growth, assess pain, observe for infeciton, s/s shock, psychosocial |
| what is epitaxis and how to care for it | nose bleeds. Lean forward, pressure, ice, calm If last 20-30 min, go to hospital, norm is 10 min |
| what is Hgb for severe anemia | <6 |
| what is most common thalassemia | B-thalassemia, Cooley anemia, need transfusions, give IM using Z track method |
| what are s/s thalassemia | frontal bossy, freckling, bronzing, retarded growth, delayed sex characteristics |
| Tx for thalassemia | bone marrow transplant |
| aplastic anemia | without or depressed - pancytopenia(all forms) |
| what is hypoplastic anemia | depressed RBC, normal WBC/platelets |
| what are two types of hemophelia | A - lack factor VIII B (Christmas disease) - lack factor IX, can be diagnosed through amniocentesis |
| how to manage hemoarthrosis | elevate and immobilize, ice, tylenol(no aspirin,NSAIDS), ROM excercises, physical therapy, avoid obesity |
| what is leading cause of death in children past infancy | neoplastic disorders |
| What is most common form of childhood cancer | Leukemia, males >1yr, peak 2-6yr, |
| children with trisomy 21 have 20x greater risk to develop what | ALL |
| what is final dx for leukemia | bone marrow aspiration/biopsy |
| what are four phases of leukemia | induction therapy- aggressive CNS prophylactic therapy - intrathecal Consolidation therapy Maintenence therapy |
| what is final tx for leukemia | Hematopoietic stem cell transplatation (HSCT) |
| what is great risk of HSCT | graft vs host disease (GVHD), organ damage |
| who is greatest at recovery | female, 2-10yr |
| what are vesicants | sclerosing agents for chemo agents causes extravasation |
| moon face can cause | body image and from prednisone |
| what age does hodgkins disease hit? Non hodgkins disease | H: 15-19 NH: <14 |
| what temperature needs to alert doctor | 100.4 or higher for 3 days, night sweats, wt loss of 10% |
| what is SCID(severe combined immunodeficiency disease) | life threatening, no cells for immunity(no humoral or cell mediated) |
| What is Wiskott-aldrich syndrome | thrombocytopenia, eczema, bloody diarrhea Tx: blood transfusion therapy |
| what are some transfusions rx | hemolytic, febrile, allergic, air emboli, hypothermia, electrolyte disturbances |
| how long should you transfuse | slowly over 15-20 min |
| what is apheresis | removal of blood from an individual, separation of blood into components |
| what is ablative therapy | kill all cells b4 transplant |
| stem cells are harvested from | bone marrow, peripheral blood, umbilical vein of placenta |
| What is allogeneic bone? autologous? | match with compatible recipient, self |
| What is Wilm Tumor aka nephroblastoma | renal/intraabdominal tumor, males, Af. am Do not palpate abd |
| Brain tumors two types | infratentorial - brainstem supratentorial - cerebrum |
| what is most common malignant extracranial solid tumor of childhood | neuroblastoma, silent killer, may grow out of it |
| what are two types of bone tumors | osteosarcoma, Ewing sarcoma |
| what does osteosarcoma attack | metaphysis of long bone (distal femur), peak 10-25yr, |
| what does Ewing Sarcoma attack | marrow |
| what is rhabdomyosarcoma | (rhabdo - striated muscle) muscle, tendon, bursa, fascia myosarcoma(muscle) |
Created by:
palmerag
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