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Ch. 49

Pediatric Hematologic/Immunologic Dysfx

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