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