1229 Exam 7: childhood anemia

Question 0

HGB

Answer 0

13-18 males
12-18 females
Newborn 14.5. - 22.5

Measures amount of iron

Question 1

RBC

Answer 1

4.2 - 5.9 
# RBC 
Reflect bone marrow function

Question 2

HCT

Answer 2

42-50% male
48-50% females

% of RBC

Question 3

MCV

Answer 3

80-94 mcm3

Mean size of one RBC

Question 4

WBC

Answer 4

5-10

Total number of WBC

Question 5

Retic count

Answer 5

0.5 % -1.5%
Erythrocytes

Reflects bone marrow production

Is the number of immature red blood cells

Question 6

Childhood anemia diet hx

Answer 6

Reflects inadequate amounts of dietary iron sources

Breast milk without supplemental iron

Question 7

Newborns have stored iron that will last ———

Answer 7

4-6 months

Question 8

S/s of childhood anemia

Answer 8

Tachycardia 
Headache 
Fatigue 
Shortness of breath 
Systolic murmur 
Pica 
Overweight, underweight , chubby 
Pale 
5-6 months old 
Decreased HgB < 10 or 11 cells are small microcytic

Question 9

Administration of ferrous sulfate

Answer 9

Give through straw or syringe 
Sid elf mouth 
Brush teeth afterwards 
Give with citrus source such as orange juice 
Vit C increase absorption
Give between meals 
DO NOT GIVE WITH MILK milk blocks uptake

Question 10

What to teach about ferrous sulfate

Answer 10

BM will be dark tarry green
IM iron must be given z tract DO NOT MASSAGE SKIN AFTER
iV - a lot of anaphylaxis and stains skin must be tested 1st
ferric form is not as absorbable as ferrous kind
Meat has formed heme leafy greens is preformed heme.

Question 11

Sickle cell

Answer 11

Suckling of RBC which occlude micriocirculation
Increase RBC destruction
Vasoocclusive , acute splenic sequestration

Question 12

Sickle cell in genetics

Answer 12

Autosomal recessive

African American

Question 13

If both parents are carriers of the trait what percentage of their children are more than likely going to have the disease?

Answer 13

25%

Question 14

If both parents are carriers of the disease what is the percentage of their child being a carrier ?

Answer 14

50%

Question 15

S/s of sickle cell

Answer 15

Vasoocclution 
Acute splenic sequestration 
Aplastic 
Hyper hemolytic (destruction of blood cells) 
CVA
Chest syndrome 
Infection

Question 16

Assessment for sickle cell anemia

Answer 16

Racial background
Results of screening (sickle turgidity / sickledex) 
Tachycardia 
Dark urine 
Enlarged spleen
Enlarged liver
Frontal bossing
Decreased activity 
Pain
SOB
Slurred speech/altered mobility 
Increase for infection 
Enuresis 
Visual disturbances 
Skeletal deformities 
Osteomyelitis - bone infection

Question 17

Nursing DX sickle cell

Answer 17

Risk for infection
Acute pain
Impaired gas exchange 
Impaired physical mobility 
Impaired cardiac output
Activity intolerance 
Self deficit
Altered growth

Question 18

What is the number 1 killer of sickle cell patients?

Answer 18

Infection

Question 19

Painful erection in young boys

Answer 19

Pripism

Question 20

PO fluids

Answer 20

100ml/ kg for 1st 10 kg
50 mL/ kg for 2nd 10 kg
20 mL/ kg for remainder

Question 21

What pain med do you not give children with sickle cell

Answer 21

Demerol

Question 22

To much iron

Iron overload

Answer 22

Hemochromatosis

Question 23

Removing heavy metals from the blood is called ?

Answer 23

Chelation

Question 24

Why no Oxygen therapy for sickle cell patients?

Answer 24

It prevents production of red blood cells

Question 25

Why will sickle cell children have enuresis ?

Answer 25

Small kidney have small nephrons so bed wetting is more frequent.

Question 26

Beta thallesemia

Answer 26

Aka Cooley anemia
Major defect HEM A chain 
Autosomal recessive 
Homozygous form 
Defective HgB with short lifespan 
Structurally impaired RBC

Question 27

Ethnicity of thallesemia

Answer 27

Mediterranean decent, Greek, Italian , Syrian

Question 28

S/s of thallesemia

Answer 28

Pallor
Fever
Poor feeding 
Enlarged liver/spleen 
Headache 
Small structure delayed sexual maturation 
Bronzed freckled skin if no chelation 
Older children( large heads ) 
Bossing frontal bones 
Check bones
Protrusion of lips 
Teeth dont set correctly 
Osteoporosis

Question 29

Nursing Dx

Answer 29

Risk for infection
Impaired cardiac output 
Impaired gas exchange 
Activity intolerance
Knowledge deficit 
Anxiety r/t multiple painful procedures.

Question 30

Goal for thalassemia HGB?

Answer 30

> 9.5

Question 31

A Heavy metal antagonist antidote

Answer 31

Desferal

Oral- defersx

Question 32

________is rubbed on the skin to decrease pain of needle sticks

Answer 32

eMLA

Question 33

Hemophilia

Answer 33

X linked recessive 80% are classic
Deficiency of factor VIII by liver
Primary males
Vonwille brand vWF deficiency effects both male and females ( treated with DDAVP )

Question 34

Can a female have hemophilia?

Answer 34

Yes

Question 35

Assess

Answer 35

Assess inheritance pattern 
Review results of clotting studies 
Assess for bleeding in joints 
Assess joints and mobility 
Assess for signs of bleeding (warmth , redness , pain)

Question 36

Nursing Dx for hemophilia

Answer 36

Risk for hemorrhage
Risk for injury
Deficient knowledge
Acute pain

Question 37

Signs of bleeding ?

Answer 37

P, R increase

bP decreases

Question 38

What do you reconstitute factor VIII with before you administer?

Answer 38

Sterile water

Question 39

Keeps clots from breaking down.

Given for oral surgery and trama

Answer 39

Amicar

Question 40

Which is better vein puncture or heal stick for hemophilia patients ?

Answer 40

Veinipunture

Question 41

RICE

Answer 41

Rest
Ice
Compression
Elevate