Ch.43 Hematologic and immunologic dysfunction

Question 1

Define anemia

Answer 1

of RBC or hemoglobin concentration is reduced below normal values. Diminishes the oxygen carrying capacity of the blood causing reduction in the oxygen available to the tissues

Question 2

How long do the transferred iron stores from mother last in a newborn

Answer 2

5-6months- full term

2-3 months- preterm

Question 3

T/F infants younger than 12months should not be given cow’s milk

Answer 3

True, it may increase the risk for GI blood loss occurring from exposure to a heat labile protein

Question 4

T/F citrus juice taken with iron medication aids in absorption

Answer 4

True

Question 5

T/F an adequate dosage of oral iron turns the stools a tarry green color

Answer 5

True

Question 6

What type of inheritance is Sickle Cell disease

Answer 6

Autosomal recessive, if both parents have the trait, there is 25% chance of the offspring having SCA

Question 7

Describe the clinical features associated with Sickle Cell anemia

Answer 7

1. Obstruction caused by the sickled RBC
2. Vascular inflammation
3. Increased RBC destruction

Question 8

Describe the patho causing the pain associated with Sickle Cell anemia

Answer 8

The abnormal adhesion, entanglement, and enmeshing of rigid sickle-shaped cells accompanied by inflammatory process intermittently block the microcirculation, causing vasoocclusion

Question 9

Describe a vasoocclusive crisis

Answer 9

Painful episode, characterized by mild-sever pain that last from minutes to days

Question 10

Describe a Sequestration crisis

Answer 10

Pooling of a large amount of blood (spleen or liver) that causes decreased blood volume and untimely shock

Question 11

Describe Aplastic crisis

Answer 11

Diminished RBC production usually caused by viral infection

Question 12

Describe hyperhemolytic crisis

Answer 12

Accelerated rate of RBC destruction characterized by anemia, jaundice, and reticulocytes

Question 13

Describe acute chest syndrome

Answer 13

Similar to pneumonia

Presence of new pulmonary infiltrate, may be associated with chest pain, fever, cough, tachypnea, wheezing, hypoxia

Question 14

How can sickle cell cause a CVA

Answer 14

If the sickled cells block the major blood vessels in the brain, resulting in cerebral infarction, which causes variable degrees of neurologic impairment

Question 15

What are the main objectives to mange a sickle cell crisis

Answer 15

1. Rest to minimize energy
2. Hydration through oral and IV
3. Electrolyte replacement because hypoxic results in metabolic acidosis
4. Analgesia for the severe pain
5. Blood replacement to treat anemia and reduce viscosity of the sickled blood
6. Antibiotics to treat any existing infection

Question 16

T/F For treatment of SCA Oxygen is of little therapeutic value unless the patient has hypoxic a

Answer 16

True

Question 17

Why is oxygen administration not effective in reversing sickling or reducing pain

Answer 17

Because oxygen is usable to reach the enmeshed sickled erythrocytes in clogged vessels

Question 18

Define hemophilia

Answer 18

Bleeding disorders in which there is a deficiency of one of the factors (proteins) necessary for coagulation of the blood

Question 19

Why is iron deficiency anemia common in childhood

Answer 19

Milk is a poor source of iron

Question 20

When should iron fortified cereal be introduced to the infant

Answer 20

@ 6 months

Question 21

What is the inheritance factor for hemophilia

Answer 21

X-linked recessive

Question 22

Describe the pathophysiology of leukemia

Answer 22

unrestricted proliferation of immature WBC in the the blood forming tissues of the body

Question 23

What is an immediate sign or an air embolus

Answer 23

difficulty breathing

Question 24

What are signs of circulatory overload

Answer 24

precordial pain, dyspnea, distended neck veins, slight cyanosis, dry cough

Question 25

Which immunizations should not be given to a child receiving chemotherapy

Answer 25

Measles, mumps, rubella