Ch.43 Hematologic and immunologic dysfunction Flashcards
Define anemia
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
How long do the transferred iron stores from mother last in a newborn
5-6months- full term
2-3 months- preterm
T/F infants younger than 12months should not be given cow’s milk
True, it may increase the risk for GI blood loss occurring from exposure to a heat labile protein
T/F citrus juice taken with iron medication aids in absorption
True
T/F an adequate dosage of oral iron turns the stools a tarry green color
True
What type of inheritance is Sickle Cell disease
Autosomal recessive, if both parents have the trait, there is 25% chance of the offspring having SCA
Describe the clinical features associated with Sickle Cell anemia
- Obstruction caused by the sickled RBC
- Vascular inflammation
- Increased RBC destruction
Describe the patho causing the pain associated with Sickle Cell anemia
The abnormal adhesion, entanglement, and enmeshing of rigid sickle-shaped cells accompanied by inflammatory process intermittently block the microcirculation, causing vasoocclusion
Describe a vasoocclusive crisis
Painful episode, characterized by mild-sever pain that last from minutes to days
Describe a Sequestration crisis
Pooling of a large amount of blood (spleen or liver) that causes decreased blood volume and untimely shock
Describe Aplastic crisis
Diminished RBC production usually caused by viral infection
Describe hyperhemolytic crisis
Accelerated rate of RBC destruction characterized by anemia, jaundice, and reticulocytes
Describe acute chest syndrome
Similar to pneumonia
Presence of new pulmonary infiltrate, may be associated with chest pain, fever, cough, tachypnea, wheezing, hypoxia
How can sickle cell cause a CVA
If the sickled cells block the major blood vessels in the brain, resulting in cerebral infarction, which causes variable degrees of neurologic impairment
What are the main objectives to mange a sickle cell crisis
- Rest to minimize energy
- Hydration through oral and IV
- Electrolyte replacement because hypoxic results in metabolic acidosis
- Analgesia for the severe pain
- Blood replacement to treat anemia and reduce viscosity of the sickled blood
- Antibiotics to treat any existing infection
T/F For treatment of SCA Oxygen is of little therapeutic value unless the patient has hypoxic a
True
Why is oxygen administration not effective in reversing sickling or reducing pain
Because oxygen is usable to reach the enmeshed sickled erythrocytes in clogged vessels
Define hemophilia
Bleeding disorders in which there is a deficiency of one of the factors (proteins) necessary for coagulation of the blood
Why is iron deficiency anemia common in childhood
Milk is a poor source of iron
When should iron fortified cereal be introduced to the infant
@ 6 months
What is the inheritance factor for hemophilia
X-linked recessive
Describe the pathophysiology of leukemia
unrestricted proliferation of immature WBC in the the blood forming tissues of the body
What is an immediate sign or an air embolus
difficulty breathing
What are signs of circulatory overload
precordial pain, dyspnea, distended neck veins, slight cyanosis, dry cough
Which immunizations should not be given to a child receiving chemotherapy
Measles, mumps, rubella
