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Pediatric Nursing Care > Chapter 47: The Child with a Hematologic Alteration > Flashcards

Chapter 47: The Child with a Hematologic Alteration Flashcards

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1
Q

characterized by uncontrolled formation and deposition of fibrin thrombi

A

disseminated intravascular coagulation (DIC)

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2
Q

manifestations may include excessive bleeding from injury, petechiae, and blood oozing from minor procedure sites

A

disseminated intravascular coagulation (DIC)

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3
Q

treatment for iron deficiency anemia involves ___________

A

replacing iron

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4
Q

acute sequestration crisis can result in these two complications

A

acute anemia
respiratory failure

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5
Q

thalassemia major presents in children who inherit (1,2) copy/copies of the gene mutation

A

2

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6
Q

patients with moderate to severe hemophilia are at risk for bleeding in the _________

A

joints

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7
Q

treatment for painful episodes of a vasoocclusive crisis includes oral or IV __________ such as ___________ and/or _________, oral/IV ____________, aggressive ____________________ use, consistent pain ________________, and ______________ pain management

A

analgesics, morphine, NSAIDs, hydration, incentive spirometry, assessment, nonpharmacologic

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8
Q

thalassemia minor presents in children who inherit (1,2) copy/copies of the gene mutation

A

1

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9
Q

three causes of iron deficiency anemia in children

A
  1. decreased iron intake
  2. increased iron/blood loss
  3. periods of increased growth
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10
Q

complex process that results in simultaneous bleeding and clotting

A

disseminated intravascular coagulation (DIC)

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11
Q

treatment for thalassemia focuses on three main aspects

A

RBC transfusions, chelation therapy, splenectomy

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12
Q

most common form of anemia in children

A

iron deficiency anemia

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13
Q

this condition is caused by a genetic abnormality in hemoglobin synthesis, where there is a reduction or absence of one of the chains of normal hemoglobin

A

thalassemia

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14
Q

iron deficiency anemia has been linked to consumption of ___________, particularly before 12 months of age

A

cows’ milk

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15
Q

characterized by underproduction of a carrier protein for factor VIII

A

von Willebrand disease

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16
Q

another name for thalassemia major

A

Cooley anemia

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17
Q

two age groups that have the most rapid growth and therefore increase risk of iron deficiency anemia

A

infants, adolescents

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18
Q

diagnosis of thalassemia is made based on this lab work (4)

A

CBC, reticulocyte count, serum iron, TIBC

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19
Q

dactylitis (hand-and-foot syndrome) in vasoocclusive crisis occurs in children aged _________ to _________ and is characterized by ________________________

A

6 months, 4 years
swelling of hands or feet, pain, warmth in affected area

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20
Q

diagnosis of iron deficiency anemia involves these four lab tests

A

CBC, serum ferritin, serum iron, TIBC

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21
Q

this bleeding disorder can cause septic shock and multiorgan failure

A

disseminated intravascular coagulation (DIC)

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22
Q

hemophilia C lacks factor ____

A

XI

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23
Q

the dietary supplement ____________ helps blood cells form appropriately in patients with sickle cell disease

A

folic acid

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24
Q

treatment for acute chest syndrome with vasoocclusive crisis involves IV ___________ at ______ times maintenance, ___________, ___________, _____ transfusion, and ___________.

A

hydration, 1-1.5, antibiotics, oxygen, RBC, analgesics

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25
Q

acute sequestration crisis is characterized by blood volume pooling in ________, causing enlargement, and life-threatening _____________

A

spleen, hypovolemic shock

26
Q

hemophilia B lacks factor ____

A

IX

27
Q

treatment of aplastic crisis involves these two things

A
  1. RBC transfusions
  2. treatment of symptoms
28
Q

painful episodes of a vasoocclusive crisis are typically characterized by pain in _______ or ________

A

bones, joints

29
Q

five sources of dietary iron

A

egg yolks, dark green leafy vegetables, dried fruits (apricots), beans, liver

30
Q

thalassemia is inherited in this pattern

A

autosomal recessive

31
Q

acquired bleeding disorder that results in low platelet counts with an unknown cause

A

immune thrombocytopenic purpura (ITP)

32
Q

priapism with vasoocclusive crisis is characterized by

A

persistent, painful erection

33
Q

hereditary blood disorder that results in an interruption in clotting cascade, where the patient lacks one of the clotting factors

A

hemophilia

34
Q

acute chest syndrome in a vasoocclusive crisis is typically characterized by these four manifestations

A

chest pain, fever, cough, abdominal pain

35
Q

sickle cell disease is typically found in people with these four ethnic backgrounds

A

African, Mediterranean, Middle Eastern, Indian

36
Q

manifestations include hepatosplenomegaly, pallor, bronze or greenish-yellow skin tone, anemia, delayed growth

A

beta-thalassemia

37
Q

five things that can precede a sickle cell crisis

A

illness, dehydration, hypoxia, increased altitude, trauma

38
Q

aggressive incentive spirometry use for painful episodes during a vasoocclusive crisis means ___ breaths every __ hours while awake

A

10, 2

39
Q

treatment of acute sequestration crisis includes emergency treatment to restore _____________________ with ____________ and __________ infusion, long-term ____________ therapy if recurrent, and eventual ______________ in cases of persistent recurrence

A

circulating blood volume, crystalloid, colloid (blood), transfusion, splenectomy

40
Q

lab tests show these six things when iron deficiency anemia is present

A

low RBCs
decreased hemoglobin
smaller RBCs
decreased serum ferritin
decreased serum iron
increased TIBC

41
Q

these two medication classes help treat pain related to sickle cell disease

A

opioids (morphine)
NSAIDs

42
Q

hemophilia A lacks factor ____

A

VIII

43
Q

iron deficiency anemia is most common in these three age groups

A
  1. premature infants
  2. infants between 9-24 months
  3. adolescents
44
Q

to diagnose immune thrombocytopenic purpura, a ____________ is performed to rule out other causes of thrombocytopenia

A

bone marrow biopsy

45
Q

patients with sickle cell may have ___________ growth and puberty and may appear _______ or ______________ due to chronic hemolytic anemia

A

delayed, pale, jaundiced

46
Q

occurs when bone marrow ceases production of all cells

A

aplastic anemia

47
Q

three characteristic facial features of beta-thalassemia

A

frontal bossing (prominent and protruding forehead)
maxillary prominence
wide-set eyes with flattened nose

48
Q

aplastic crisis is characterized by

A

profound anemia caused by diminished erythropoiesis

49
Q

characterized by sudden onset of petechiae and bleeding from mucus membranes

A

immune thrombocytopenic purpura (ITP)

50
Q

treatment for cerebrovascular accident with vasoocclusive crisis includes long-term ________________ therapy or _________________, possible ___________ therapy, and sometimes requires extensive _____________.

A

RBC transfusion, erythrocytapheresis, chelation, rehabilitation

51
Q

this sickle-cell crisis includes these manifestations: decreased hemoglobin, acutely ill-looking child, pallor, irritability, tachycardia, impressively enlarged spleen, hypovolemic shock

A

acute sequestration crisis

52
Q

sickle cell disease refers to a group of congenital disorders, which include these three

A

sickled hemoglobin
chronic hemolytic anemia
ischemic tissue injury

53
Q

iron supplements are typically given ____ times a day and should be given ______________ to increase absorption

A

3, between meals

54
Q

treatment for hemophilia involves these three points

A

patient education to prevent injury/bleeding
infusions of missing factor
RICE therapy to treat bleeds

55
Q

treatment for priapism with vasoocclusive crisis includes ___________, ___________, avoiding ______________, and _____________ therapy if prolonged

A

analgesics, hydration, hot and cold packs, transfusion

56
Q

treatment for dactylitis is ______________ and involves these three things

A

self-limiting
oral analgesics, IV or oral hydration, rest

57
Q

treatment of disseminated intravascular coagulation (DIC)

A

give platelets and anticoagulants at same time

58
Q

typical hemoglobin goal for patients with thalassemia

A

11

59
Q

Sources of __________ such as _______ impede absorption of iron

A

calcium, milk

60
Q

manifestations include general pallor, pale mucous membranes and conjunctiva, tachycardia, tachypnea, lethargy, increased fatigue, and irritability

A

iron deficiency anemia

Pediatric Nursing Care (17 decks)

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