Chapter 47: The Child with a Hematologic Alteration Flashcards
characterized by uncontrolled formation and deposition of fibrin thrombi
disseminated intravascular coagulation (DIC)
manifestations may include excessive bleeding from injury, petechiae, and blood oozing from minor procedure sites
disseminated intravascular coagulation (DIC)
treatment for iron deficiency anemia involves ___________
replacing iron
acute sequestration crisis can result in these two complications
acute anemia
respiratory failure
thalassemia major presents in children who inherit (1,2) copy/copies of the gene mutation
2
patients with moderate to severe hemophilia are at risk for bleeding in the _________
joints
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
analgesics, morphine, NSAIDs, hydration, incentive spirometry, assessment, nonpharmacologic
thalassemia minor presents in children who inherit (1,2) copy/copies of the gene mutation
1
three causes of iron deficiency anemia in children
- decreased iron intake
- increased iron/blood loss
- periods of increased growth
complex process that results in simultaneous bleeding and clotting
disseminated intravascular coagulation (DIC)
treatment for thalassemia focuses on three main aspects
RBC transfusions, chelation therapy, splenectomy
most common form of anemia in children
iron deficiency anemia
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
thalassemia
iron deficiency anemia has been linked to consumption of ___________, particularly before 12 months of age
cows’ milk
characterized by underproduction of a carrier protein for factor VIII
von Willebrand disease
another name for thalassemia major
Cooley anemia
two age groups that have the most rapid growth and therefore increase risk of iron deficiency anemia
infants, adolescents
diagnosis of thalassemia is made based on this lab work (4)
CBC, reticulocyte count, serum iron, TIBC
dactylitis (hand-and-foot syndrome) in vasoocclusive crisis occurs in children aged _________ to _________ and is characterized by ________________________
6 months, 4 years
swelling of hands or feet, pain, warmth in affected area
diagnosis of iron deficiency anemia involves these four lab tests
CBC, serum ferritin, serum iron, TIBC
this bleeding disorder can cause septic shock and multiorgan failure
disseminated intravascular coagulation (DIC)
hemophilia C lacks factor ____
XI
the dietary supplement ____________ helps blood cells form appropriately in patients with sickle cell disease
folic acid
treatment for acute chest syndrome with vasoocclusive crisis involves IV ___________ at ______ times maintenance, ___________, ___________, _____ transfusion, and ___________.
hydration, 1-1.5, antibiotics, oxygen, RBC, analgesics
acute sequestration crisis is characterized by blood volume pooling in ________, causing enlargement, and life-threatening _____________
spleen, hypovolemic shock
hemophilia B lacks factor ____
IX
treatment of aplastic crisis involves these two things
- RBC transfusions
- treatment of symptoms
painful episodes of a vasoocclusive crisis are typically characterized by pain in _______ or ________
bones, joints
five sources of dietary iron
egg yolks, dark green leafy vegetables, dried fruits (apricots), beans, liver
thalassemia is inherited in this pattern
autosomal recessive
acquired bleeding disorder that results in low platelet counts with an unknown cause
immune thrombocytopenic purpura (ITP)
priapism with vasoocclusive crisis is characterized by
persistent, painful erection
hereditary blood disorder that results in an interruption in clotting cascade, where the patient lacks one of the clotting factors
hemophilia
acute chest syndrome in a vasoocclusive crisis is typically characterized by these four manifestations
chest pain, fever, cough, abdominal pain
sickle cell disease is typically found in people with these four ethnic backgrounds
African, Mediterranean, Middle Eastern, Indian
manifestations include hepatosplenomegaly, pallor, bronze or greenish-yellow skin tone, anemia, delayed growth
beta-thalassemia
five things that can precede a sickle cell crisis
illness, dehydration, hypoxia, increased altitude, trauma
aggressive incentive spirometry use for painful episodes during a vasoocclusive crisis means ___ breaths every __ hours while awake
10, 2
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
circulating blood volume, crystalloid, colloid (blood), transfusion, splenectomy
lab tests show these six things when iron deficiency anemia is present
low RBCs
decreased hemoglobin
smaller RBCs
decreased serum ferritin
decreased serum iron
increased TIBC
these two medication classes help treat pain related to sickle cell disease
opioids (morphine)
NSAIDs
hemophilia A lacks factor ____
VIII
iron deficiency anemia is most common in these three age groups
- premature infants
- infants between 9-24 months
- adolescents
to diagnose immune thrombocytopenic purpura, a ____________ is performed to rule out other causes of thrombocytopenia
bone marrow biopsy
patients with sickle cell may have ___________ growth and puberty and may appear _______ or ______________ due to chronic hemolytic anemia
delayed, pale, jaundiced
occurs when bone marrow ceases production of all cells
aplastic anemia
three characteristic facial features of beta-thalassemia
frontal bossing (prominent and protruding forehead)
maxillary prominence
wide-set eyes with flattened nose
aplastic crisis is characterized by
profound anemia caused by diminished erythropoiesis
characterized by sudden onset of petechiae and bleeding from mucus membranes
immune thrombocytopenic purpura (ITP)
treatment for cerebrovascular accident with vasoocclusive crisis includes long-term ________________ therapy or _________________, possible ___________ therapy, and sometimes requires extensive _____________.
RBC transfusion, erythrocytapheresis, chelation, rehabilitation
this sickle-cell crisis includes these manifestations: decreased hemoglobin, acutely ill-looking child, pallor, irritability, tachycardia, impressively enlarged spleen, hypovolemic shock
acute sequestration crisis
sickle cell disease refers to a group of congenital disorders, which include these three
sickled hemoglobin
chronic hemolytic anemia
ischemic tissue injury
iron supplements are typically given ____ times a day and should be given ______________ to increase absorption
3, between meals
treatment for hemophilia involves these three points
patient education to prevent injury/bleeding
infusions of missing factor
RICE therapy to treat bleeds
treatment for priapism with vasoocclusive crisis includes ___________, ___________, avoiding ______________, and _____________ therapy if prolonged
analgesics, hydration, hot and cold packs, transfusion
treatment for dactylitis is ______________ and involves these three things
self-limiting
oral analgesics, IV or oral hydration, rest
treatment of disseminated intravascular coagulation (DIC)
give platelets and anticoagulants at same time
typical hemoglobin goal for patients with thalassemia
11
Sources of __________ such as _______ impede absorption of iron
calcium, milk
manifestations include general pallor, pale mucous membranes and conjunctiva, tachycardia, tachypnea, lethargy, increased fatigue, and irritability
iron deficiency anemia
