Families Exam 5 - hematologic disorders Flashcards
What does iron deficiency anemia look like?
- decreased H&H
- brittle, spoon-shaped nails
- pallor, fatigue
When can iron supplements NOT be given?
1 hr before or 2 hrs after milk/antacids
When is it best to give iron supplements?
on an empty stomach
What is it best to give iron supplements with?
vitamin C
- orange juice
How can staining of teeth be prevented with oral iron supplements?
- use a straw
- brush teeth after
How should iron supplement injections be given?
- z-track
- IM
What normal finding happens with iron supplements?
tarry, green stools
How much milk should a toddler taking iron supplements consume?
no more than 32 oz/day
What type of anemia causes jaundice, SOB, cold hands/feet, dizziness, and HA?
sickle cell anemia
A vaso-occlusive crisis can occur with sickle cell anemia. What happens with this?
- severe pain (bones, joints, abdomen)
- swollen joints/hands/feet
Sequestration can occur with sickle cell anemia. What happens with this?
- splenomegaly
- possible hepatomegaly
- hypovolemia/hypovolemic shock
Aplastic crisis can occur with sickle cell anemia. What does this cause?
- decreased RBC production
- extreme anemia
What do tachycardia, hypotension, decreased urine output, and a pale/weak pulse indicate with sickle cell anemia?
shock
What is important to maintain with sickle cell anemia?
HYDRATION!!!
- give fluids
- maintain F&E balance
What pain medication is given for sickle cell anemia? What pain medication is contraindicated?
- YES: morphine
- NO: meperidine
Why is meperidine contraindicated for sickle cell anemia?
it increases the risk for seizures
What can increasing fluids cause with sickle cell anemia?
hypokalemia
What complications can occur with sickle cell anemia?
- cerebrovascular accident
- acute chest syndrome
What does a cerebrovascular accident look like with sickle cell anemia?
- seizures
- abnormal behavior
- weakness/inability to move extremity
- slurred speech
- visual changes
- HA
- vomiting
What does acute chest syndrome look like with sickle cell anemia?
- chest/back/abdominal pain
- fever > 101.3
- cough
- dyspnea, tachypnea
- retractions
- decreased O2 sat
What deficiency occurs with haemophilia A?
factor VIII
What deficiency occurs with haemophilia B?
factor IX
What does haemophilia look like?
- BLEEDING
- joint pain and stiffness
- prolonged aPTT
What type of sports can children with haemophilia play?
low-impact
- wear protective equipment (helmet)
How can you control bleeding with haemophilia?
- pad corners of furniture
- use a soft-bristled toothbrush
- use RICE (rest, ice, compression, elevation)
What medication can be used for haemophilia? What medication should NOT be used?
- YES: acetaminophen
- NO: aspirin
What are adverse effects of replacing factor VIII or IX?
- HA
- flushing
- decreased sodium
- alterations in HR and BP
