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Pediatrics > Hematologic Disorders > Flashcards

Hematologic Disorders Flashcards

1
Q

What is the site of RBC production?

A

Bone marrow

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2
Q

What are RBC’s responsible for?

A

Oxygen and carbon dioxide transport

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3
Q

What are platelets?

A

Cell fragments that work to stop blood flow from an injury by adhering to the walls of blood vessels and forming platelet plugs

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4
Q

The newborn has a ___ (higher or lower?) level of erythropoietin which stimulates ___ production

A

Higher; RBC production

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5
Q

Which levels are high in infants? RBC, HgB, Hct, Platelet

A

RBC, HgB, Hct

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6
Q

Which levels are low in infants? RBC, HgB, Hct, Platelet

A

Platelet

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7
Q

Anemia results from __, __, __.

A
  • Blood loss
  • Decreased production of erythrocytes or HgB
  • Hemolysis
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8
Q

Normal RBC blood value

A

Between 4 and 5

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9
Q

Normal Hct blood value

A

35 or 36

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10
Q

Normal HgB blood value

A

around 15

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11
Q

Normal WBC blood value

A

10, if it’s over then you are thinking about infection

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12
Q

Normal platelet blood value

A

200,000

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13
Q

If LOW MCV, what can be suspected?

A
  • Iron deficiency
  • Lead or toxins
  • Thalessemias
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14
Q

If HIGH MCV, what can be suspected?

A
  • Vitamin B12 deficiency
  • Aplastic anemia
  • Alcoholism
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15
Q

What is Anemia?

A

Anemia is a condition in which there is a decrease in the oxygen carrying capacity of the blood.

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16
Q

What are some general effects of anemia that stand out?

A

Being tired and concentration stand out; mental confusion and changes in appetite

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17
Q

What are early signs of Iron Deficiency Anemia?

A

Pallor, irritability, fatigue

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18
Q

What are late signs of Iron Deficiency Anemia?

A
  • Nail bed deformities (spooning)
  • Tachycardia
  • Growth retardation
  • Systolic heart murmur
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19
Q

What is the most common type of anemia in the US?

A

Iron Deficiency Anemia

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20
Q

Dietary iron is absorbed in the __.

It then passes to the bloodstream or stored in the intestinal epithelial cells as __.

A

Small intestine

Ferritin

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21
Q

3 diagnostic evaluations for Iron Deficiency Anemia

*What is reticulocyte count?

A
  • CBC (HgB is usually 6-11, decrease MCV)
  • Reticulocyte count (newly produced immature RBC)
  • Serum iron and serum ferritin (levels are low)
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22
Q

What is preferred as a replacement for iron?

A

Ferrous sulfate d/t it being absorbed the best

23
Q

What can chronic iron deficiency lead to?

A

Heart Failure

24
Q

What interferes with the absorption of iron? When should you give these items to avoid interference?

A

Fluoride, antacids, dairy products; give one hour before or two hours after

25
Q

What increases absorption of iron?

A

Vitamin C

26
Q

What does iron do to teeth?

A

Stains teeth; give iron with a straw, dropper or syringe

27
Q

What is Aplastic Anemia?

A

Failure of the bone marrow to produce adequate numbers of circulating blood cells

28
Q

Treatment for aplastic anemia

A

Stem cell transplant

29
Q

What are some safety interventions for a patient with aplastic anemia?

A
  • Preventing hemorrhage!!
  • No injections
  • No rectal temps
  • Extra soft tooth brush
30
Q

How do we help aplastic anemia patients protect against infection?

A

Private room and meticulous hand washing

31
Q

Explain what sickle cell anemia is

A
  • Autosomal recessive condition where normal hemoglobin is partially or completely replaced by the sickle shaped HgB S
32
Q

When do symptoms manifest in sickle cell anemia?

A

4-6 months

33
Q

What do many children undergo in early childhood regarding sickle cell anemia and what does it lead to?

A

They undergo a splenectomy which leads to severely compromised immunity.

34
Q

What is the reason for a splenectomy with sickle cell anemia?

A

Old cells get collected in the spleen

35
Q

S/S of sickle cell anemia

What ethnicities is sickle cell most common in?

A

Pain, pallor, hands and feet are cold, dizziness, headache, SOB

African American, Mediterranean, Indian or Middle Eastern

36
Q

Complications of sickle cell anemia:

  • Acute chest syndrome
  • Dactylitis
  • Priapism
  • CVA
A
  • Acute chest syndrome (chest pain): acute chest pain, fever, tachycardia, dyspnea, decreased O2 sat, retractions
  • Dactylitis: swelling in hands and feet
  • Priapism (persistent painful erection)
  • CVA (abnormal behavior, weakness, slurred speech, severe headache)
37
Q

Acute sequestration crisis: blood pooling in the spleen can lead to ___.

A

Hypovolemic shock

38
Q

What are some triggers for sickle cell crisis?

A
  • High altitudes
  • Increased blood viscosity (dehydration)
  • Infection, fever
  • Hypoxia
  • Hypoventilation
  • Vasoconstriction (cold exposure)
39
Q

What is a transcranial doppler test used for and at what age?

A

Used to assess intracranial vascular flow and determine risk for CVA, done annually on children 2-16

40
Q

What pain medication is NOT used for sickle cell anemia?

A

Demerol d/t side effect profile

41
Q

Early symptoms of lead poisioning

A

Fatigue, headaches, irritability, metallic taste

42
Q

Late symptoms of lead poisoning

A

Cognitive changes, memory problems, mentation becomes poor, kidney problems, weight loss

43
Q

Therapeutic management for long term exposure to lead

A
  • isolation from the source

- chelation therapy to remove lead from the body

44
Q

Therapeutic managements for someone who potentially ate doses of lead

A
  • Gastric lavage

- Bowel irrigation with polyethylene glycol solution

45
Q

Hemophilia is a..

A

X linked recessive trait expressed almost exclusively as carrier females and affected males

46
Q

Hemophilia A (classic hemophilia) is factor __ deficiency

A

Factor VIII; most common

47
Q

Hemophilia B (Christmas Disease) is factor __ deficiency

A

Factor IX

48
Q

Hemophilia lab tests results (normal or abnormal):

  • aPTT
  • Platelets and prothrombin time
  • Whole blood clotting time
A

aPTT is prolonged
Platelets and prothrombin is within range
Whole blood clotting time is within range or prolonged

49
Q

Hemophilia A is a __ bleeding disorder

A

Hereditary

50
Q

S/S of Hemophilia A

A

Spontaneous bleeding, easy bruising, nosebleeds, hematuria, bleeding after minor trauma

51
Q

What is the biggest worry with Hemophilia A?

A

Hemarthrosis (joint capsule swollen with blood)

52
Q

What is Factor VIII used for? Corticosteroids? N-SAIDS?

A

Factor VIII is used to prevent and treat hemorrhage

Corticosteroids is used to treat hemarthrosis

NSAIDS is used to treat synovitis

53
Q

What are some nursing interventions for epistaxis?

A
  • Sit forward with head tilted slightly forward
  • Apply pressure to nose for 10 minutes (ATI says 30 min)
  • Kleenex can be packed in nose
  • Swab with vaseline after it stops
  • May apply ice
  • Breath through the mouth
  • Seek ER is bleeding persists for more than 10 minutes

Pediatrics (3 decks)

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