HEMATOLOGIC/IMMUNOLOGIC DYSFUNCTION Flashcards
Signs of : IMMUNE THROMBOCYTOPENIC PURPURA
platelet count under 100k petechiae nose bleeds bleeding gums easy bruising
Nursing interventions for nose bleeds from ITP
keep child calm and quiet
compress nostrils for 10mins
plug nose with cotton and apply cold pack to bridge of nose
What meds would we give for longterm treatment of bleeding with ITP
anti D antibodies
What would we give for short term treatment of bleeding from ITP
IV immunoglubin (IVIG) prednisone
What are the most common viral infection associated with ITP
upper resp measles mumps rubella varicella human parvovirus
Best longterm care med for ITP and when to take it
splenectomy when the child is 5 or greater
What will be given to a ITP pat after a splenectomy
3 yrs of penicillin
What meds do we restrict for ITP
avoid ibuprofen
and aspirin but obviously bce they are a child
What med do we recommend to ITP pats for pain or fever
acetaminophen
Signs of sickle cell anemia
fatigue
fever
hand and feet swelling
joint pain
What is the most indicative sign of vasoocclusive sickle crisis
joint pain
What is the most important care for sickle cell
drink lots of water
Is increasing more iron for sickle cell good and why
no, bec RBC get broken down more rapidly releasing a lot of iron
Teaching for sickle cell
provide factual info
s/s of crisis
stress importance of immunizations
Why is immunizations important for sickle cell
infections can precipitate pain crisis
What nursing diag is best for sickle cell
altered tissue perfusion
What is the diag procedure for aplastic anemia
bone aspiration or biopsy
What is aplastic anemia
decreased prod of WBC, RBC, and platelets
What finding from a bone aspiration or biopsy would indicate aplastic anemia
25% or less cellularity of the bone marrow so 75% or more fat in the bone marrow
s/s of iron def anemia
irritabilty pale skin fatigue tachycardia tachypnea
How much breast milk/formula should an infant receive at 10 mo
no more than 24oz
What is something to check for regarding milk and infants under a year
make sure the milk they get is formula or breast, cows milk’s proteins can cause problems like iron def anemia
Should a 10mo diet be mostly milk or solid foods
solid foods
teaching for ferrous sulfate
use syringe or med dropper bec it can stain teeth
brush teeth after
stools may change to black/tarry appearance
keep med out of reach, iron toxicity can cause death
s/s of hemophilia A
prolonged bleeding
easy bruising
joint bleeding
what is hemo A lacking
factor 8
What is inheiritance pattern of hemo A
X linked
femals typically carriers
males typically affected
emergency care for hemo A
FFP
specific factor therapy
DDAVP or vaspressant
exercise freq
Most common internal bleed in Hemo A
joint bleeding
Differences betw Wilms tumor (nephroblastoma) and neuroblastoma
wilms doesnt cross midline
wilms are more common in older toddler
neuroblast usu affects newborn to early toddler
Treatment of wilms tumor
nephrextomy
and chemo
nursing care for wilms tumor
problems related for renal system BP edema I/O lung sounds from fluid retention electolytes
What is a palpation con for wilms tumor
is suspected dont palp
What percentage of children survive wilms tumors
90%
What prognosis for neuroblastoma
poor, doesnt get caught until late
signs of brain tumor
HA and vomiting, often causing them to wake up
What is a con with HA and brain tumors
its an emergency, HA’s dont typically wake children so if they do its not okay
cons for pre-op teaching before brain tumor removal
give info in small chunks- bec overwhelmed
repeat info
symptoms may be worse immediately after surg
Normal symptoms in post-op for brain tumor removal
sleepy
worse symptoms from before like weakness, no gag reflex
Abnormal findings that require ermergent care post op for brain tumor removal
CSF drainage
pupil probs like fix dilated pupils, unequal pups or pin point pups
What position is contraindicated for post op brain tumor removal
trendelenburg, should be semi fowlers with head at midline
