Hematological

Question 1

What is the baseline/normal Hgb range?

Answer 1

Baseline = 7-10
Normal = 12-17

Question 2

What type of Hgb do babies have? How is it different?

Answer 2

Fetal Hgb (last 4-6 months of life)
Shorter cell-life & higher quantities
↑ risk for anemia & O2 carrying probs

Question 3

When do babies switch to Hgb A?

Answer 3

Around 6 months and on

Question 4

Patho of allergies =

Answer 4

there is damage to antigen-antibody response that releases histamine –> causing allergy S/S

Question 5

What are the THREE types of reactions to latex?

Answer 5

1. ) IgE mediated
2. ) Cell-mediated (contact dermatitis)
3. ) Irritant dermatitis
   * * spinda bifida pt’s should NEVER be exposed to latex **

Question 6

What pt’s should NEVER be exposed to latex?

Answer 6

Pt’s w/spina bifida

Question 7

What is anaphylaxis?

Answer 7

An immediate/severe IgE response to an allergen

5-10 minutes

Question 8

Common triggers of anaphylaxis =

Answer 8

Nuts, shellfish, eggs, insect stings, penicillin, NSAIDs, dyes, & latex

Question 9

What happens during anaphylaxis?

Answer 9

Tissue edema –> vasodilation & circulatory collapse

Question 10

Treatment for anaphylaxis =

Answer 10

IV epi, corticosteroids, & antihistamines (if @ hospital)
If lip swelling/airway comp –> intubations & ventilation
Monitor for 2 hours after reaction

Question 11

What type of disease is sickle cell?

Answer 11

Autosomal recessive disorder

Question 12

What is sickle-cell?

Answer 12

Abnormal Hgb gene (Hgb S) & sickle-cell shaped RBCs

Question 13

What triggers a sick-cell crises?

Answer 13

Hypoxia, acidosis, dehydrations, fever, and/or hypothermia

Question 14

Complications of sickle-cell crises =

Answer 14

Vasoocclusive: pain r/t ischemia & dactylitis (fingers/toes swell)
Blood trapped in spleen
Silent cerebral infarct–stroke –> frequent neruo assess
Acute chest syn. – pulm. occlusion that mimics pneumonia but infarcts instead of infiltrates

Question 15

Treatment for sickle-cell disease =

Answer 15

Isotonic fluids
Warm compress
Penicillin (prevent infx)
Manage fever
Human leukocyte antigen-matching
Help make RBCs (folic acid)

Question 16

What medications can be used for sickle-cell dz?

Answer 16

Hydroxyurea (monitor neutrophils)
Deferoxamina (use w/vit C – helps free iron)
PRBCs

Question 17

What is Beta Thalassemia (Cooley’s Anemia)?

Answer 17

Autosomal recessive condition

Abnormal Hgb beta chain –> rapid RBC destruction

Question 18

What may you see w/Beta Thalassemia?

Answer 18

Ineffective erythropoesis –> bone probs/frontatl bossing
Yellow/bronze skin
Spleno/hepatomegaly
Iron overload

Question 19

Treatment for Beta Thalassemia =

Answer 19

Transfusion
Chelation (monitor kidney/liver & take w/vitamin C)
Bone marrow transplant
Splenectomy
Growth hormone

Question 20

When is chelation therapy used?

Answer 20

Iron & lead poisoning (or overload)

Question 21

What medications are given w/chelation therapy?

Answer 21

IV Desferal (deferoxamine) = iron removal via pee/poop

Exjade (PO deferoxamine) = dissolve in water/juice & monitor renal, liver, & GI function

EDTA

Question 22

How does a fetus get iron? What is a complication of premi babies r/t iron?

Answer 22

Fetus gets iron via mom’s placenta

Premi babies miss out on iron via placenta –> ↑ risk for iron deficiency anemia

Question 23

When do maternal iron stores deplete?

Answer 23

4-6 months

Question 24

When does normal infant physiologic anemia occur?

Answer 24

2-6 months

Question 25

What is iron deficiency anemia?

Answer 25

Not enough iron to make Hgb

Question 26

S/S of iron deficiency anemia =

Answer 26

``` Fatigue Pallor Spoon nails Tachy/murmurs Splenomegaly ```

Question 27

Iron rich foods =

Answer 27

Iron fortified rice cereal (babies), red meat, dried fruit

Question 28

How to admin iron =

Answer 28

Main stain teeth (rinse/straw) ↑ fluids/fiber to prevent constipation Stool may turn dark in color