Hematological Flashcards
What is the baseline/normal Hgb range?
Baseline = 7-10 Normal = 12-17
What type of Hgb do babies have? How is it different?
Fetal Hgb (last 4-6 months of life)
Shorter cell-life & higher quantities
↑ risk for anemia & O2 carrying probs
When do babies switch to Hgb A?
Around 6 months and on
Patho of allergies =
there is damage to antigen-antibody response that releases histamine –> causing allergy S/S
What are the THREE types of reactions to latex?
- ) IgE mediated
- ) Cell-mediated (contact dermatitis)
- ) Irritant dermatitis
* * spinda bifida pt’s should NEVER be exposed to latex **
What pt’s should NEVER be exposed to latex?
Pt’s w/spina bifida
What is anaphylaxis?
An immediate/severe IgE response to an allergen
5-10 minutes
Common triggers of anaphylaxis =
Nuts, shellfish, eggs, insect stings, penicillin, NSAIDs, dyes, & latex
What happens during anaphylaxis?
Tissue edema –> vasodilation & circulatory collapse
Treatment for anaphylaxis =
IV epi, corticosteroids, & antihistamines (if @ hospital)
If lip swelling/airway comp –> intubations & ventilation
Monitor for 2 hours after reaction
What type of disease is sickle cell?
Autosomal recessive disorder
What is sickle-cell?
Abnormal Hgb gene (Hgb S) & sickle-cell shaped RBCs
What triggers a sick-cell crises?
Hypoxia, acidosis, dehydrations, fever, and/or hypothermia
Complications of sickle-cell crises =
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
Treatment for sickle-cell disease =
Isotonic fluids Warm compress Penicillin (prevent infx) Manage fever Human leukocyte antigen-matching Help make RBCs (folic acid)
What medications can be used for sickle-cell dz?
Hydroxyurea (monitor neutrophils)
Deferoxamina (use w/vit C – helps free iron)
PRBCs
What is Beta Thalassemia (Cooley’s Anemia)?
Autosomal recessive condition
Abnormal Hgb beta chain –> rapid RBC destruction
What may you see w/Beta Thalassemia?
Ineffective erythropoesis –> bone probs/frontatl bossing
Yellow/bronze skin
Spleno/hepatomegaly
Iron overload
Treatment for Beta Thalassemia =
Transfusion Chelation (monitor kidney/liver & take w/vitamin C) Bone marrow transplant Splenectomy Growth hormone
When is chelation therapy used?
Iron & lead poisoning (or overload)
What medications are given w/chelation therapy?
IV Desferal (deferoxamine) = iron removal via pee/poop
Exjade (PO deferoxamine) = dissolve in water/juice & monitor renal, liver, & GI function
EDTA
How does a fetus get iron? What is a complication of premi babies r/t iron?
Fetus gets iron via mom’s placenta
Premi babies miss out on iron via placenta –> ↑ risk for iron deficiency anemia
When do maternal iron stores deplete?
4-6 months
When does normal infant physiologic anemia occur?
2-6 months
What is iron deficiency anemia?
Not enough iron to make Hgb
S/S of iron deficiency anemia =
Fatigue Pallor Spoon nails Tachy/murmurs Splenomegaly
Iron rich foods =
Iron fortified rice cereal (babies), red meat, dried fruit
How to admin iron =
Main stain teeth (rinse/straw)
↑ fluids/fiber to prevent constipation
Stool may turn dark in color