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Peds > heme flashcards updated > Flashcards

heme flashcards updated

1
Q

An x-linked recessive disorder transmitted by females and predominantly found in male offspring’s

A

Haemophilia, in this disease, a group of bleeding disorders characterized by a deficiency in a blood clotting factor

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2
Q

Cara just delivered a baby that has excessive bleeding from the umbilical cord after it is cut. What disease do you think this newborn has?

A

Haemophilia. The nurse should also assess for bruising, nose bleeds, deep internal bleeding, and joint damage.

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3
Q

Haemophilia management includes:

A

meds (Factor VIII, Advate for Factor XI), DDAVP (increases the level of factor VIII), medic-alert bracelet, injury prevention, reg. dental diet, and no aspirin or aspiring like meds

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4
Q

Scotty, a 6 year old was recently diagnosed with Hemophilia. As his nurse, what are you going to educate mom about?

A

ANY head trauma= factor infusion, bleeding episodes need immediate attention, limitation in sports but encourage reg. exercise, make sure child wears medic-alert bracelet, and no aspirin or aspirin-like meds

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5
Q

Peety Pablo comes into the ED complaining of a headache when he work up, blurry vision and vomiting. He denies nausea though. What could he possible have?

A

Brain tumor. Patients with brain tumors typically will have a headache when awakening, vomiting without nausea, loss of concentration, change in behavior and vision problems

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6
Q

1 disease related death in children

A

Cancer

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7
Q

Most common childhood cancer

A

leukemia

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8
Q

Most common solid tumor

A

brain

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9
Q

What is the most common presenting symptom of brain tumors

A

headache on awakening

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10
Q

Pain, fever, weakness, cachexia, anemia, persistent vomiting, headache, infection, and bruising are all what?

A

Clinical presentations of brain tumors

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11
Q

In an assessment of a infant with a brain tumor, what might you find?

A

widening sutures, increasing frontal occipital circumference, and tense/bulging fontanel

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12
Q

Post op care for brain tumor includes:

A

observing for increased ICP and seizures, monitor I and O, and appropriate post-op positioning

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13
Q

While monitoring I and O, what are you specifically looking out for?

A

SIADH and DI

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14
Q

Upon assessment, your patient has voided a large amount of dilute urine. Since he is post-op brain tumor removal, what might this patient be exhibiting?

A

Diabetes insipidus caused by a deficiency in antidiuretic hormone. When ADH is inadequate, the renal tubules do not absorb water, leading to polyuria

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15
Q

Most postop clients with infratentorial (lower portion of back of the head) tumors are prescribed to:

A

lie flat or turn to either side

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16
Q

T or F, a large tumor may require that the child not be turned to the operative side

A

TRUE

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17
Q

Suctioning, coughing, and straining can all cause :

A

increased ICP

18
Q

Malignant, encapsulated renal tumor

A

Wilm’s Tumor- usually affects young, preschoolers

19
Q

Clinical manifestations of Wilm’s tumor include:

A

abdominal mass in flank area, confided to midline (usually discovered by parents), fever, pallor, lethargy, ^ BP (excess renin secretion)

20
Q

You are the nursing caring for 5 year old Billie who has a Wilm’s Tumor. What should you make sure you NEVER do to this patient?

A

NO abdominal palpation

21
Q

Most kids with Wilm’s Tumor undergo a nephrectomy, what is included in their post-op care?

A

Watch for ^ BP, monitor kidney function (I & O, urine specific gravity), maintain NG tube, check for bowel sounds, and support family during chemo and radiation

22
Q

This form of childhood cancer attacks the developing nerve cells in the adrenal gland

A

Neuroblastoma also called the “Silent Tumor”

23
Q

Onset of Neurblastoma

A

22 months of age

24
Q

Clinical manifestations of Neuroblastoma

A

May have weight loss, irritability, and fever.

25
Q

What is the INSS?

A

International Neuroblastoma Staging System

26
Q

Stage 1

A

localized tumor with COMPLETE gross excision (lymph node may be positive)

27
Q

Stage 2A

A

localized tumor with INCOMPLETE gross excision (lymph nodes negative)

28
Q

Stage 2B

A

localized tumor WITH OR WITHOUT complete gross excision, with ipsilateral nonadherent lymph node positive for tumor

29
Q

Stage 3

A

unresectable unilateral tumor infiltrating across the midline, with or without regional lymph node involvement; or localized unilateral tumor with contralateral regional lymph node involvement; or midline tumor with bilateral extension by infiltration (unresectable) or by lymph node involvement

30
Q

Stage 4

A

any primary tumor with dissemination to distant lymph nodes, bone, bone marrow, liver, skin, and/or other organ (except as defined by 4S)

31
Q

Stage 4S

A

localized primary tumor (as defined for stage 1, 2A, or 2B) in infants aged less than one year with dissemination limited to skin, liver, or bone marrow (marrow involvement should be minimal)

32
Q

Unrestricted proliferation of immature WBCs

A

Leukemia

33
Q

Consequences of Leukemia

A

Anemia ( v RBCS, infection (neutropenia), and bleeding (from thrombocytopenia)

34
Q

Nursing considerations for Leukemia

A

prepare pt/family for tests, relieve pain, prevent infection, prevention bleeding, protect the kidneys from uric acid (allopurinol), manage nausea and vomiting, and soothe mucosal ulceration

35
Q

Why are we worried about uric acid in a leukemia patient?

A

Rapid cell destruction from chemo results in a high level of uric acid being excreted during treatment. This can plug the glomeruli and renal tubules, causing loss of kidney function

36
Q

What do you want to look out for in a patient with neutropenia?

A

Febrile Neutropenia- watch for temp > 38.3 C (101F). Nurse should be concerned about possible infection.

37
Q

What are common sites of infection?

A

Central lines, oral mucosa, and surgical sits. Infections can be bacterial, viral, and fungal

38
Q

Timmy has leukemia. His parents noticed a he just has not been acting “right”. They bring him into the ED. He has an elevated temp. What labs might the MD order STAT?

A

CBC with differentials, blood cultures from all lumens of CVAD and obtain a peripheral specimen

39
Q

Culture pos. in lumen, but negative in the periphery. What might the course of action be?

A

Kill bacteria in CVAD with antibiotics, but keep it indwelling.

40
Q

Culture pos. in both lumen and periphery, what might be the course of action?

A

Take the CVAD out, because now we are dealing with a systemic infection.

Peds (8 decks)

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