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peds (josh) > T3 - Blueprint 2 (Josh) > Flashcards

T3 - Blueprint 2 (Josh) Flashcards

1
Q

Hallmarks of DIC are – and –

A

bleeding

clotting

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2
Q

What are the Vaso-occlusive complicatons w/ SCD?

A

Stroke

Pain assoc. w/ obstructed blood flow and ischemia

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3
Q

Why is the Spleen effected by SCD?

A

Splenic sequestration caused by pooled blood, which enlarges the spleen significantly.

Treat with blood transfusion.

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4
Q

Patho of DIC

A

When the clotting process gets started abnormally. Thrombin is made faster than body can neutralize it.

This is bad because the child is susceptible to uncontrollable hemorrhage into vital organs.

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5
Q

Why is iron deficiency anemia common in infancy?

A

cow’s milk too soon

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6
Q

Hemophilia A and B are X-linked recessive disorders which means that – are more likely to get it.

A

boys

  • remember the Punnet Square
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7
Q

Pathophysiology of Kawasaki Disease

A

inflammation in the walls of medium-sized arteries throughout the body (including the coronary arteries, which supply blood to heart muscle)

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8
Q

What is the definitive test for SCD?

A

Hbg Electrophoresis

  • mearsures the various HGBs
  • differentiates b/t trait and anemia
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9
Q

— is a secondary disorder of coagulation that occurs as a complication of a number of pathologic processes.

A

DIC (Disseminated Intravascular Coagulation)

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10
Q

What is the analgesia of choice for SCD pain?

A

IV morphine

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11
Q

Why is Kawasaki Disease serious?

A

can lead to MI

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12
Q

S/S of RHD:

What is Erythema Marginatum

A

Classic eruption of RF

Flat, macular, circular, distinct wavy border (chicken wire–no itching) on trunk or arms

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13
Q

Prevention of RHD?

A

uses ASPIRIN for polyarthitits (inflammation f joints)

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14
Q

Hemophilia — is more common and is a deficiency in —

A

A (80% of cases)

Factor VIII

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15
Q

Stopping a nose bleed

A

sit up and slightly lean forward

pinch bridge of nose–hold about 5 minutes;

*****longer if hemophilia

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16
Q

What is the drug of choice to fight infection w/ SCD clients?

A

Penicillin

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17
Q

What is one of the first S/S of Vaso-occlusive complications w/ SCD?

A

Hand and Foot Syndrome (dactylitis)

  • sausage finger
  • inflammation of an entire digit (finger/toe)
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18
Q

SCD problems:

Aplastic Crisis is caused by — and leads to — and —-

A

human parvo virus

lowered Hgb

lethargy

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19
Q

S/S of RHD:

What is SubQ Nodules?

A

Small, hard, nontender swellings

Contain Aschoff bodies

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20
Q

What are the Ophthalmic complications with SCD?

A

hemmhorage and retinal detachment that can lead to blindness

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21
Q

S/S of RHD:

What is Sydenhams Chorea?

A

sudden, aimless, purposeles movements

  • relieved by rest and sleep
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22
Q

RICE treatment for Hemophila

A

Rest

Ice

Compression

Elevation

23
Q

Prevention for Hemophilia clients:

A

padded crib

clutter-free (tripping)

soft bristle toothbrushes

immunizations

RICE (rest, ice, compression, elevation)

24
Q

Screening tests for Hgb are limited because…

A

they are not specific for trait or anemia

25
Q

— is systematic vasculitis.

A

Kawasaki Disease

26
Q

SCD is an — disease with an average lifespan of —

A

inherited

45 years

27
Q

Hgb count for Iron Deficiency Anemia.

A

6-11 g/dL

28
Q

What can be given to increase clotting w/ Hemophilia clients?

A

Factor VIII and Factor IX

via port-a-cath at home

29
Q

S/S of Kawasaki Disease

A

High Fever

Red Eyes

Ring around Iris

Strawberry Tongue

Rash (skin peels off in flakes)

30
Q

S/S of Endocarditis

A

Low grade, intermittent fever

Malaise

Joint Pain (arthralgia)

New Murmur

31
Q

In Endocarditis, what happens tot the heart valve?

A

infection/inflammation makes it stenotic

  • typically Mitral Valve
32
Q

SCD clients will likely need a — due to severe pain.

A

PCA pump

33
Q

Jones Criteria (Major/Minor Manifestations of Rheumatic Heart Disease)

memorize

A

Major:

  • Carditis
  • Polyarthritis
  • Sydenham’s Chorea
  • Erythema Marginatum
  • SubQ Nodules

Minor:

  • Fever
  • Arthalgia
  • Elevated Acute Phase Reactants
  • Prolonged PR Interval
34
Q

Complications from SCD

A

Ophthalmic Complications

Vaso-occlusive Crisis

Cardiomegally

Abd. Pain and GI dysfunction

ENLARGED SPLEEN

Stroke

35
Q

Enlarged Spleen (caused by SCD) can lead to…

A

Anemia

Hypovolemic Shock

INFECTION

36
Q

Normal RBCs live about –

Sickled RBCs live about –

A

3 mths

1 mth

37
Q

What is the cure for SCD?

A

nothing

there is no cure, only treat symptoms

  • controlling anemia
  • relieving pain
38
Q

In treating Sickle Cell Disease (SCD), what is key?

A

Hydration and Oxygenation

39
Q

— is a symptom of Rheumatic Fever.

A

Endocarditis

  • bacterial infection/inflammation of heart valves and inner lining
40
Q

What should we avoid w/ Hemophilia clients unless absolutely necessary?

A

Rectal temp

Skin puncture

41
Q

Normal Hgb is —.

With SCD, Hbg is —

A

Normal = 11 gm/dL

SCD = 2-5 gm/dL

42
Q

S/S of Hemophilia

A

Active bleeding

Hematomas

Hemarthrosis

Headache

Slurred Speech

Decreased LOC

43
Q

With Hemophilia, why avoid a Hot/Warm compress?

A

increases bleeding to the site!

44
Q

S/S of DIC

A

Petechiae

Purpura

Bleeding from openings in venipuncture site and surgical incision

Bleeding from umbilicus or trachea (newborn)

Bleeding evidence in GI

Hypotension

Organ dysfunction from infarction and ischemia

45
Q

Why is infection a problem with SCD?

A

Spleen filters out infection

Spleen is one of the major organs affected by SCD due to blood sequestering in the organ

46
Q

What is the key sign of Hemophilia?

A

hemoarthritis

  • treat immediately
  • rest, immobilize, elevate, supply ice
47
Q

Treatment for Kawasaki Disease

A

High dose of IVIG and Salicylate therapy

ASPIRIN

48
Q

How common is stroke w/ SCD children?

A

10%

49
Q

Nursing considerations when giving PO Iron.

A

If tolerated, give on empty stomach (with juice NOT MILK)

Give with meals and start with reduced dose and gradually increase if GI disturbance occurs

Give with Vitamin C to increase absorption

Use straw to prevent staining of teeth

Stools will be tarry green–this is normal

Brush teeth after dose to minimize/prevent staining

50
Q

What helps keep SCD kids healthy?

A 
good nutrition (folic acid)
- (though they can eat normal food)

**important b/c even a little cold can make them very ill

51
Q

Sickle Cell Crisis is triggered by — or — and signs include — and —

A

viral infection

depletion of folic acid

profound anemia

pallor

52
Q

— – – follows strep when it is not treated properly.

A

Rheumatic Heart Disease

53
Q

Treatment for Endocarditis

A

Prophylaxis Antibiotics (Penicillin best)

  • especially BEFORE dentistry
54
Q

In Kawasaki Disease, dilation of the Aorta from inflammation leads to —

A

aneurysm

peds (josh) (41 decks)

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