Hematology Flashcards
(25 cards)
Nursing care of hemarthrosis
Ice pack, Non weight bearing, elevate affected limb to heart, immobilization, no PROM exercises until acute injury phase is done
Health promotion/ education for Hemarthrosis
sport choices (non contact), healthy weight and good fitness, normalization (chronic illness), use of prophylactic infusions
Patient education for hemarthrosis
teach venipuncture and factor administration, stress that f.a. is never delayed, avoid aspirin (motrin ok) physical activity and exercise is fine and encouraged when not bleeding (choose sports carefully)
Who is Hemophilia B named after?
Stephen Christmas, the first patient described outlining the symptoms of Hem B
Why do cells sickle (what causes the clinical symptoms)
blood viscosity and hemoglobin increases and causes cells to sickle
SCD labs
CBC – decreased HGB/Hct, increased reticulocyte count, increased WBC’s and platelets, increased total bilirubin, Kids with SCD usually “live” at a hgb of sometimes 6-7. will typically not be symptomatic
What is hemoglobin electrophoresis?
lack of HGB A
1 cause of death in SCD
infection
1 cause of hospitalization in SCD
vaso-occlusive crisis
SCD nursing care post splenectomy
PICU transfer, Immediate, conservative pRBC transfusion (<10cc/kg), Raise HGB to no higher than 8.0 to avoid autotransfusion, Pain management, Antibiotics, THESE CHILDREN MAY RAPIDLY DETERIORATE
Nursing Care in Vaso Occlusive Crisis
Hydration: 1.5 x maintenance (not for every type of crisis!)
Analgesics- Opioid/NSAID combo, Appropriate dose, Appropriate time intervals
Antibiotics if infection is suspected
Oxygen is not routinely given unless there is an increased O2 demand/hypoxia
Discharge Teaching for Vaso Occlusive Crisis
Assessment tools, Tapering PO analgesics, Side effects, Incentive spirometry, deep breathing, Tolerance vs addiction, Keep pain journal
Genetics in SCD
Autosomal Recessive- 25% chance of getting
Pain and Fever management for SCD- Pt ed
Monitor temp, give NSAIDs as needed, ATC regimen should be instituted, Usually Ketorolac (Toradol), Morphine, Motrin, Use PCA if needed, Use non pharmacological techniques as well (heating pads, guided imagery, distraction), Assess and reassess pain frequently, ADVOCATE, Monitor your own beliefs and LISTEN to your patient
Pain management in kids
Pharm and non pharm methods
Pharm- Opioids and NSAIDs
Nonpharm- Psychological, Behavioral, Physical (slide 64)
Adjuvant medications given to calm child
S&S of Anemia
Pallor, weakness, fatigue, decreased HGB, HCT, RBCs
What is ITP
autoimmune destruction of platelets
Lab data for ITP
Lab Data: low platelet count (< 20,000) & antiplatelet antibodies, normal Hgb, normal differential, normal bone marrow (only done if something else is suspected)
Prognosis for ITP
usually good, most children recover with no long term consequences
PT ed in Iron deficiency anemia
Give iron supplements with fruit, not with milk
Give liquid iron through a straw or perform oral care after administration
Monitor for constipation, pallor, weakness, fatigue
Normal CBCs for kids
Normal hgb- 11-15
Normal Hct- 30-44%
Normal retic- 0.5-1.5%
Normal WBC- 4.5-11
Parvovirus and staff education
Appears with Aplastic anemia, B19 titers are elevated
Staff- pregnant staff should avoid contact with these patients because infection can cause harm to the fetus
Treatment of Beta Thalassemia
RBC transfusions, folic acid, chelation, splenectomy, BMT, cord blood, SCT
Gene therapy in the works
NO IRON
Von Willebrand’s Nursing Care
Treatment is given pre-operatively with surgery/dental work or bleeding episodes
Desmopressin (DDAVP®)
vWF: FVIII concentrate (Humate P®)
Other Supportive Measures- Anti-fibrinolytics, Oral contraceptives, Topical hemostatic agents
