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T or F. Iron deficiency anemia, sickle cell anemia, thalassemia, and hemophila are all childhood hematologic conditions that can either be fixed or treated?



Normal Hgb for newborns

14 to 24 g/dl


Normal Hgb for infants

10 to 17 g/dl


Normal Hgb for children

9.5 to 15.5 g/dl


Anemia caused by an inadequate supply of dietary iron.

Iron deficiency anemia. It is also described as Hgb levels below normal range because of the body's inadequate supply, intake, or absorption of iron.


In regards to Iron, iron deficiency anemia can be caused by any number of factors that ________, ________, _________, or _______?

Decrease the supply of iron, impair its absorption, increase the body's need for iron, or affect the synthesis of Hgb.


Name 2 examples that would increase the demand of iron

Pregnancy and growth spurts increase volume


What can cause a decreased supply of iron?

Surgery and poor diet


T or F. For iron deficiency anemia, it is important to assess for s/s similar to dehydration?



Tachycardia and signs of poor oxygen delivery are common signs and symptoms of what condition?

Iron deficiency anemia


What are common manifestations of poor oxygen delivery?

Fatigue, lethargy, SOB, chest pain, ice craving (picophagia), poor cardiac output, respiratory distress (tachypnea, apnea, low O2 sat, poor perfusion, and capillary refill greater than 4 sec


What are 6 tips you can use when teaching families about the administration of oral iron supplements?

Give on an empty stomach for better absorption, give with citrus juices (vitamin C) to aid in absorption, use dropper or straw to avoid discoloring teeth, teach that stools will become tarry, teach that overdose can be fatal and the importance of keeping iron away from other children, and teach to not give with any dairy products.


Why are preterm infants at increased risk for iron deficiency anemia?

Because of their reduced fetal iron supply.


T or F. Many infants have iron deficiency anemia because of excessive milk ingestion (cow's milk)?

True, because milk hinders the absorption of iron. Milk is a poor source of iron and contributes to a fecal loss of iron in the blood.


Baby Christina has been Dx with Iron deficiency anemia. How should this condition be treated?

Treatment is mainly focused on increasing the amount of supplemental iron. This is usually done with diet modification (fortified formula or cereal) and oral supplementation (after 6 months and in exclusively breastfed infants).


In regards to treatment, why is iron supplementation especially important for exclusively breastfed infants?

Because fetal Hgb has a short-life span.


In peds patients, what Hgb levels indicate anemia?

Low level= 9.5- 13; Moderate= 8- 9.5; Severe-less than 8.


T or F. To prevent nutritional anemia, a primary nursing objective is to prevention through family education, especially breastfeeding moms.

True. Because breast milk is a poor iron source after 5 months of lactation, the nurse must reinforce the importance of administering iron supplements to the exclusively breastfed infant by 6 months


T or F. No evidence that screening in asymptomatic children results in improved health outcomes?



T or F. Evidence supports a substantial decrease in the incidence of anemia in healthy infants as a result of iron supplementation?



T or F. Fair evidence that iron supplementation may improve neurodevelopmental outcomes in children at risk for iron deficiency anemia?



T or F. AAP recommends screening for all infants between the ages of 9-12 months and then 6 months later; for children at high risk, screen once a year from ages 2 to 5 years.



Besides fortified formula and cereal, what are other dietary sources of iron?

Meat, green leafy veggies, fish, liver, whole grains, and legumes


Baby Christina's mother wants to help get her daughter better, but shares with you that she doesn?t think that she can afford to buy these iron-rich resources. What important resource should you refer her to?



One of a group of diseases collectively termed hemoglobinopathies, in which normal adult Hgb (Hgb A) is partially or completely replaced by abnormal sickle Hgb S)?

Sickle Cell Anemia (SCA)


At what age does SCA become evident? Why?

After 6 months because this is the time when FETAL Hgb starts to decrease and ADULT Hgb starts to take over.


What 2 conditions are considered autosomal recessive inherited bleeding disorder?

Hemophilia and Sickle Cell Anemia


T or F. SCA is an example of autosomal recessive inherited blood disease, meaning BOTH parents MUST be carriers of the recessive trait?

True. With each pregnancy, there is a 1 in 4 chance that these parents will have a child with the disease. However, ALL children of these parents can GET the disease, not just 25 percent of them.


S/S of SCA are the primary result of 2 problems. What are they?

OBSTRUCTION caused by the sickled RBCs and increased RBC DESTRUCTION.


What process contributes to the absence of blood flow to adjacent tissues, causing local hypoxia that eventually leads to cellular death?

The abnormal adhesion, entanglement, and enmeshing of rigid, sticky, and meshy sickled shaped RBCs with one another that intermittently block the microcirculation, causing vasooclusion.